The Use of Simulation in Assessing Readiness for Full Time Acute Care Clinical Experience Following Remediation.
Purpose
Physical therapy education programs are required to assess student readiness for clinical experiences, particularly in the areas of safety. 1 The use of simulation to prepare health care practitioners for clinical practice has become very common. Physical therapy is no exception and simulated experiences have proved to be very valuable, especially in the area of acute care.2 The skills that are crucial for physical therapist practice in acute care have been identified.3 Simulation is critical for providing physical therapy students a venue for practicing these skills especially in light of the shrinking number of full time acute care rotations available for students. Simulation has also been used to assess some healthcare students for readiness for clinical practice, as well as remediation. 4
There is a paucity of literature on remediation of physical therapy students who are not successful in a clinical rotation, and less on assessing readiness to return to the clinic after remediation. The purpose of this pilot study was to assess whether a simulated scenario could be used after a remedial program to assess a student’s readiness to safely return to a full time clinical experience in an acute care setting.
Methods/Description
The subject of this pilot study was a physical therapy student who failed a full time clinical experience in an acute care hospital setting. A remedial program was established for the student based on review of her final evaluation. The remedial plan was designed to include both written assignments and integrated clinical visits which focused on the noted areas of deficiency. The student’s performance on integrated visits included safety, professional behaviors, communications, and clinical reasoning. The written assignments were graded on the basis of accuracy, thoroughness and a demonstrated understanding.
After the remedial work was successfully completed, a simulation case scenario was developed to address the areas of clinical performance in which the student struggled. The simulation suite was set up appropriately and 2 faculty members from nursing, who were not previously acquainted with the student were enlisted to assist. One nurse assumed the role of the simulated patient’s nurse, and one nurse took on the role of the patient. The student was then left to carry out her evaluation and interventions. The student’s performance was videotaped and scored by three physical therapy faculty members.
Results/Outcomes
The outcome measure used was the average of scores earned from each faculty member who graded the simulation, with several items such as safety being pass or fail. The student earned passing scores from all evaluators, and was allowed to begin another full time acute care clinical experience, which was successfully completed.
Conclusions/Relevance to the conference theme: Shaping the Future of Physical Therapy Education
In this pilot study, simulation was found to be useful in assessing a student’s readiness to return to an acute care clinical after a failed clinical experience, and can be a useful tool in the assessment of student readiness.
References
Commission on Accreditation in Physical Therapy Education. Evaluative Criteria for Accreditation of Education Programs for the Preparation of Physical Therapists. Adopted October 26, 2004 and effective January 1, 2006; revised 5/07, 10/07, 4/09, 10/09, 4/10, 5/11, 11/11, 11/12, 11/13; 8/14.
Silberman NJ, Panzarella KJ, Melzer BA. Using human simulation to prepare physical therapy students for acute care clinical practice. Journal of Allied Health. 2013;42:25-32.
Sujoy B, Crist MH, Cue JB, et al. Nationwide acute care physical therapist practice analysis identifies knowledge, skills, and behaviors that reflect acute care practice. Physical Therapy. 2010;90:1453-1467.
Ragan RE, Virtue DW, Chi SJ. An assessment program using standardized clients to determine student readiness for clinical practice. American Journal of Pharmaceutical Education. 2013;77:14.