Classroom-Based Simulation: Participants and Observers Perceive High Psychological Fidelity and Improved Clinical Preparedness

Abstract

Introduction. High-fidelity simulation-based learning experiences (SBLEs) can improve student confidence for clinical practice, but there are several barriers to incorporating these activities into physical therapy program curricula. Review of Literature. Studies have explored high-fidelity acute care SBLEs in simulation laboratories, but little is known about the effectiveness of low-cost classroom-based SBLES in physical therapy education. Additionally, there is a gap in the literature related to the role of the active observer during SBLEs in physical therapy education. The purpose of this study was to uncover student perspectives about participating as both participant and observer in classroom-based SBLEs and the impact of this experience on preparedness for acute care clinical practice. Subjects. Subjects included a convenience sample of first-year doctor of physical therapy (DPT) students. Methods. Students participated in a series of classroom-based SBLEs as part of a first-year DPT course. This mixed methods study included focus groups to qualitatively analyze student perspectives of classroom-based SBLEs and a pre–post quasi-experimental design to evaluate changes in perceived self-efficacy for acute care clinical practice before and after a series of classroom-based SBLEs using the Acute Care Confidence Survey (ACCS). Results. Quantitative data analysis (n = 60) revealed a statistically significant increase in perceived self-efficacy for the total ACCS (Z = −6.250, P < .000) and all 4 subscales from presimulation to postsimulation. Qualitative data analysis (n = 22) revealed 4 primary themes related to participating in classroom-based SBLEs: (1) psychological fidelity—it felt real; (2) promotes clinical reasoning for participants and observers; (3) stimulates self-reflection and observational learning; and (4) fosters self-efficacy for future clinical practice. Conclusion. Classroom-based SBLEs can provide a high-fidelity and cost-effective means of exposing students to a range of clinical situations that engage all participants in experiential learning through both direct participation and active observation.