Date of Award

2014

Degree Type

Thesis

Degree Name

Master of Science (MS)

Department

Pharmaceutical Sciences

First Advisor

Clinton O. Chichester

Abstract

Doctor of Physical Therapy (DPT) curricula are designed to train physical therapy students to treat patients across a range of treatment needs and settings. However, the ability to provide students with hands on experience in a variety of settings can be limited. Acute care setting experience can be particularly challenging to provide students due to availability issues, legal concerns, and limited clinical opportunities. Human patient simulators; however, are not hindered by the same restrictions. Consequently, simulators provide a valuable resource for students to expand their acute care experience. This study was designed to evaluate the confidence and exposure levels of DPT students following a simulated acute care case administered as part of a practical for an existing cardiopulmonary course. The findings of this study were used to evaluate the potential benefits of a simulated case for students enrolled in this course and make recommendations regarding expansion of simulated cases. This study was conducted using a blinded one group randomized pre- and posttest design in which 36 students participated. While participation in the practical was required for the course in which students were enrolled, students voluntarily completed consent forms and relevant study materials used to assess their experience. Prior to the practical, students participated in a practice laboratory session in order to gain familiarity with the simulators and practice skills needed for the simulation practical. The class was divided in half; each half of the class attended one of two laboratory sessions and rotated around the three stations present during the session. Six weeks later, students completed pre-Competency and Confidence Scales. Ten days after the pre-Competency and Confidence Scales were completed, students participated in the simulation practical. The class of students individually signed up for one of the provided time slots, creating groups of two to three students. Two scenarios were developed to address time concerns and simulator capability, and each group of students only participated in one of the scenarios. However, key aspects of the cases were kept consistent, such as the staging of the simulator and the response by the simulator to the decisions of the students. Following each group’s completion of the practical one of two instructors for the course would debrief them on the experience. After the debriefing session, students completed post-Confidence and Competency Scales as well as satisfaction surveys. Information recovered from the Confidence and Competency Scales and satisfaction surveys was analyzed statistically and mathematically, using Microsoft Office Excel 2011. The pre- and post-confidence and exposure parameters were analyzed using a paired two-tailed t-test. From this analysis several parameters were determined to demonstrate statistical significance. These parameters encompassed technical and non-technical skills across both categories of confidence and exposure. Individual scores were further evaluated by determining the mathematical difference between pre- and post-confidence parameters as well as pre- and post-exposure parameters. This approach was used to determine the degree of change or lack thereof in individual student scores. From this approach it became clear that while many students’ scores improved by one unit on the scale used, several improved three units; indicating that some students had a stronger response to the simulation than others.

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