Traditional Clinical Placements Research Articles

Non-traditional mental health clinical placements: An effective means for reducing self-stigma in pre-registration nursing students.

Pre-registration nursing students report high rates of stigma, leading to low help-seeking attitudes when seeking help for mental health issues. Traditional mental health clinical placements can improve stigma related to attitudes and social distance for pre-registration nursing students. There are nil recorded clinical placement interventions that have decreased self-stigma for pre-registration nursing students, with this study highlighting a clinical placement model that is effective in significantly decreasing self-stigma. The knowledge around the mental health struggles experienced by pre-registration nursing students, and the effect of a non-traditional mental health placement in decreasing self-stigmatizing attitudes in this population, is important for the future of retaining mental health nurses. There is an opportunity to use the clinical placement model presented, and design interventions for nursing students that aims to promote help-seeking behaviours. INTRODUCTION: Traditional mental health clinical placements can improve pre-registration nurse stigma toward mental illness, particularly in measures of attitudes and social distance. However, they have not yet been shown to improve self-stigma, which affects mental health disclosure and help-seeking behaviour. The present study investigates nursing students' stigma following a non-traditional mental health placement immersed alongside people living with mental illness. Three stigma subtypes were measured using the Opening Minds Scale for Healthcare Providers: Attitudes, Social Distance, and Disclosure/Help-seeking. Pre-registration nurses (N = 848) completed the instrument pre- and post-placement. A multivariate analysis of variance (MANOVA) identified a large effect of placement on stigma (p < .001, = .101). Post hoc pairwise comparisons revealed all three types of stigma decreased after the non-traditional placement (Attitudes: p < .001, = 0.09, Social Distance: p < .001, = 0.07, Disclosure/Help-seeking: p < .001, = 0.04). These findings emphasize that attending a non-traditional mental health clinical placement can effectively reduce multiple types of nursing student stigma. Further research in this area could focus on which attributes of the clinical placement setting foster positive help-seeking. These results are noteworthy for stigma surrounding disclosure/help-seeking, as traditional (i.e. hospital-based) mental-health clinical placements have been found ineffective in reducing nursing student stigma in this domain. Further research into the effectiveness of non-traditional clinical placements in reducing nursing students' stigma regarding mental health disclosure and help-seeking, is required.

Clinical Psychologists’ Experiences of “Community Service” in South Africa: Community-Based Service Learning and Primary Healthcare

Many South African master’s degree programmes in Clinical Psychology integrate community psychology training modules into the first year (M1) of the coursework. Such modules often incorporate community-based service learning (CBSL) to equip trainees for work in primary healthcare settings. After completing their M1 year, trainees complete a year’s internship (M2) in a psychiatric setting, followed by a mandatory third year of “community service”, before being able to register for independent practice. This raises questions about the preparation of trainees for this additional year, including its links with CBSL and the provision of primary healthcare. The aim of this study was to investigate the clinical psychologists’ experiences of and settings for community service, and resonances with and contrasts to CBSL. The data were collected through an online survey accessing reflections of trainee clinical psychologists from five South African universities (n = 12), who had recently completed, or were currently completing, their community service. The data were analysed by template analysis. The resonances in the findings seem to be linked to the trainees’ relational and attitudinal skills and concepts related to community psychology, refined and applied during their M1 year. The contrasts in the themes illustrate the predominance of traditional clinical placements during community service, with their associated demands linked to dominant clinical practice. In conclusion, this study indicates that community service settings for clinical psychologists are seldom well linked to primary healthcare or based in community settings. Recommendations are made for CBSL in the M1 year and for expanding the settings of community service more widely into primary healthcare.

How Are Alternative Clinical Placements Performed Compared to Traditional Clinical Placements During the COVID-19 Pandemic? Sought Through a Systematic Review and Meta-Analysis.

