Developing a Complex Simulation Experience to Prepare Students for Emergent Clinical Situations

Research Objectives: Evaluate the effectiveness of a complex clinical simulation with regard to knowledge retention and perception of overall learning experience.

Design: Retrospective case study

Setting: This study was conducted in a doctorate of occupational therapy (OT) program in a "Clinical Reasoning in Occupational Therapy" course. The simulation was completed in an on-campus lab.

Participants: Forty-nine OT students participated in the study. Inclusion criteria: Third semester OT student in doctorate of OT program and enrollment in "Clinical Reasoning in Occupational Therapy." Data was collected retrospectively and students were unaware of their participation in the study.

Interventions: During the simulation, students were asked to complete a treatment session with a standardized patient (SP). Prior to treatment, the student was asked to review the SP’s chart and medical history. They were expected to determine which vital signs to assess prior to treatment and then transfer the SP to a wheelchair. After the transfer, the SP was directed to lose consciousness to create an emergent situation. Once the student responded to the medical emergency, the simulation ended. The simulation was recorded and students were asked to reflect on the experience in a small group with a clinical counselor, in class, and in a short reflection assignment. Students were provided feedback from the instructor and the SP.

Main Outcome Measures: The grading rubric assessed building rapport, safety, treatment quality, assessment of medical stability, and response to a medical emergency. After debriefing with a clinical counselor and as a class, students were asked to complete an ungraded reflection assignment.

Results: Qualitative data from student reflections was coded and themes were identified. Themes were "ability to build rapport," "emergency response," "preparing equipment prior to treatment," "importance of assessing environment," "learning from mistakes," and "fostering clinical reasoning."

Conclusions: Applying classroom knowledge to a clinical situation fosters the development of clinical reasoning skills. A complex simulation experience to prepare students for emergent clinical situations requires students to not only understand but to apply knowledge, therefore fostering the development of clinical reasoning skills.

Author(s) Disclosures: No disclosures.