Medicine and Health Sciences Commons^™

Enhancing Simulation Fidelity In Occupational Therapy Education: Considerations For Standardized Patient Training And Implementation, John V. Rider, Linda Frasier, Jessica Parkin

Journal of Occupational Therapy Education

The use of high-fidelity simulation and standardized patients (SPs) in occupational therapy (OT) education is expanding. However, the implementation of simulation varies across programs, leading to inconsistent outcomes and research limitations. Furthermore, details on SP use and training are lacking in OT literature. This article aims to provide OT educators with considerations for improving simulation fidelity by effectively using highly trained SPs. For example, recruiting SPs from diverse backgrounds is necessary to improve sociological fidelity, and proper training of SPs is required to ensure psychological fidelity. This article also emphasizes the need for standardized training for SPs and recommends following …

Evaluating Change In Skill Performance Over Time And Practice Context In Introductory Fieldwork Simulation, Kaitlin R. Sibbald, Diane E. Mackenzie

Journal of Occupational Therapy Education

Simulation has been recognized for its ability to develop competency-level skills and as a replacement for some introductory fieldwork (FW) hours. This study explored how occupational therapy competency-related skills developed over sequential in-person simulations across health practice contexts during Level 1 FW. Entry-to-practice occupational therapy students (N = 66) participated in six sequential, formative, Level 1 FW simulations. The first three sequential simulations (the same patient case evolves in each successive interaction) included a trained simulated patient in a community mental health context and the following three engaged a trained simulated inpatient in a physical health context. Evaluation rubric variables …

Occupational Therapy Assistant Students’ Perceptions Of Using Standardized Patient Encounters As A Replacement For Traditional Level I Fieldwork, Tiffany L. Benaroya, Deborah Mckernan-Ace, Sandra L. Rogers, Meredith Cimmino

Journal of Occupational Therapy Education

Standardized patient encounters are being utilized more often in occupational therapy education as a replacement for traditional fieldwork. While there is a growing body of research to support the use of this model in developing student skillsets and confidence, there remains limited information on the topic, and no studies which look at its use with occupational therapy assistant students. Twenty-four occupational therapy assistant students participated in standardized patient encounters which served as a replacement for traditional Level I fieldwork. All students completed an anonymous supplementary course evaluation regarding their experiences. A secondary analysis of the data looked at their perceptions …

Sequential Simulations During Introductory Part-Time Fieldwork: Design, Implementation, And Student Satisfaction, Kaitlin R. Sibbald, Diane E. Mackenzie

The Open Journal of Occupational Therapy

Background: Simulation is used in various ways in occupational therapy education and is recognized as a replacement for some conventional fieldwork hours. However, design and student satisfaction has had limited exploration.

Method: Sequential best practice simulations were designed for Level 1 fieldwork objectives in mental and musculoskeletal practice. The Satisfaction with Simulation Education scale (SSES) and qualitative feedback were used to assess student satisfaction. An exploratory factor analysis was used to validate the SSES in occupational therapy, and a three-factor repeated measures ANOVA was used to determine factors contributing to satisfaction across simulations.

Results: A three-factor model …

The Utility Of Peer-To-Peer Practice For Teaching Speech-Language Pathology Students Transnasal Endoscopy, Laura L. Wolford, George W. Wolford, Charlotte A. Bolch

Teaching and Learning in Communication Sciences & Disorders

Introduction: Transnasal flexible endoscopy (TNFE) is necessary for multiple assessments in speech-language pathology (SLP), but it is generally considered an advanced practice technique to be learned during clinical practice. As such, there is no standardized way that it is taught in training programs, leading to a substantial knowledge gap for new graduates. Though peer-to-peer practice has been discussed as an important step in training, it is not clear whether it confers additional benefits above and beyond simulation. This study sought to answer that question in the areas of student confidence, endoscopy speed, and motivation to pursue further TNFE experiences. Methods: …

Level I Fieldwork: Could Simulation Be The Answer? A Descriptive Study, Darla Coss, Stephanie De Sam Lazaro, Katelyn Brady

