High-Fidelity Patient Simulation on Clinical Reasoning Skills and Interprofessional Competencies
- Conditions
- Healthy
- Interventions
- Other: Interprofessional Simulation Experience
- Registration Number
- NCT06549998
- Lead Sponsor
- Youngstown State University
- Brief Summary
The proposed study is looking to examine the effects of High-Fidelity Patient Simulation (HFPS) on clinical reasoning skills and interprofessional competencies in Physical Therapy and Nursing students.
The proposed study will have two objectives:
1. Assess the volume of HFPS delivered and whether it has an additive effect of improving physical therapy and nursing student performance related to clinical reasoning skills during simulated clinical situations.
2. Assess the volume of HFPS and whether it has an additive effect of improving physical therapy and nursing student self-reported changes in team work and communication based on the IPEC core competencies
Researchers will compare students who do not receive a simulation (Control) to those who receive 1 simulation (Group 1) and two simulations (Group 2).
Participants will:
1. Be assigned to one of 3 groups (control, group 1, group 2)
2. Based on group assignment receive no simulation, one simulation, or 2 simulations
3. Each group will be assessed at the end for their inter-professional attitudes and clinical reasoning skills
- Detailed Description
Background Information Patient-centered care is important in helping individuals who live with multiple health conditions, requiring collaboration among healthcare professionals of different disciplines. Interprofessional collaborative practice has been defined by the World Health Organization as "multiple health workers from different professional backgrounds working together with patients, families, caregivers, and communities to deliver the highest quality of care". It is difficult for any one healthcare professional to address the number and variety of healthcare problems, making collaboration an important part of healthcare. An ability to effectively collaborate among health care disciplines in the areas of communication, role identification, team working skills, and conflict resolution are critical components of practice for health care professionals. This has led to educational institutions placing a greater emphasis on the development and integration of interprofessional education (IPE) into health professions curricula. The emphasis of IPE is to prepare health professions students to work together with the aim of building a safe, patient-centered health care environment5.
Experiential learning provides learners an opportunity to practice skills and techniques learned in the classroom in a real-world or practical setting. The benefits of experiential learning have long been held in high regard and include enhancing understanding of content and improvement in interpersonal skills. Implementation of experiential learning varies significantly across PT curricula. Some experiential learning methods are time and labor intensive, while others are less so. Cost, feasibility, time constraints, and course outcomes play a role in determining which methods work best for a particular course or program. Simulation has been used for decades to assist with skill acquisition and assessment. High-fidelity human patient simulation (HFPS) with a focus on clinical situations/scenarios is highly conducive to IPE. The term "simulation" refers to an experiential educational technique which "creates a situation or environment to allow persons to experience a representation of a real event for the purpose of practice, learning, evaluation, testing, or to gain understanding of systems or human actions.". In health care simulation, high-fidelity refers to "simulation experiences that are extremely realistic and provide a high level of interactivity and realism for the learner".
The use of simulation as a teaching pedagogy can be especially valuable in replicating the acute care setting.
Statement of the Problem The Interprofessional Education Collaborative (IPEC) set forth a series of core competencies for interprofessional collaborative practice. The IPEC describes these core competencies as: " to the safe, high-quality, accessible, patient-centered care and enhanced population health outcomes desired by all". These core competencies were developed in order to prepare students to engage in lifelong learning and collaboration to improve community health outcomes. These competencies include: Values and Ethics (work with team members to maintain a climate of shared values, ethical conduct, and mutual respect), Roles and Responsibilities (Use the knowledge of one's own role and team members' expertise to address health outcomes), Communication (Communicate in a responsive, responsible, respectful, and compassionate manner with team members.), Teams and Teamwork (Apply values and principles of team science to adapt one's own role in a variety of team settings).
The use of HFPS has been utilized in education settings involving physical therapy students. A recent review that examined the effect of HFPS learning in Acute Cardiorespiratory Physical Therapy noted that there is currently a lack of quality studies that have examined this area of study. Part of the quality involved the choice of research design and the lack of validated outcome measures to assess variables of interest. The review was unable to determine whether HFPS can improve physical therapists' clinical performance and/or preparedness. In addition, many studies examine pre-post simulation when capturing outcome data, demonstrating a further need for longer longitudinal studies to further assess student performance. There is also reported variability in how HFPS is used, the optimal delivery, timing, volume, and content.
The proposed study will have two objectives:
1. Assess the volume of HFPS delivered and whether it has an additive effect of improving physical therapy and nursing student performance related to clinical reasoning skills during simulated clinical situations.
2. Assess the volume of HFPS and whether it has an additive effect of improving physical therapy and nursing student self-reported changes in team work and communication based on the IPEC core competencies.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 72
- Must be a student currently enrolled in either the physical therapy or nursing program
- Not currently enrolled as a student in the physical therapy or nursing program
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Experimental Group Interprofessional Simulation Experience This group will receive 2 simulations
- Primary Outcome Measures
Name Time Method Interprofessional Attitudes Scale (IPAS) baseline and through study completion (an average of 8 months) The tool measures 5 subscales that include: Teamwork roles and responsibilities, Patient centeredness, Interprofessional biases, Diversity and ethics, Community centeredness. The IPAS is based off of the 4 competencies for interprofessional education.
The tool is a 27 item 5-point agreement scale ranging from strongly disagree to strongly agree. Internal consistency reliability for the sub-scales were good (i.e., Cronbach alpha = 0.62 to 0.92). Exploratory factor analysis revealed that items loaded sufficiently (i.e., loading greater than 0.30) on only one of five factors (i.e., did not cross-load). Confirmatory factor analysis supported the sub-scale structure, Goodness of Fit Index (GFI) = 0.86 and Root Mean Squared Error of Approximation (RMSEA) = 0.90.Lasater Clinical Judgment Rubric (LCJR) baseline and through study completion (an average of 8 months) The rubric's 11 dimensions of student performance are grouped into 4 subscales (Noticing, Interpreting, Responding, and Reflecting), with clear performance descriptions for dimension scores between 1 (beginning) and 4 (exemplary), and LCJR totals between 11 and 44 points. The LCJR is considered a valid and reliable instrument with the Cronbach α for total scores between 0.80 and 0.97 and subscale results of 0.89 to 0.93. Although it has been mainly used in simulation, use of the LCJR in clinically focused studies has been successful with Manetti reporting reliability of 0.89.
Performance Assessment Communication and Teamwork Tool Set (PACT) baseline and through study completion (an average of 8 months) The PACT tools are designed to provide assessment feedback for learners, and evaluation information for program faculty. For this study, only the expert observation rating tool will be used. The overall inter-rater reliability of the novice, expert, and video observational tools was good (Intraclass Correlation Coefficient (ICC) = 0.85, 0.76, and 0.90, respectively). The inter-rater reliability for four of the five domains in the expert observational tool were acceptable (ICC = 0.44-0.66); the exception was the team structure domain (ICC = 0.21). The inter-rater reliability for all five domains in the video observational tool were acceptable (ICC = 0.54-0.84).
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (1)
Youngstown State University
🇺🇸Youngstown, Ohio, United States