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Research ArticleSpecial Series on Rehabilitation for People With Critical Illness: Using Quality Improvement to Translate Research Into Practice

Simulation Experience Enhances Physical Therapist Student Confidence in Managing a Patient in the Critical Care Environment

Patricia J. Ohtake, Marcilene Lazarus, Rebecca Schillo and Michael Rosen
Demo Journal of Physical Therapy February 2013, 93 (2) 216-228; DOI: https://doi.org/10.demo/ptj.20110463
Patricia J. Ohtake
P.J. Ohtake, PT, PhD, Department of Rehabilitation Science, University of Buffalo, 515 Kimball Tower, Buffalo, NY 14214 (USA).
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Marcilene Lazarus
M. Lazarus, PT, DPT, Department of Rehabilitation Science, University of Buffalo.
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Rebecca Schillo
R. Schillo, PT, DPT, Department of Rehabilitation Science, University of Buffalo.
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Michael Rosen
M. Rosen, PhD, Armstrong Institute for Patient Safety and Quality and Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland.
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Abstract

Background Rehabilitation of patients in critical care environments improves functional outcomes. This finding has led to increased implementation of intensive care unit (ICU) rehabilitation programs, including early mobility, and an associated increased demand for physical therapists practicing in ICUs. Unfortunately, many physical therapists report being inadequately prepared to work in this high-risk environment. Simulation provides focused, deliberate practice in safe, controlled learning environments and may be a method to initiate academic preparation of physical therapists for ICU practice.

Objective The purpose of this study was to examine the effect of participation in simulation-based management of a patient with critical illness in an ICU setting on levels of confidence and satisfaction in physical therapist students.

Design A one-group, pretest-posttest, quasi-experimental design was used.

Methods Physical therapist students (N=43) participated in a critical care simulation experience requiring technical (assessing bed mobility and pulmonary status), behavioral (patient and interprofessional communication), and cognitive (recognizing a patient status change and initiating appropriate responses) skill performance. Student confidence and satisfaction were surveyed before and after the simulation experience.

Results Students' confidence in their technical, behavioral, and cognitive skill performance increased from “somewhat confident” to “confident” following the critical care simulation experience. Student satisfaction was highly positive, with strong agreement the simulation experience was valuable, reinforced course content, and was a useful educational tool.

Limitations Limitations of the study were the small sample from one university and a control group was not included.

Conclusions Incorporating a simulated, interprofessional critical care experience into a required clinical course improved physical therapist student confidence in technical, behavioral, and cognitive performance measures and was associated with high student satisfaction. Using simulation, students were introduced to the critical care environment, which may increase interest in working in this practice area.

Footnotes

  • Dr Ohtake, Dr Lazarus, and Dr Schillo provided concept/idea/research design and data collection. Dr Ohtake and Dr Lazarus provided writing. Dr Ohtake and Dr Schillo provided data analysis. Dr Ohtake provided project management, study participants, and institutional liaisons. All authors provided consultation (including review of manuscript before submission). The authors gratefully acknowledge the expertise and assistance of Blair W. Boone, PhD, Jeff W. Myers, DO, EdM, W. Scott Erdley, DNS, RN, Fritz Sticht, BS, and the University at Buffalo Behling Simulation Center.

  • This study was approved by the Social and Behavioral Sciences Institutional Review Board at the University at Buffalo.

  • Received November 22, 2011.
  • Accepted January 7, 2013.
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Demo Journal of Physical Therapy: 93 (2)
Demo Journal of Physical Therapy
Vol. 93, Issue 2
1 Feb 2013
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Simulation Experience Enhances Physical Therapist Student Confidence in Managing a Patient in the Critical Care Environment
Patricia J. Ohtake, Marcilene Lazarus, Rebecca Schillo, Michael Rosen
Demo Journal of Physical Therapy Feb 2013, 93 (2) 216-228; DOI: 10.demo/ptj.20110463

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Simulation Experience Enhances Physical Therapist Student Confidence in Managing a Patient in the Critical Care Environment
Patricia J. Ohtake, Marcilene Lazarus, Rebecca Schillo, Michael Rosen
Demo Journal of Physical Therapy Feb 2013, 93 (2) 216-228; DOI: 10.demo/ptj.20110463
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