Clinical placement is the essential method of learning in health professions education, but it has been the most disrupted by the COVID-19 pandemic. Institutions of higher education resorted to alternative learning such as telehealth, simulations, and blended-learning for clinical placement to ensure that educational activities continue without delay. However, this raises questions about student competency and necessitates making up for missed in-person hours. A thorough investigation of the effectiveness of alternative clinical placement learning is required. A systematic searching was conducted on ten electronic databases, and the quality of the included articles was assessed using the Medical Education Research Study Quality Instrument (MERSQI). A meta-analysis was conducted by pooling studies with examination mark outcomes. Twenty-four articles were included in the systematic review and nine were included in the meta-analysis. The average MERSQI score for included studies is 11.15. Outcomes on student performance favor alternative placement, whereas perceived-based outcomes have mixed results and are slightly prone to traditional clinical placement. Meta-analysis indicates that alternative learning is either more effective than traditional clinical placement or at least on par with it. There is a discrepancy between perceived outcome and performance assessment regarding the utility of alternative learning to conventional clinical placement. Nonetheless, objective measurement outcomes and the meta-analysis support alternative learning as a reliable learning strategy for clinical education. Alternative learning for clinical placement experience can be improved further by adding more synchronous sessions, and implementing various learning methods, learning activities based on strong instructional design, and at least a short real-setting attachment.

A112Vital conversations for student podiatrists: a ‘real’ simulated placement

It is recognized that clinical placements are sometimes limited for allied health professionals (AHPs) [1]. This, coupled with the ‘People Plan’ [2], which highlights the need for increasing numbers of AHPs in the workforce, has led to considerations of alternatives to traditional clinical placements. We were approached by a podiatry undergraduate programme to assist with delivering a podiatry simulated placement, for BSc and separately for MSc podiatry students, each for three days, for the academic year 2022/2023. Development of the simulated placement took five weeks; it was collaborative, with input from HEI academics, subject specialists, and simulation-based educationalists. Six scenarios were created which aligned with the HCPC Standards of Proficiency for Podiatrists [3]. These reflected the breadth of experiences students might have experienced in a clinical placement; they focused on communication and behaviours. Actors were involved in playing the roles of simulated colleagues, patients, and relatives, with experienced facilitators setting up a safe, non-threatening, immersive learning environment, covering triggers and time outs in the pre-brief. The following were areas covered: Scope of practice and autonomous practice Professional judgement Culture, equality, diversity and non-discriminatory practice Confidentiality and professionalism Team working Communication skills, face to face and telephone Safe practice environments The learning was underpinned by a communication skills framework enabling students to structure their conversations and behaviours appropriately. Reflection was used post debrief and explored the subsequent day. All scenarios were presented as either forum theatre or fishbowl simulation, with all students being present in the same space as the simulation. Evaluation was positive from both BSc and MSc groups. Students highly rated the structured approach provided by the communication framework stating it helped them converse effectively and build rapport with patients, relatives and colleagues. The inclusion of actors, although daunting for some initially, added hugely to their learning experience. Students commented on how they felt more prepared for real-world situations and how they hadn’t appreciated the breadth and impact of their practice. Simulated placements can offer a safe and controlled environment for podiatry students to develop their skills and engage in vital conversations with patients, relatives and colleagues. Facilitators should adapt to different confidence levels and learning styles of the students and actors fully briefed and in line with these adaptations. These simulated real-life placements are replicable and can help in preparing a workforce fit for purpose. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

A Case Study of a Five-Day Virtual Clinical Simulation with Pre-Licensure Nursing Students

Background: The COVID-19 pandemic exacerbated existing clinical placement shortages for nursing students in the United Kingdom. Placements using virtual simulation have the potential to replace or supplement traditional clinical placements. Objective: The objective of this case study was to examine the perceptions and experience of pre-licensure mental health nursing students and facilitators who took part in a five-day virtual simulation. Methods: A virtual simulation placement focused on mental health nursing was developed. Students from three universities in London engaged in the virtual simulation placement and a student focus group. Virtual simulation facilitators participated in one-on-one semi-structured interviews. Focus group and interview data were thematically analyzed using NVivo 12. Results: Pre-licensure mental health nursing students and simulation facilitators felt that virtual simulation training filled gaps in education, increased the accessibility of education, and led to the formation of a supportive community of students in a depressurized learning environment. Students reported that virtual simulation provided a safe opportunity for them to practice and learn new skills. However, facilitators reported an increased cognitive load while teaching online. Limitations: This was a small-scale case study of a placement that was converted to suit the online environment during the COVID-19 pandemic. Future work would benefit from an interventional approach with a larger and more diverse group of students. Conclusions: Virtual simulation has potential to increase placement capacity for nursing students. Students and facilitators perceived that virtual simulation was effective for student learning. Challenges with virtual simulation, such as increased cognitive load for facilitators, should be explored further in future research.

