"It's Still Exposure Just in a Slightly Different Way"-Understanding the Contribution of Simulation to Developing Physical Therapist Skills in Ireland: An Interpretive Description Study.

Abstract

Importance: Simulation-based education (SBE) is increasingly used in physical therapist training to address growing student numbers and clinical placement shortages. However, clinical educators' perspectives on the role of SBE in preparing students for practice remain unexplored.

Objective: The objective of this study was to explore physical therapy clinical educators' perspectives on academic-based SBE, particularly how it can equip students for clinical placement and whether it should contribute to practice education hours.

Design: Qualitative interpretive description methodology using semi-structured interviews was used.

Setting: Five hospital sites across the island of Ireland engaged in physical therapist practice education.

Participants: This study involved 8 physical therapist practice educators and tutors with 6 to 15 years of experience, supervising 2 to 50 students annually.

Intervention(s) or exposure(s): Individual semistructured interviews were conducted exploring participants' perspectives on SBE's role in clinical education, lasting 40 to 60 minutes each.

Main outcome(s) and measure(s): Thematic analysis identified patterns in clinical educators' perceptions of SBE's educational value and contribution to practice preparation.

Results: Simulation supported the transition to practice by: (1) priming for clinical environments, (2) enhancing feedback literacy in the workplace, and (3) tackling complexity of clinical practice. Specific clinical skills including documentation, basic safety, manual handling, subjective assessment, and understanding the multidisciplinary team's role were recognized as appropriate for instruction through SBE. Participants reported activities spent in SBE should count toward clinical hours and highlighted that processing feedback during SBE established a foundation for feedback practices in the workplace. Engaging simulated patients in scenarios informed by real patient experiences was proposed as a way of managing complex patient encounters.

Conclusions and relevance: SBE provides a means to scaffold the learning of essential clinical skills before practice placement and contributes to clinical education, though more research is needed to determine the proportion. Future research should examine simulated interventions to boost feedback literacy and readiness for clinical settings. Involving patients and the public in the design of SBE curricula is crucial for relevant and beneficial learning outcomes.