Alicia Fernandez-Fernandez

High Fidelity Human Simulation Improves Physical Therapist Student Self-Efficacy for Acute Care Clinical Practice

Purpose. High fidelity human simulation (HFHS) is a pedagogical tool implemented in physical therapy curricula to prepare students for acute care clinical experiences. While evidence in nursing and medical education supports implementing HFHS in preparation for clinical practice, there is limited literature related to efficacy of HFHS in physical therapy education. The purpose of this study was to compare selfefficacy between physical therapist (PT) students who did and did not participate in HFHS training prior to acute care clinical experiences. Methods. In this randomized, exploratory study, using a mixed quantitativequalitative methodology, 16 PT students were randomly assigned to either the control or the experimental groups. The experimental group participated in 6 HFHS experiences prior to an acute care clinical experience. Self‐efficacy was measured using the Acute Care Confidence Survey (ACCS) on 3 occasions: baseline, after HFHS training, and midterm of the clinical experience. A focus group was conducted with the experimental group upon completion of the clinical experience to examine the students’ perceived value of HFHS training. Baseline demographics were compared using the Mann‐Whitney test for continuous data and the chi‐square test for categorical data. Self‐efficacy scores on the ACCS were analyzed using Friedmans analysis of variance (ANOVA) and the Mann‐Whitney test. Qualitative methods were utilized in analysis of the focus group. Results. Significant difference between groups was found on self‐efficacy scores following HFHS and on total change in self‐efficacy from baseline to midterm of the clinical experience. Focus group qualitative analysis revealed 4 themes: (1) Simulation provided a safe, nonjudgmental, and productive learning environment; (2) students gained confidence in preparation for acute care clinical experience in initial interaction with clinical instructor, patient, and interprofessional team communication, and knowledge of the clinical setting; (3) simulation fostered clinical reasoning skills; and (4) simulation facilitated skills in multitasking in a complex setting. Themes were triangulated and supported by quantitative self‐efficacy scores. Conclusion. HFHS in physical therapy education leads to increased self‐efficacy for acute care clinical practice. Academic programs may consider the curricular integration of HFHS experiences when preparing PT students for acute care clinical experiences. While further research is warranted, this study indicates students may be better prepared for acute care clinical practice when given exposure in the academic setting through HFHS, allowing them to enter clinical practice in the acquisition stage of learning.

Student Clinical Performance In Acute Care Enhanced Through Simulation Training

Purpose:High-fidelity human simulation (HFHS) is implemented in physical therapy (PT) curricula to prepare students for acute care clinical experiences (CEs). Nursing and medical education literature supports HFHS in preparation for clinical practice, but there is limited evidence describing efficacy of HFHS in PT education. The purpose of this study was to compare clinical performance between PT students who did and did not participate in HFHS training before acute care CEs. Methodology:In this exploratory study, 16 PT students were randomly assigned to either the control or the experimental groups. The experimental group participated in 6 hours of HFHS before an acute care CE. Clinical performance was evaluated by quantitative and qualitative analysis of Clinical Performance Instrument (CPI) ratings during the CE. Baseline demographics and CPI ratings were compared using the Mann-Whitney U for continuous data and chi-square analysis for categorical data. Qualitative methods were used in analysis of CPI narrative comments. Results:No significant differences were found on CPI quantitative analysis, but qualitative analysis demonstrated different perceptions between groups. Students participating in HFHS were described to excel in safety and communication as well as overall preparation for acute care practice. Conclusion:High-fidelity human simulation in PT education may lead to improved performance during acute care CEs.

Barriers and Facilitators for a Collaborative International Physical Therapist Residency Program in Nairobi, Kenya

Introduction: With the globalization of higher education through online training, opportunities exist for collaboration between institutions to promote ongoing advancement of healthcare professionals in resource-limited countries. The success of these programs is dependent on the ability of the program to meet the educational needs of the student and assist with implementation of the new information into practice. A post graduate residency program for physical therapists was introduced to Kenya to promote the development of the profession of physical therapy. This study sought to explore barriers that affected participation in the residency program, and how participants perceived the residency program fostered the use of new skills in the clinical environment, as well as the limitations they faced in applying the skills gained through the residency program in a clinical setting. Methods and Materials: The participants in this study were in the third and fourth cohorts of the residency program (n = 27). One-on-one interviews were performed with the residents following completion of the program. A qualitative phenomenology research design was used to describe the manner in which the residency was experienced within the context of the environment in which the experience took place. Descriptions and narratives were obtained from the residents to provide a window into their lived experience. Results: Four themes were discovered: (1) The ongoing challenge to balance often conflicting responsibilities: family, work and education, (2) A need to educate patients and colleagues on newly acquired skills to gain acceptance, (3) Success in the program requires reliance on support networks, and (4) Increased confidence gained in delivery of patient care. Discussion: Although the residents faced obstacles for completing the residency and integrating newly acquired knowledge and skills into clinical practice, they were able to formulate strategies to meet these challenges. Understanding the barriers and facilitators that affect participants in international collaborative efforts may ultimately assist residency and other educational programs in designing new models of education, which will advance the physical therapy profession globally.

Pediatric Integrated Clinical Experiences: Enhancing Learning through a Series of Clinical Exposures

Background and Purpose.Physical therapists (PTs) provide services to individuals throughout the lifespan. Previous research supports the inclusion of opportunities for PT students in entry-level programs to observe and interact with both children who are typically developing and those with disabilit