(L)earning: Exploring the value of paid roles for medical students.

The Medical Student Technician (MST) role is a paid position established in Northern Ireland in 2020. The Experience-Based Learning (ExBL) model is a contemporary medical education pedagogy advocating supported participation to develop capabilities important for doctors-to-be. In this study, we used the ExBL model to explore the experiences of MSTs and how the role contributed to students' professional development and preparedness for practice. A convenience sampling strategy was used to recruit a total of 17 MSTs in three focus groups. Semi-structured interviews were transcribed verbatim and analysed using the ExBL model as a framework. Transcripts were independently analysed and coded by two investigators and discrepancies resolved with the remaining investigators. The MST experiences reflected the various components of the ExBL model. Students valued earning a salary; however, what students earned transcended the financial reward alone. This professional role enabled students to meaningfully contribute to patient care and have authentic interactions with patients and staff. This fostered a sense of feeling valued and increased self-efficacy amongst MSTs, helping them acquire various practical, intellectual and affective capabilities and subsequently demonstrate an increased confidence in their identities as future doctors. Paid clinical roles for medical students could present useful adjuncts to traditional clinical placements, benefiting both students and potentially healthcare systems. The practice-based learning experiences described appear to be underpinned by a novel social context where students can add value, be and feel valued and gain valuable capabilities that better prepare them for starting work as a doctor.

Emerging Professional Identity Formation: Exploring Coloniality in the Rehabilitation Professions

This paper explores professional identity formation in undergraduate education. The paper positions professional identity formation within coloniality. A qualitative case study was conducted using critical theory as a guiding conceptual framework. Data collection included document reviews, observations and arts-based research methodologies. We present a case study of a speech-language pathology student, Aqueelah, transitioning from a traditional clinical placement to a learning site which encourages the development of an emerging practice. The paper focuses on how Aqueelah forms her emerging professional identity through her learning. We foreground the concept of “centring the self” as essential in developing patient-centred care and challenge coloniality of being embedded in clinical education. The paper argues that liminal spaces are necessary to allow students to explore different ways of thinking and doing to support new ways of being. The paper advocates for arts-based methodologies and critical reflection as essential pedagogic tools in shaping professional identity.

Development of a simulation placement in a pre-registration nursing programme.

A 4-week simulation placement for first-year student nurses using an innovative blended approach was developed and delivered in one university. This was the first tariff-funded simulation placement in the UK for student nurses. To describe how this flexible simulation placement was developed, operated and adapted due to COVID-19 while exploring the student nurses' experiences and preparedness for practice. An anonymous online survey was undertaken and a placement evaluation was completed and compared with traditional clinical placement evaluations by previous students at the same point in their studies. Students were as satisfied with the simulation placement as students who had attended real practice placements: 92% of students were satisfied with their simulated placement experience and 92% felt prepared for practice. This simulated placement has been an acceptable replacement for traditional practice placements, particularly during the COVID-19 pandemic.

Prosthetic and orthotic students' perceptions on online courses during the COVID-19 pandemic in Japan.

The effects of the novel coronavirus (COVID-19) pandemic have changed both the traditional teaching methods and clinical placements. To investigate the effects of COVID-19 on the prosthetics and orthotics (P&O) training program in Japan. A cross-sectional national survey. A Google form survey was distributed to students through the heads of the department of P&O program across Japan. Descriptive statistics were used to analyze the data. One hundred sixty-six students (107 males and 59 females) responded to the survey. The respondents' grades were as follows: freshman, 22.3% (n = 37); sophomore, 33.7% (n = 56); junior, 27.1% (n = 45); and senior, 16.9% (n = 28). Forty-seven percent (n = 78) reported that their clinical placements have been cancelled because of the COVID-19 pandemic. Only 15.1% (n = 25) have performed their clinical placements during the pandemic. Regarding career preparation, 16.3% (n = 27) had face-to-face interviews and 10.2% (n = 17) have reported being interviewed online. Of a total of 44 respondents who were interviewed for jobs in P&O industries and rehabilitation centers, 79.5% (n = 35) job appointments have been cancelled and 15.9% (n = 7) postponed. The event of the COVID-19 pandemic has proved necessary to renew the traditional teaching and learning model in colleges worldwide. Most students have been affected by clinical placements and career preparation. Therefore, promoting telehealth in the existing rehabilitation facilities and P&O industries to provide services might be an alternative method to address students' clinical placements in similar life condition events.