Journal of Occupational Therapy Education

This article describes the creation and outcomes of simulation as Level I Fieldwork for entry level graduate occupational therapy students. The simulations were created by a team of interprofessional educators following the International Nursing Association for Clinical Simulation and Learning best practices. Additionally, the simulations were designed to meet the student learning outcomes of Level I Fieldwork. Students participated in eight high-fidelity simulations and were evaluated with self-ratings, peer ratings, and faculty ratings. Each student completed a student evaluation of the fieldwork experience, with rating scales and open-ended questions to understand student perceptions of the experience. The vast majority of …

Occupational Therapy Students’ Perceptions Of Feedback During Pre-Fieldwork Simulation Debrief: Useful And Why, Kaitlin R. Sibbald, Diane E. Mackenzie, Jonathan Harris

Journal of Occupational Therapy Education

Simulation is increasingly used in occupational therapy education with the objectives of developing practice skill competency and enhancing clinical reasoning. Debriefing, an integral part of the simulation process, is critical to achieving these objectives. This study sought to determine the types of debrief feedback Master of Science in Occupational Therapy (MScOT) students perceived as most useful and why, and how the advocacy inquiry model of debriefing influenced self-reported increases in clinical reasoning, client care, and planned implementation of feedback in practice. Using an embedded mixed method design with secondary data analysis, sixty-three first-year MScOT students provided 357 descriptions of the …

Ot Graduate Students’ Perceived Preparedness For Level Ii Fieldwork: Traditional, Nontraditional And Mixed Fieldwork I Experiences, Reagan Bergstresser-Simpson, Emily Sweetman, Claudia Maloberti, Miranda Hall, Francis Hermes, Brody Worl

Journal of Occupational Therapy Education

This study explored the perceived level of preparedness of occupational therapy (OT) graduate students for entering Level II fieldwork after completing nontraditional, traditional, and mixed Level I fieldwork experiences. This mixed-methods exploratory study included an online 22-question survey that was delivered to Occupational Therapy Doctoral (OTD) and Master of Occupational Therapy (MOT) programs throughout the United States. Participants were selected through voluntary convenience response sampling. Students (N=145) self-reported their level of preparedness for Level II fieldwork experiences. The quantitative data collected in this study reflected a statistically significant difference between Level I fieldwork experience-related questions for the three groups, …

Impact Of Virtual Simulation-Based Level I Fieldwork On Level Ii Fieldwork Performance, Rebecca Ozelie, Maggie Moeller, Taylor Newmark

Journal of Occupational Therapy Education

Fieldwork is an essential part of a student’s education and development to become competent in entry-level occupational therapy skills (ACOTE, 2018). The implications of COVID-19 coupled with staffing shortages and an increase in academic programs resulted in academic fieldwork coordinators competing for a limited number of spots. The Accreditation Council of Occupational Therapy Education (ACOTE) integrated the use of simulation as an instructional method to meet Standard C.1.9 for Fieldwork I. This study used a retrospective cohort design to determine the impact of virtual simulation-based Level I fieldwork on performance in Level II fieldwork. Thirty-seven Doctor of Occupational Therapy students’ …

A Simulation Of Auditory Hallucinations Improved Empathy Among Occupational Therapy Students, Molly Whitlow, Anna E. Carl, Andrea Thinnes

Journal of Occupational Therapy Education

Clinical empathy has been identified as an essential skill for healthcare workers to provide quality healthcare. One teaching strategy for improving clinical empathy towards people with psychiatric disabilities is the Hearing Voices Simulation. This study used an explanatory sequential mixed methods design to evaluate change in clinical empathy among occupational therapy students after participating in the Hearing Voices Simulation. Participants (N=71) completed the Jefferson Scale of Empathy- Health Professions Student Version (JSE-HPS) prior to and following the simulation. A paired samples t-test compared whether the change in scale scores was equal to zero. Subsequently, focus groups were used to collect …

