Simulation Improves Podiatry Student Skills and Confidence in Conservative Sharp Debridement on Feet

Abstract

An essential skill for podiatrists is conservative sharp debridement of foot callus. Poor technique can result in lacerations, infections and possible amputation. This pilot trial explored whether adding simulation training to a traditional podiatry clinical placement improved podiatry student skills and confidence in conservative sharp debridement, compared with traditional clinical placement alone. Twenty-nine podiatry students were allocated randomly to either a control group or an intervention group on day 1 of their clinical placement. On day 4, the intervention group (n = 15) received a 2-hour simulation workshop using a medical foot-care model, and the control group (n = 14) received a 2-hour workshop on compression therapy. Both groups continued to learn debridement skills as opportunities arose while on clinical placement. The participants' debridement skills were rated by an assessor blinded to group allocation on day 1 and day 8 of their clinical placement. Participants also rated their confidence in conservative sharp debridement using a questionnaire. Data were analyzed using logistic regression (skills) and analysis of covariance (confidence), with baseline scores as a covariate. At day 8, analysis showed that those in the intervention group were 16 times more likely to be assessed as competent (95% confidence interval, 1.6-167.4) in their debridement skills and reported increased confidence in their skills (mean difference, 3.2 units; 95% confidence interval, 0.5-5.9) compared with those in the control group. This preliminary evidence suggests that incorporating simulation into traditional podiatry clinical placements may improve student skills and confidence with conservative sharp debridement.