Date Presented 03/28/20
This qualitative descriptive study examined students’ perceptions of the impacts of simulation on preparation for OT Level II fieldwork. Participants indicated ways in which thoughtfully designed simulations can help enhance confidence as well as interprofessional relationships, role delineation, and communication skills. Outcomes provided insight into considerations for the design of future simulations emphasizing professional-skill development.
Primary Author and Speaker: Ellen Herlache-Pretzer
Additional Authors and Speakers: Jean Prast
Contributing Authors: Rachel Andrzejewski, Sara Gapski, Brittany Raisanen, Monica Wilds, Natalie Miller
PURPOSE: Simulation is an educational method used to help students learn and practice skills, that replicates real-world clinical environments in an interactive way. It provides the opportunity for deliberate and repeated practice of clinical skills in a safe and risk-free environment (Bethea, Castillo, & Harvison, 2014), gives opportunity for the practical application of knowledge, and allows students to reflect on their practice of skills with peers and educators (Jansen, 2015). The limited research on the benefits of simulation in occupational therapy (OT) education has shown that simulation can improve communication, decision-making, and crisis-intervention skills (Ozelie, Both, Fricke, & Maddock, 2016). The purpose of this qualitative descriptive study was to explore OT student and alumni perceptions of simulation as a form of preparation for Level II fieldwork.
DESIGN: This study used a qualitative descriptive approach. Recruitment was completed via an email blast sent from the researchers’ university. Participants were graduate-level OT students or alumni from the researchers’ university who were currently completing Level II Fieldwork, or had completed Level II fieldwork within the last 12 months.
METHOD: Two focus groups were used to gather information regarding perceptions of the use of simulation as a form of preparation for OT Level II fieldwork. Six students participated in an in-person focus group; four students and one alumnus participated in a virtual focus group via Skype for Business. All interviews were transcribed; a three-step process was used for data analysis (Patten, 2014). Open coding was used to examine ideas and experiences of the participants that arose during the interviews and identify basic themes. Axial coding was used to identify relationships between the categories that were identified during open coding. Lastly, selective coding was used to identify major themes focusing on the impact of simulation as a form of preparation for Level II Fieldwork, and ideas for improving clinical simulation to better meet student learning needs.
RESULTS: After analysis and coding of the data from the focus groups, four main themes emerged. Participants felt that simulation did not improve clinical reasoning or critical thinking skills, but did help improve their confidence as well as interprofessional relationship, role delineation, and communication skills. Simulations that involved students role-playing clinicians in unpredictable situations were viewed as especially beneficial. Participants felt that utilization of written case synopses and standardized patients helped to further enhance the benefits of simulations. Table-top simulations, as well as simulations that were highly structured, were reported to be not as beneficial, as they decreased opportunities to make mistakes, which was regarded as an important part of the learning process.
CONCLUSION: Results suggest that simulations may not have a strong impact on development of clinical reasoning or critical thinking skills necessary for Level II Fieldwork. However, thoughtfully-designed simulations may help enhance confidence, as well as interprofessional and communication skills.
IMPACT STATEMENT: Outcomes suggest that simulations can help enhance student preparation for Level II fieldwork in select areas. As a small qualitative study, additional research is recommended to further explore the impact of simulation on various aspects of skill development in OT students in preparation for Level II Fieldwork.
References
Bethea, D. P., Castillo, D. C., & Harvison, H. (2014). Use of simulation in occupational therapy education: Way of the future? American Journal of Occupational Therapy, 68(2), S32-S38. doi:10.5014/ajot.2014.012716
Jansen, L. J. (2015). The benefits of simulation-based education. Perspectives on Issues in Higher Education, 18(1), 32-42. doi:10.1044/ihe18.1.32
Ozelie, R., Both, C., Fricke, E., & Maddock, C. (2016). High-fidelity simulation in occupational therapy curriculum: Impact on level II fieldwork performance. Open Journal of Occupational Therapy, 4(4), 1-11. doi:10.15453/2168-6408.1242
Patten, M. L. (2014). Understanding research methods: An overview of the essentials (9th ed.) (p.169) Glendale, CA: Pyrczak Publications.
