Publication Title

American Physical Therapy Association, Educational Leadership Conference

Medical Subject Headings

Clinical Competence, Self-Efficacy, Clinical Decision-Making, Simulation Training, Physical Therapy Specialty, Professional Education, Cross-Sectional Studies, Students, Humans

Abstract

Background: Simulation-based learning has a significant footprint on entry-level physical therapy programs. Students’ clinical decision-making (CDM) skills development through simulation-based learning (SBL) format when compared to the Integrated Clinical Experience (ICE) remains unknown. Self-efficacy of Clinical and CDM skills tool measures clinical skills, clinical decision-making, and total self-efficacy of clinical and CDM skills.2 A need to evaluate the effectiveness of simulation-based learning compared to ICE in development of CDM skills

Purpose: The purpose of this study was to compare the effectiveness of simulation-based learning and the Integrated Clinical Experience (ICE) in the development of DPT student clinical decision-making skills as determined by:

  1. Total Clinical Decision Making (CDM) Clinical Skills tool scores,
  2. CDM (21-item) subscale scores, and
  3. Clinical Skills (4-item) subscale scores

Survey-based descriptive and exploratory cross-sectional design. The survey was administered before and after an 8-week simulation course, and after a 6-week Integrated Clinical Experience (ICE). Survey comprised of 36-questions on clinical decision making (CDM), clinical skills, self-efficacy, demographics, and effectiveness of simulation. Participants- 215 second year DPT students from private health science university during Fall 2021- Summer 2022 simulation–based learning course and ICE. N=79 students pre-simulation, N=73 post-simulation, and N=63 post-ICE.

Results: Clinical Decision Making (CDM) clinical skills total :

  • Significant increase in score from pre-simulation (Md=94, n=79) to post-simulation (Md=103, n=73), U=4296, r=.42, p=
  • No significant difference in post-simulation (Md=103, n=73) and post-ICE (Md=102, n=63), U=2326, p=.908 (Fig 1b; Table).

CDM (21-item) subscale:

  • Significant increase in score from pre-simulation (Md=79, n=79) to post-simulation (Md=86, n=73), U=4257.5, r=.41, p=
  • No significant difference in post-simulation (Md=86, n=73) and post-ICE (Md=85, n=63), U=2326, p=.908 (Fig 2.b; Table).

Clinical Skills subscale:

  • Significant increase in score from pre-simulation (Md=16, n=79) to post-simulation (Md=17, n=73), U=4187, r=.40, p=
  • No significant difference in post-simulation Md=17, n=73) and post-ICE (Md=17, n=63), U=2302, p=.991 (Fig 3.b; Table).

Discussion: Significant increases in DPT Students clinical skills, clinical decision-making, and total self-efficacy of clinical and CDM skills tool scores were found between pre-simulation and post-simulation in curriculum. No Significant differences in clinical skills, clinical decision-making, and total self-efficacy of clinical and CDM skills tool scores were found between post-simulation and post-ICE, although CDM skills continued to improve during ICE, suggesting a ceiling effect for development of CDM skills may exist. Findings suggest simulation-based learning was effective in preparing DPT students to begin their ICE with enhanced clinical skills, clinical decision-making, and self-efficacy. We recommend expanding DPT students’ simulation-based learning to optimize the development of clinical decision-making skills prior to clinical experiences.

Comments

Poster presented at the 2022 American Physical Therapy Association Educational Leadership Conference, held October 28-30, 2022 in Milwaukee, Wisconsin.

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