Observational Study Exploring the Efficacy and Effectiveness of a New Model of Peer-Assisted Simulation-Based Learning Clinical Placement.

(1) Background: Immersive simulation-based learning is relevant and effective in health care professional pre-licensure training. Peer-assisted learning has reciprocal benefit for the learner and the teacher. A fully simulated model of fieldwork placement has been utilised at Curtin University since 2014, historically employing full-time faculty supervisors. Due to the COVID-19 pandemic in 2020, traditional clinical placement availability diminished. (2) Methods: This mixed-methods prospective observational study aimed to translate the existing faculty-led placement for penultimate-year physiotherapy students to a peer-taught model, thereby creating new teaching placements for final-year students. Final- and penultimate-year physiotherapy students undertook the fully simulated fieldwork placement either as peer learners or peer teachers. The placement was then evaluated using four outcome measures: The ‘measure of quality of giving feedback scale’ (MQF) was used to assess peer learner satisfaction with peer-teacher supervision; plus/delta reflections were provided by peer teachers and faculty supervisors; student pass/fail rates for the penultimate-year physiotherapy students. (3) Results: For 10 weeks during November and December 2020, 195 students and 19 faculty participated in the placement. Mean MQF scores ranged from 6.4 (SD 0.86) to 6.8 (SD) out of 7; qualitative data reflected positive and negative aspects of the experience. There was a 4% fail rate for penultimate-year students for the placement. Results suggested that peer learners perceived peer-led feedback was of a high quality; there were both positives and challenges experienced using the model. (4) Conclusions: Physiotherapy students effectively adopted a peer-taught fully simulated fieldwork placement model with minimal faculty supervision, and comparable clinical competency outcomes.

A call to reform undergraduate nursing clinical placements

A call to reform undergraduate nursing clinical placements

Students’ Perceptions of Simulation-Based Learning in Speech Pathology: A Pilot Study

Due to increased student numbers and workforce limitations, speech pathology students have fewer opportunities to develop skills in working with adult populations in traditional clinical placements. Using simulation-based learning has proven to be advantageous in other disciplines. The use of simulation to develop clinical skills in speech pathology range of practice areas, including speech, language and swallowing in adults, has been less well researched. The aim of this study was to investigate students' overall perceptions about simulation-based learning, particularly their confidence related to specific clinical skills and perceived anxiety about working with adult clients. Six final year speech pathology students enrolled in either a 4-year undergraduate or 2.5-year masters program participated in this research. Students engaged in five simulation-based learning activities across one day. Purposefully developed pre- and post- surveys were completed to explore students' anxiety levels and perceptions of confidence regarding clinical skills across domains of foundation knowledge, case history, assessment, intervention, interaction and clinical reasoning, and anxiety levels. The Satisfaction with Simulation Experience (SSE) Scale was completed post-simulation experience. Students also participated in a focus group discussion following the simulation experience. Student median ratings of clinical skills improved from pre- to post-simulation across the six domains. All students reported that the simulation-based learning experience was valuable and reported increased levels of confidence and enhanced preparedness for their clinical placements. Findings from this study suggested that students value simulation-based learning and future research should explore learning outcomes from a longer, more intensive simulation program.

Determinants of mental health professionals' attitudes towards recovery: A review.