Quality Delivered: How A Pandemic Fostered Innovation And Creative Solutions In Clinical Education, Alice M. Davis, Laura Laporta, Nancy F. Mulligan, Stacy Carmel, Shelene Thomas, Denise O'Dell

Internet Journal of Allied Health Sciences and Practice

Background: Clinical education placements for students enrolled in healthcare programs were abruptly upended in March 2020 due to COVID-19. Programs were faced with decisions of how to mitigate substantive challenges due to an unforeseen pandemic within timeframes that would align with curricular sequences and graduation dates. Schools quickly modified curriculum formats, implemented alternative teaching and learning instruction and developed safety protocols to protect students, clinical faculty, and patients. Purpose: The aim of this study explored the strategies employed by one physical therapy school’s clinical education team, which resulted in successful completion of clinical course requirements and on-time graduation. Method: Data …

Evolution Of Level I Fieldwork During An International Pandemic: Students’ Perceptions Of The Effectiveness Of Virtual Simulation-Based Level I Fieldwork, Rebecca Ozelie, Shiori Domenighetti, Amanda Sugar, Samantha Conrad

Journal of Occupational Therapy Education

Fieldwork education is an essential component of occupational therapy (OT) curriculum; yet national shortages and the COVID-19 pandemic have affected fieldwork availability. To combat the shortage, some academic programs implemented simulation-based Level I fieldwork experiences. The objective of this research study was to compare the perceived knowledge, confidence, and attitude of OT students that completed a virtual simulation-based Level I fieldwork to those that completed a traditional Level I fieldwork. This study involved a sample of 26 doctorate of OT students that completed a traditional or virtual simulation-based Level I fieldwork. Students completed pre-and-post fieldwork surveys regarding their perceived knowledge, …

Barriers, Challenges, And Supports To The Implementation Of Standardized Patients And Simulated Environments By Occupational Therapy Education Programs, Amanda Mack, Anne Escher, John Wong

Journal of Occupational Therapy Education

A national survey examined the implementation rates, barriers, challenges, and supports to implementation of two types of simulation (standardized patients and simulated environments) by entry-level occupational therapy education programs in the United States. It also sought to identify relationships between program characteristics and implementation of these types of simulation. An online survey inquiring about academic program characteristics and use of simulation was sent to all occupational therapy and occupational therapy assistant programs in the United States in 2017 prior to the implementation of the 2018 Accreditation Council for Occupational Therapy Education Standards and the onset of the COVID-19 Pandemic. Data …

Level I Fieldwork Using Simulation: Student Performance Outcomes And Perceptions, Nicole C. Harris, Sarah Nielsen, Marilyn G. Klug

Journal of Occupational Therapy Education

The purpose of this study was to examine students’ perceptions and performance outcomes of a virtual fieldwork using Simucase® in conjunction with supplemental activities and debriefing opportunities. The simulation replaced Level I clinic-based fieldwork experiences that were cancelled due to COVID-19. Quantitative and qualitative data were collected using a modified evaluation tool to assess student performance outcomes and perceptions for students in the Year one Occupational Therapy Doctorate (OTD) cohort (n=57) and the Year two Master of Occupational Therapy (MOT) cohort (n=57) enrolled in a public university in the rural Midwest. Student ratings were compared using chi-square test of independence …

Exploring Simulation Design For Mental Health Practice Preparation: A Pilot Study With Learners And Preceptors, Diane E. Mackenzie, Niki Kiepek, Leanne Picketts, Stephanie Zubriski, Karen Landry, Jonathan Harris

The Open Journal of Occupational Therapy

The purpose of this exploratory pilot study was to determine the feasibility of delivering mental health practice simulations for occupational therapy learners, and whether different debriefing approaches yielded performance differences over successive simulations. Five clinical preceptors and nine first year MScOT students participated in this mixed-method study. In week one simulations, one student group received preceptor facilitated debriefing while the other group used self-debriefing. Both groups used the same scripted questions informed by an advocacy-inquiry approach. In the second week, both groups received the preceptor-led debriefing. Preceptors rated student performances while students self-rated their confidence, competence screen, and satisfaction using …

