Simulation Training for Physiotherapists in Critical Care Setting – A Pilot Study

Abstract Description

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Authors (including presenting author) :

KWAN WS, TAM OY, FAN KY, YIU DH, LEUNG WC, MAK MY

Affiliation :

Physiotherapy Department, Tuen Mun Hospital

Introduction :

Simulation training allows staff to practices skills and enhances clinical reasoning in a safe and controlled environment without jeopardizing patient safety. Simulation training has been used in medical and nursing education for a number of years which had been found to enhance clinical competencies at both undergraduate and postgraduate levels. However, simulation training in allied health is less well established. Indeed, there are many emergency situations that the physiotherapist may encounter in the critical care environment. Scenario-based simulation training not only ensures the service safety but also develop confidence in physiotherapist’s hands-on skills before real patient contact.

Objectives :

To determine if a pilot simulation program incorporated into the tradition training can enhance junior physiotherapists’ confidence and competency in critical care setting

Methodology :

The target participants were physiotherapists with limited exposure to ICUs. The simulation training was conducted in the NTWC clinical skill training centre which is equipped with patient simulator (SimManⓇ, Laerdal Medical) that allowed real-time adjustment in physiological data. The program consisted of 2 separate sessions. The first session covered essential skills such as positioning, bronchohygiene techniques, suctioning and interpretation of ventilator waveform in both adult and neonates. The second session was a scenario-based learning experience with each participant given a case that required the integration of the learnt skills and clinical reasoning. Emergency situations such as desaturation and unstable heart arrhythmia were designed to train participants’ ability to identify patients at risk and how to manage them. The sessions were video-taped and the performance was debriefed with the participants. Pre-course training materials on basic knowledge were provided to the participants. The participants were asked to complete an MCQ quiz and self-rated confidence level before and after the training.

Result & Outcome :

5 physiotherapists with average working experience of 1.3 years attended the training. The mean score of the MCQ (15 Questions) changed from 11.2 (77.3%) to 12.6 (84%). All the participants had improvement in self-rated confidence level (12 Items on 5 points Likert scale, 1=Not confident to 5 = very confident) from 22.6 to 41.2 (out of 60). All participants had given positive feedback and expressed the training would enhance the experience in interaction with real patients. The pilot program had achieved the objective in enhancing the physiotherapist in confidence level and necessary skills required in critical care setting. Implementation of simulation training should be considered as a component of a structured training program.