Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.
Simulation as a Level I fieldwork (FW) has not been widely studied in OT. This presentation will portray student satisfaction outcomes from a 1-week Level I FW using the Simucase™ platform. This descriptive study investigated students' satisfaction with simulated case-based learning and their perception of clinical reasoning skill development compared with paper case scenarios. Students showed a statistically significant change in debrief and reflection, clinical reasoning, and clinical learning (p < .05).
Primary Author and Speaker: Amy Mattila
Additional Authors and Speakers: Elizabeth Dwyer DeIuliis
Contributing Authors: Retta Martin, Emily Casile
PURPOSE: Simulation can be described as a technique for practice and learning that replaces and amplifies real experiences with guided ones that evoke and replicate aspects of the real world in an interactive fashion (Lateef, 2010). Evidence indicates that simulation provides various opportunities for learners to develop competence and confidence (Mieure et al., 2010). Although ACOTE has indicated that simulation is an acceptable method to deliver level I FW, there is limited research available in this area. Investigating student perceptions and level of satisfaction with simulation is critical and aligned with the scholarly agenda for OT education set by AOTA. Case-based learning (CBL) is another teaching practice familiar among health professional training (McLean, 2016). Using guided inquiry as a basis for learning, CBL promotes self-directed behavior, stimulates the process of knowledge discovery and integration, and promotes an exploration of ambiguity via the use of authentic clinical scenarios, structured discussion and debriefs (Srinivasan et al., 2007). CBL requires learners to recall previously learned content to solve clinical cases, which is the true foundation of clinical practice. The amount of research on the impact of simulation and CBL as singular teaching approaches is growing; however, there is limited data on the use of both approaches together in OT education, specifically combined with FW education. The research question guiding this study is ‘What is the occupational therapy students’ overall experience and perception of clinical reasoning through simulated case-based learning?
DESIGN: The research study used a descriptive design aimed to investigate student satisfaction with a computer-based simulation platform that incorporates case-based learning principles, via Simucase and their perception of clinical reasoning skills. The study was embedded in a grad-level OT course focused on clinical reasoning and which requires a level I FW experience. 29 participants were purposively sampled from a cohort of BS/MS OT students during the 3rd semester of their professional education.
METHOD: Data was collected from the Satisfaction with Simulation Experience (SSE) Scale. The SSE is an 18-item self-rated scale that assesses student perception in three areas: Debrief and Reflection, Clinical Reasoning, and Clinical Learning. The scale was administered at the start of the 3rd semester, asking students to reflect on paper-case scenarios and in-class discussions thus far in the curriculum, then again at the end of the simulation case-based FW experience. Descriptive statistics for scores on the SSE pre-and post-simulation were analyzed and a Wilcoxon signed ranks test was used due to the small sample size and the inability to assume a normal distribution; it revealed a significant difference between pre-and postintervention means.
RESULTS: The results indicated statistically significant increases across all areas. Post-simulation, statistically significant increases were found in Debrief and Reflection (p = .00), Clinical Reasoning (p = .02), and Clinical Learning (p = .01), suggesting that students develop in-depth reflection, reasoning, and clinical abilities as they progress through their simulated experience.
CONCLUSION/IMPACT STATEMENT: This study’s findings suggest that simulated case scenarios enable students to experience aspects of clinical learning and clinical reasoning through guided inquiry, integration of knowledge, and reflection/feedback. Given the current landscape with shortage of FW placements across the US and the impact of COVID-19 on site availability, understanding the students experience with these teaching modalities will help shape and further define the future use of simulation for level I FW.
References
Lateef, F. (2010). Simulation-based learning: Just like the real thing. Journal of Emergencies, Trauma and Shock, 3(4), 348–352. http://doi.org/10.4103/0974-2700.70743
McLean S. F. (2016). Case-Based Learning and its Application in Medical and Health-Care Fields: A Review of Worldwide Literature. Journal of medical education and curricular development, 3, JMECD.S20377. https://doi.org/10.4137/JMECD.S20377
Mieure, K. D., Vincent, W. R., Cox, M. R., & Jones, M. D. (2010). A high-fidelity simulation mannequin to introduce pharmacy students to advanced cardiovascular life support. American Journal of Pharmaceutical Education, 74(2), 22. https://doi.org/10.5688/aj740222
Srinivasan, M., Wilkes, M., Stevenson, F., Nguyen, T., & Slavin, S. (2007). Comparing problem-based learning with case-based learning: Effects of a major curricular shift at two institutions. Academic Medicine, 82(1), 74–82. https://doi.org/10.1097/01.ACM.0000249963.93776.aa