Meaning And Impact Of Interprofessional Simulation Participation For Occupational Therapy Students: A Qualitative Descriptive Study, Elena Wong Espiritu, Steven Busby

Journal of Occupational Therapy Education

Occupational therapy programs are incorporating simulation experiences more regularly into their curricula. However, there continues to be a need for more evidence demonstrating simulation benefits, particularly when various client populations, standardized actors, interpersonal skill practice, and multiple disciplines are incorporated into scenarios. The purpose of this qualitative descriptive study was to describe the meaning and impact of participating in an interprofessional simulation for occupational therapy students as part of their current academic preparation and future clinical practice in the hopes of increasing the participants’ interpersonal and clinical reasoning skills. Study participants were entry-level occupational therapy doctoral students (N=64) and their …

Student Perspectives And Standardized Patient Feedback On An Innovative Simulated Patient Encounter, Kimberly S. Mollo, Tina M. Deangelis, Maclain Capron, Sierra Wells

Journal of Occupational Therapy Education

This retrospective survey analysis sought to explore student perspectives and application of therapeutic use of self during a simulated standardized patient encounter (SSPE) with standardized patient actors portraying serious mental illness (SMI). Researchers collected retrospective data from post SSPE student surveys dating between 2009 and 2019 and standardized patient actor surveys dating between 2017 and 2019. Students’ level of expertise with therapeutic use of self and self-perceptions of the SSPE were analyzed for response categories. Descriptive analysis was conducted on all items. Student survey responses were organized into response categories. Standardized patient actor surveys were analyzed for frequencies of yes/no …

Level I Fw In A Simulated Environment: A Blueprint On How To Use Simucase™, Elizabeth D. Deiuliis, Amy Mattila, Retta M. Martin

Journal of Occupational Therapy Education

Simulation education is a sought-out teaching modality in allied healthcare education to bridge the classroom and the clinic. In addition to developing healthcare student professionals’ skills, attitudes and key competencies, simulation can also be used to address the national fieldwork shortage, as well as site capacity issues related to the current pandemic. Although the Accreditation Council for Occupational Therapy Education (ACOTE) has recently indicated that simulation is an acceptable method to deliver Level I fieldwork, there are limited resources available. This paper will provide a pedagogical blueprint for incorporating computer-based simulation and case-based learning principles using the Simucase™ platform for …

Evaluation Of A Simulation-Based Training Program On Childhood Trauma With Occupational Therapy Students, Julie Miller-Cribbs, Jedediah E. Bragg, Mary Isaacson, Eden D. E. Nay, Daniel Howell, Kristin Rodriguez, Frances Wen, Martina Jelley, Kim Coon

Journal of Occupational Therapy Education

An educational and simulation-based training model, the Professional ACEs-Informed Training for Health Professionals designed for allied health students was evaluated using a pre-and-post design. The training model emphasizes trauma-informed care and uses social simulation to educate and train students with skills to address adverse childhood experiences. This study evaluated occupational therapy students’ (N=70) levels of self-efficacy and knowledge of trauma-informed care at both pre- and post-training. Analysis of variance results indicated a statistically significant improvement in students’ levels of general self-efficacy and knowledge from pre- to post-assessment (p < .01). These results are suggestive of the usefulness of brief …

Clinical Educators’ Perceptions Of Students Following A Simulation-Based Learning Program, Sally Hewat, Joanne Walters, Emma Caird, Danielle Aldridge, Adriana Penman, Elizabeth Cardell, Rachel Davenport, Bronwyn Davidson, Simone Howells, Patricia Mccabe, Alison Purcell, Elizabeth Ward, Anne E. Hill

Teaching and Learning in Communication Sciences & Disorders

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 …

Clinical Simulations In Academic Courses: Four Case Studies Across The Medical Slp Graduate Curriculum, Amanda Stead, Rik Lemoncello, Caitlin Fitzgerald, Melissa Fryer, Marcia Frost, Rachael Palmer

Teaching and Learning in Communication Sciences & Disorders

Simulation practices are growing in both popularity and necessity within speech pathology programs. Simulation use can serve to not only minimize client risk but to increase student confidence and competence prior to patient contact, particularly with low incidence or medically fragile patients. This paper describes and reflects on four individual simulation experiences within one graduate speech language pathology program and their outcomes. The use of both simulated patients and mannequin training resulted in an increase in students' perception of knowledge and confidence in their clinical skills with medical patients.