ObjectiveThe attitudes of mental health professionals towards consumers’ recovery are far more pessimistic than what is needed for the recovery-orientation to truly permeate systems of care. It has become pressing to depict determinants for these attitudes and how they evolve during professionalization. This, in the hopes to adjust not only medical education, but also ongoing training of professionals.MethodsA systematic search of PubMed and PsycINFO databases was conducted, yielding a net 15 303 records. Twenty-two publications from specific educational journals and reference lists were added. Finally, thirty-four full texts were read, from which twenty-two articles were included.ResultsFrom the reviewed studies emerged five main determinants: profession, education, age, clinical experience, and nature of the contact with consumers. Traditional clinical placements during residency, negative experiences with acute patients, younger age and the professional attitudes of psychiatrists seem to all be determining factors for professionals’ pessimistic attitudes towards recovery.ConclusionsThis review found specific determinants for attitudes in recovery and four out of five can be acted upon. For a recovery-orientation to be implemented across our mental health system, we formulate recommendations within the Canadian context for revision of curriculum, recovery-specific training, and operationalisation through state/provincial technical assistance centers.

Development and Implementation of Unfolding Pediatric Simulations.

Inpatient pediatric clinical placements for undergraduate nursing students can present a challenge, given the limited number of pediatric hospitals and growing demand for clinical placements. Pediatric clinical learning experiences are also impacted by increasing restrictions in patient care and variations in disease patterns. Subsequently, unfolding simulation scenarios were developed as a critical component of undergraduate pediatric rotations. The literature was searched to determine the top admitting diagnoses for pediatric admissions. Unfolding pediatric simulations were developed and implemented to replace clinical hours and standardize pediatric clinical experiences for common diseases. Five unfolding simulations were developed over a 2-year period. By the end of that period, 36.5% of traditional clinical hours had been replaced. Student clinical readiness indicators demonstrated increases in critical thinking and preparedness. Unfolding pediatric clinical simulations are a useful alternative to traditional clinical placement, and they can provide consistent exposure to common pediatric conditions. [J Nurs Educ. 2020;59(2):107-110.].

Clinical Educators’ Perceptions of Students Following a Simulation-Based Learning Program

Purpose: Clinical education is a key component of speech-language pathology university curriculum, whereby students have the opportunity to apply theoretical knowledge and practical skills learned in the classroom into a real workplace. However, more recently the availability of high quality, consistent clinical placements and learning experiences across the range of practice areas in the discipline is reducing. Therefore, alternative clinical learning opportunities that enable students to develop skills and competencies are being explored. Recently, replacing clinical time with a simulated learning program has been shown to achieve equivalent levels of clinical competency in speech pathology. However, it is unknown how simulation impacts on student learning in traditional clinical placements. Therefore, this research explored clinical educators’ perceptions of students undertaking clinical placements in their workplace immediately following a five-day simulation-based learning program related to the same area of practice. Method: Thirty-five clinical educators who supervised students in the workplace immediately after they completed the simulation program participated in semi-structured interviews. All interviews were transcribed verbatim and analyzed using qualitative methods described by Graneheim and Lundman (2004). Result: The analysis identified four key themes related to the impact of students in the workplace, simulation priming students for learning, the importance of the transition from simulation-based learning to the workplace, and the role of simulation in clinical education programs. Conclusion: The use of simulation to support student learning and develop clinical skills and competencies in adult speech pathology practice is supported by workplace clinical educators. However, results of this study suggest that the simulation program needs to be embedded within the curriculum and clinical education program to enhance transition between learning experiences and maximize benefits of learning experiences in real workplace contexts.

Economic evaluation of simulated and traditional clinical placements in occupational therapy education.

This economic evaluation complements results of the randomised controlled trial that established non-inferiority of the learning outcomes of a one-week simulated clinical placement (SCP) in occupational therapy qualifying degrees in comparison to an equivalent traditional clinical placement (TCP). This companion study presents detailed cost analyses of two placement alternatives and a cost-benefit study to assess the value for money of SCP. An economic evaluation of simulated versus traditional placements has not previously been conducted in Australia. Nine SCP/TCP rounds were conducted by six Australian universities. Costs were collected using study-specific instruments. Public health sector costs were sourced from available literature. Willingness-to-pay for SCP/TCP was estimated using both a Discrete Choice Experiment and a Contingent Valuation method. These methods were employed to assess a comparative 'value' of SCP/TCP from the perspective of heads of occupational therapy departments (N=28), who were asked to put a monetary value on the broader range of benefits associated with SCP/TCP. From the universities' perspective the average cost per student ranged from AUD$460 to AUD$1511 for simulated and AUD$144 to AUD$1112 for traditional placement. From the health care sector perspective, the difference in costs favoured simulated placements for four implementations and traditional placements for five. In the Discrete Choice Experiment respondents preferred traditional rather than simulated placement and would pay additional AUD$533. The estimated monetary value of simulated placements from a contingent valuation ranged from AUD$200 to AUD$1600. For universities that procure TCPs predominately at public health care facilities and sustain high administrative overheads, the SCP program could be a cost-saving alternative. From a broader value-for-money perspective, respondents favoured TCP over SCP, yet placed importance on placement availability and opportunity to demonstrate competence for students during the placement. Results should be interpreted with caution and further research with larger sample sizes is required.

