The impact of low-cost, optimal-fidelity simulation on physical therapy students’ clinical performance and self-efficacy: a pilot study

Hagan, Laura; Schecter Weiner, Shira; Rosen, Zohn

Purpose: Patient simulation has emerged as a useful tool to refine cognitive, psychomotor, and affective skills in realistic yet controlled settings. However, the cost associated with simulation labs can be a barrier. The purpose of this pilot study was to 1) assess the feasibility of a low-cost optimal-fidelity simulation lab integrated into an academic course and 2) assess the effectiveness of a low-cost optimal-fidelity patient simulation on self-efficacy and clinical performance of Doctor of Physical Therapy (DPT) students.
Methods: This prospective study utilized a repeated measures quasi-experimental research design. Subjects were recruited through convenience sampling from two branches of the same accredited program run separately on different campuses. Students from one campus served as the experimental group and students from the other campus served as the control group. The control group received usual training for a course on patient assessment. Simultaneously, the experimental group received usual training with the addition of simulation. The Jones and Sheppard self-efficacy questionnaire was administered at baseline (T0), after simulation (T1), and after the subjects’ first clinical experience (T2). The PT Clinical Performance Instrument (CPI) assessed clinical performance. Faculty time, space, equipment, and funds were recorded for descriptive analysis
Results: A low-cost optimal-fidelity simulation lab was developed in a 360 square feet room with approximately $500 of supplies. Mann–Whitney independent sample tests demonstrated no statistical significance between groups at each of the data collection points. Within group changes in self-efficacy were statistically significant from T0 to T1 in the experimental group only. No statistically significant changes in CPI scores were noted between groups at the midterm or final assessment. A small-to-moderate effect size (d = 0.386) was noted.
Conclusion: The feasibility of the low-cost optimal-fidelity simulation was demonstrated by the limited cost and space requirements. Exposure to one simulated patient encounter appeared to accelerate the development of self-efficacy prior to a first clinical placement compared to usual training in this pilot study.


Also Published In

The Journal of Clinical Education in Physical Therapy

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Published Here
August 19, 2022


self-efficacy, simulation, physical therapy, low-cost, clinical performance, fidelity