Standardized Patient Encounter: An Innovative Curricular Design To Enhance Fieldwork Readiness, Lisa M. Sakemiller, Susan Toth-Cohen

Journal of Occupational Therapy Education

Occupational therapy (OT) educators are challenged to utilize instructional strategies that ensure student preparedness for Level II fieldwork. Standardized patient encounters (SPEs) offer students a low risk simulation opportunity to develop clinical skills and improve fieldwork readiness while enhancing OT students’ confidence. Yet, despite the benefits and perceived value of simulation among educators and students, SPEs are not used as frequently as other instructional methods. The purpose of this educational innovation paper is to describe the curriculum development process of an overall SPE experience embedded within a synthesis course that prepared students for Level II fieldwork and to evaluate the …

Effectiveness Of Instructor-Led Discussion Versus Simulation To Prepare Students For Fieldwork, Elena W. Espiritu, Thu M. Can, Natalie N. Michaels, Allison Koch, Beth F. Hallmark

Journal of Occupational Therapy Education

Occupational therapy students do not always feel prepared to start fieldwork. The study purposes were to 1) measure the effectiveness of refresher sessions on students’ perceived self-efficacy, knowledge, and skills related to fieldwork preparedness and 2) determine whether using simulation with standardized patients (SPs) was more effective than a discussion-based format. The participants (N=34) were entry-level occupational therapy doctoral (OTD) students. Four students acted as a control group while the remaining 30 students were randomly assigned to experimental groups (discussion or simulation). Outcome measures included a readiness for fieldwork survey (quantitative self-reported ratings and qualitative questions), a knowledge-based exam, and …

Correlation Between Simulation And Fieldwork Performance In Adult Physical Rehabilitation, Whitney Lucas Molitor, Ranelle Nissen

Journal of Occupational Therapy Education

The purpose of this study was to explore the relationship between performance in simulation used as a learning method in an adult physical rehabilitation and Level II fieldwork. A retrospective cohort research design was utilized to analyze data gathered from occupational therapy student cohorts between 2011-2017 enrolled in an entry-level Masters (MS) and Doctor of Occupational Therapy (OTD) program located in the Midwest United States. Course performance on skills checks, which utilized simulation methods, as well as final exam and course grades were analyzed and compared to performance scores on the FWPE. The overall course exam performance is the strongest …

Qualitative Analysis Of Student Physical Therapist Reflective Writing: Does An Interprofessional Discharge Planning Simulation Increase Their Understanding Of The Role They Play In Discharge Planning?, Leslie M. Smith, Benjamin Sachs, Karen Berg, Megan Keiser, Laura J. Smith, Carman Turkelson, Amy Yorke

Internet Journal of Allied Health Sciences and Practice

Purpose: The Core Competencies for Entry-Level Practice in Acute Care Physical Therapy provides an expectation of entry-level practice in acute care for physical therapists including discharge planning (DP). Physical therapists (PT), despite having appropriate clinical reasoning and unique skills for determining the functional abilities of patients, are less often a part of the DP process. The purpose of this study was to determine, by use of qualitative analysis of reflective writing, if an interprofessional discharge planning simulation will increase students’ understanding of the role of physical therapy in DP. Methods: Students from physical therapy (n=57), undergraduate nursing (n=36), graduate …

A Pilot Study Exploring The Impact Of Interprofessional Simulation On Role Clarity And Student Readiness For Collaborative Clinical Practice, Shira Schecter Weiner, Laura Hagan, Julie F. Kardachi

