To obtain clinical competence physical therapy students must apply basic knowledge, skills and attitudes and translate these capabilities into action. Simulation environments decrease the risk to real patients, while still preserving clinical fidelity. Using standardized patients allow students to practice communication and patient management skills with an actor. Practical examinations provide a summative assessment of clinical performance in individual PT courses. The APTA White Paper-The Human Movement System (2015) describes the need for physical therapists integrate “…knowledge of the human movement system and its component elements”, and “… identify physical impairments across various body systems”. The purpose of this study was to examine the utilization of standardized patients during a combined lab practical to assess the ability of students to integrate knowledge, skills and attitudes from two different courses.
57 Doctorate Physical Therapy (DPT) students in the second year of an entry-level DPT program participated in a combined neurological and cardiopulmonary lab practical examinations. Cases were developed that encompassed both a neurological disorder and a cardiopulmonary diagnosis and actors were given scripts to perform the role of this case. Faculty served as proctors and were given a detailed rubric to assess student performance of knowledge, skills and attitudes. Students were randomly assigned a case and were provided with a medical record for their patient. Students were expected to complete a pre-practical worksheet that prompted them to identify key history questions, tests and measures and interventions. On the day of the lab practical, students submitted their worksheet to the proctor and were given 35 minutes to complete an examination, provide patient education, and initiate a treatment. Immediately after the lab practical, debriefing occurred which allowed the students to reflect, ask questions, and receive feedback on their performance. Students were also required to complete documentation for the standardized patient interaction. Student’s integration was measured by review of the pre-lab practical worksheet, practical rubric, and documentation submission.
Preliminary results indicate that the students were prepared to integrate test and measures across both neurological and cardiopulmonary practice patterns. Students expressed the value in utilizing standardized patients in providing a realistic and safe environment for assessment of clinical skills. Results on integration by review of the worksheet, rubric, and documentation is pending.
Conclusions/Relevance to the conference theme: The Pursuit of Excellence in Physical Therapy Education
Academic faculty have increasing demands to ensure students have contemporary physical therapy knowledge and are highly prepared to manage the demands of the clinical environment. Intentionally designing and utilizing simulations and standardized patient in lab practicals across courses promotes integration of content material which will be required in clinical settings.
APTA White Paper— Physical Therapist Practice and The Human Movement System. August 2015. Retrieved from: http://www.apta.org/
Leung K, Trevena L, Waters D. Systematic review of instruments for measuring nurses' knowledge, skills and attitudes for evidence-based practice. Journal of Advanced Nursing. October 2014;70(10):2181-2195.
Sabus C, Macauley K. Simulation in physical therapy education and practice: opportunities and evidence-based instruction to achieve meaningful learning. Journal of Physical Therapy Education. 2016; 30(1):3-13.
Shoemaker M, Riemersma L, Perkins R. Use of high fidelity human simulation to teach physical therapist decision-making skills for the intensive care setting. Cardiopulmonary Physical Therapy Journal. March 2009;20(1):13-18.
Hayward L, Blackmer B, Markowski A. Standardized patients and communities of practice: A realistic strategy for integrating the core values in a physical therapist education program. Journal of Physical Therapy Education, 2006; 20(2), 29-37.