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

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.

Journeying Towards the Profession: Exploring Liminal Learning within Mixed Reality Simulations

ABSTRACTUnlike the situated learning within traditional clinical placements, mixed-reality simulations support a laboratory learning environment where preservice teachers practice their instruction with low risk to the preservice teachers and human students. Simulation experiences can be used in teacher education programs to prepare candidates for the field within a carefully designed curriculum that measures threshold learning. This study explored liminal learning in a teacher education program that used mixed-reality simulations prior to and within clinical placements. A qualitative case study was used to understand the experiences of the participants who were bound by three levels of exposure to simulations. Findings indicated that learning within the mixed-reality simulations could be characterized by three spaces: preprofessional, liminal, and trending toward professional. The integration of mixed-reality simulations within initial teacher preparation core courses facilitated the journey of preservice teachers toward professional identities as they faced instructional and behavioral challenges over the course of three semesters.

Simulated versus traditional occupational therapy placements: A randomised controlled trial.

Professional practise placements in occupational therapy education are critical to ensuring graduate competence. Australian occupational therapy accreditation standards allow up to 200 of a mandated 1000 placement hours to include simulation-based learning. There is, however, minimal evidence about the effectiveness of simulation-based placements compared to traditional placements in occupational therapy. We evaluated whether occupational therapy students completing a 40hour (one week block) Simulated Clinical Placement (SCP) attained non-inferior learning outcomes to students attending a 40 hour Traditional Clinical Placement (TCP). A pragmatic, non-inferiority, assessor-blinded, multicentre, randomised controlled trial involving students from six Australian universities was conducted. Statistical power analysis estimated a required sample of 425. Concealed random allocation was undertaken with a 1:1 ratio within each university. Students were assigned to SCP or TCP in one of three settings: vocational rehabilitation, mental health or physical rehabilitation. SCP materials were developed, manualised and staff training provided. TCPs were in equivalent practice areas. Outcomes were assessed using a standardised examination, unit grades, the Student Practice Evaluation Form-Revised and student confidence survey. A generalised estimating equationapproach was used to assess non-inferiority of the SCP to the TCP. Of 570 randomised students (84% female), 275 attended the SCP and 265 the TCP (n=540, 94.7% retention). There were no significant differences between the TCP and SCP on (i) examination results (marginal mean difference 1.85, 95% CI: 0.46-3.24; P=0.087); (ii) unit score (mean (SD) SCP: 71.9 (8.8), TCP: 70.34 (9.1); P=0.066); or (iii) placement fail rate, assessed using the Student Practice Evaluation Form-Revised (100% passed both groups). Students can achieve equivalent learning outcomes in a 40 hour simulated placement to those achieved in a 40 hour traditional placement. These findings provide assurance to students, educators and professional accreditation bodies that simulation can be embedded in occupational therapy education with good effect.

Standardized Patient Simulation for a Graduate Nursing Program

Clinical placement for nurse practitioner (NP) students is difficult due to an increase in demand for clinical sites and qualified preceptors, and the nursing faculty shortage. The American Association of Colleges of Nursing supports the use of simulation with standardized patients as an adjunct to traditional clinical placement for NPs. In this article, we describe an innovative standardized patient simulation experience implemented in a family NP master’s of science program. The purposes of this experience were to provide alternative clinical opportunities and formative feedback for NP students and to identify gaps in students' diagnostic reasoning. Lessons learned through this experience are included.