Impact of simulated patients on physiotherapy student skill performance in cardiorespiratory: a pilot study.
Walker, Craig A.
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WALKER, C.A. and ROBERTS, F.E. . Impact of simulated patients on physiotherapy student skill performance in cardiorespiratory: a pilot study. Physiotherapy Canada [online], (accepted).
Background – To date there is no evidence that high fidelity simulation (HFS) improves skill development within the university setting in physiotherapy students. With pressures to reduce costs and maintain/improve quality of the learning experience and pressures on clinical placement, it is essential to investigate methods that can improve student skill performance before they undertake clinical practice. Objective - To investigate 1) The impact of using Simulated Patients (SPs) in a practical class on physiotherapy student skill acquisition; 2) student reflections regarding the intervention. Design - Pilot study using a single centre (University Clinical Skills Centre) randomised controlled trial. Methods - Twenty eight undergraduate physiotherapy students matched using previous practical examination grades undertook a two hour practical class where core cardiorespiratory skills were practiced. Pre session resources were identical. Control group practiced on peers, intervention group practiced on SPs. Student’s skill performance was assessed two weeks after the class using the Mini Clinical Evaluation Exercise (MiniCEX) including qualitative data from student reflections. Results - Twenty eight students undertook the practical class and subsequent MiniCEX assessment. A statistically significant difference was found for all aspects of the MiniCEX except medical interview (p=0.072) and physical interview (p=0.688). A large effect size was found for all areas except physical interview (0.154) and medical interview (0.378). Student reflections focused on three key themes: behaviour and attitudes, teaching the skill, and feedback. Limitations - As a pilot study, data was collected from a small sample based in one university. This limits conclusions relating to statistical significance and generalizability. Additionally the MiniCex is not validated to assess psychomotor skill performance questioning the validity of conclusions. Conclusions - Findings of this study suggest SP interactions may improve student skill performance, however, further research using a larger sample size and using an outcome validated for this population is required.