Internet Journal of Allied Health Sciences and Practice

Purpose: Interprofessional collaboration is recognized as a healthcare practice paradigm that may decrease overall costs and minimize errors. Yet it remains common for practitioners to provide care within silos, inadequately considering the impact of their decisions on other providers and overall costs, which ultimately may negatively impact the patient. Integrating interprofessional collaboration in school curricula can establish the importance of this approach to healthcare. For optimal efficacy, every professional in the healthcare team must recognize their unique role and the roles of others, to allow for seamless interprofessional collaboration. Simulation is a teaching tool that provides students with the opportunity …

Collaborative Care Best Practices Model (Ccbpm) Development For Nursing And Occupational Therapy Assistant Interprofessional Simulation, Carrie M. O'Reilly, Lisa P. Simmons, Mary L. Romanello

The Open Journal of Occupational Therapy

The use of simulation as a teaching and learning stratagem is well supported in the professional literature. The development of a collaborative care best practices model (CCBPM) was undertaken to help the creation and implementation of an interprofessional education (IPE) learning strategy between occupational therapy assistant (OTA) and pre-licensure nursing students at a private liberal arts college. The project goals and outcomes involved faculty development, CCBPM development, and OTA and nursing novice student competency acquisition in their respective professions. Twenty-three students (10 OTA and 13 nursing) completed the IPE learning simulation exercise. A mixed-method approach to data analysis was used …

A Skills-Focused Approach To Improving Therapist Goniometry Accuracy Using A Simulation Laboratory, Miranda Yelvington, Beverly J. Spray

Journal of Occupational Therapy Education

Goniometric measurements are widely used in the field of occupational therapy to measure range of motion, define and describe movement, and predict the functional implications of joint limitations. These measurements are further used in documentation and as a means of justifying reimbursement. While goniometrics are a hallmark of our practice, therapist competency is rarely assessed. This study sought to evaluate whether a skill focused, simulation assisted training could lead to improvements in accuracy and consistency of goniometric measurements. Ten therapists at a single facility completed goniometric testing utilizing a simulation module to assess three joint motions (shoulder abduction, elbow flexion …

Hearing Voices Simulation: Impact On Occupational Therapy Students, Rebecca Ozelie, Paige Panfil, Nicole Swiderski, Elizabeth Walz

The Open Journal of Occupational Therapy

Auditory hallucinations, which are symptoms of schizophrenia, can significantly disrupt individuals’ daily lives. Occupational therapists (OTs) can address both the daily needs of people with schizophrenia and address cultural stigmas against mental illness. To combat stigma and increase empathy for patients with mental illnesses, auditory hallucinations simulations were developed. The purpose of this study was to determine if the Hearing Voices That Are Distressing (HVTAD) Simulation impacts OT students’ attitudes toward patients with auditory hallucinations and to explore the students’ perceptions of the simulation’s effectiveness as a teaching method. The participants completed a pretest Attitudes to Mental Illness Questionnaire (AMIQ) …

Co-Constructing Simulations With Learners: Roles, Responsibilities, And Impact, Diane E. Mackenzie, Kathleen E. Collins, Mylene J. Guimond, Abby C. Hunter, Kassia J. Jurcina, Johanna L. Mcdonald, Nikki L. Richards, Stephanie. H. Sinclair, Kelsey Y. Taylor

The Open Journal of Occupational Therapy

Co-constructed simulations were designed and piloted with senior occupational therapy master’s students in a neurorehabilitation practice module. The instructor served as the guide for the students through all phases of the case creation, simulation development, delivery, and debrief. The instructor facilitation promoted self-regulated learning (SRL) of knowledge and skill development through independent discovery and peer learning. This paper provides an evidence-informed co-construction simulation design with outlined stages, roles, and responsibilities for the instructor and learner. Thematic qualitative analysis of student feedback highlighted enhanced insight and SRL as a result of multiple role preparation, observation and interaction with peers, close interaction …