Student Perceived Confidence with Complex Patients Before and After a Simulated Case-Based Course.

Purpose: This study compared Doctor of Physical Therapy students' perceived confidence with evaluating/treating complex patients before and after a case-based patient management course. The impact of simulated learning and prior clinical exposure were explored.

Methods: A longitudinal, pretest-posttest design was used across 4 university campuses. A Physiotherapist Self-Efficacy survey was used to collect student responses before/after the course, related to adequate preparation, verbal/written communication, subjective/objective assessments, interpreting assessment findings, identifying/prioritizing patient problems, selecting appropriate short/long term goals, performing/evaluating treatments, discharge planning, progressing interventions, and dealing with a range of patient conditions. Descriptive statistics, paired sample t-tests, ANOVA tests, and conceptual content analyses were completed.

Results: Eighty surveys were completed (13.88% response rate). Posttest confidence levels were higher compared to pretest values in all survey items. The t-statistics indicated a significant difference (p<0.001) between the pretest/posttest scores across all 80 records. Levene's statistic revealed p-values >0.001, indicating we met the assumption of homogeneity of variance across different cohort groups.

Conclusions: Student confidence levels towards complex patients significantly improved after course exposure, for all survey components in all cohorts. Simulated experiences, supplemental course materials, and prior outpatient clinical experience contributed to self-efficacy values. Six themes were identified as useful and/or needing revision to further improve self-efficacy.