Does a Simulated Patient Experience Improve Physiotherapy Students' Confidence of Shared Decision-Making? A Mixed Methods Study.

Abstract

Purpose: Physiotherapy entry-level programmes are designed to equip graduates with the skills required to be autonomous practitioners. Innovative teaching methods, such as role-play simulation, are designed to support students' transition into practice. This study aimed to investigate whether a simulated patient experience could influence student confidence when facilitating behavioural change using a shared decision-making approach. Method: A mixed methods design comprising online pre- and post-surveys of student physiotherapists at one U.K. higher education institution, followed by an invitation to participate in a follow-up semi-structured focus group. Pre- and post-simulation surveys were completed in addition to the Modified Satisfaction with Simulation Experience (MSSE) survey. Likert scale data were treated as numeric variables with the median and Interquartile (IQR) range calculated for combined responses across potential answers. Focus groups included semi-structured questions with thematic analysis generating themes. Results: All 39 respondents "Strongly Agreed" that they were satisfied with the simulated experience, which could be transferred to clinical practice (5, IQR 4-5). The stimulation developed both confidence (5, IQR 4-5) and developed participants' perception of their shared decision-making skills (4, IQR 4-5). Three key emergent themes from the focus groups included (1) Bridging the gap between clinical practice, (2) Authenticity, and (3) Psychological safety. Conclusions: The simulated role-play patient experience improved the confidence and participants' perception of their ability to use shared decision-making to facilitate behavioural change. Themes from the semi-structured interviews suggested increased authenticity and psychological safety during the task, which could bridge the gap between theoretical teaching and clinical practice.