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    Can simulation replace part of clinical time? Two parallel randomised controlled trials

    Access Status
    Fulltext not available
    Authors
    Watson, K.
    Wright, Anthony
    Morris, N.
    McMeeken, J.
    Rivett, D.
    Blackstock, F.
    Jones, A.
    Haines, T.
    O'Connor, V.
    Watson, G.
    Peterson, R.
    Jull, G.
    Date
    2012
    Type
    Journal Article
    
    Metadata
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    Citation
    Watson, Kathryn and Wright, Anthony and Morris, Norman and McMeeken, Joan and Rivett, Darren and Blackstock, Felicity and Jones, Anne and Haines, Terry and O'Connor, Vivienne and Watson, Geoffrey and Peterson, Raymond and Jull, Gwendolen. 2012. Can simulation replace part of clinical time? Two parallel randomised controlled trials. Medical Education. 46 (7): pp. 657-667.
    Source Title
    Medical Education
    DOI
    10.1111/j.1365-2923.2012.04295.x
    ISSN
    0308-0110
    URI
    http://hdl.handle.net/20.500.11937/17061
    Collection
    • Curtin Research Publications
    Abstract

    Context: Education in simulated learning environments (SLEs) has grown rapidly across health care professions, yet no substantive randomised controlled trial (RCT) has investigated whether SLEs can, in part, substitute for traditional clinical education. Methods: Participants were physiotherapy students (RCT 1, n = 192; RCT 2, n = 178) from six Australian universities undertaking clinical education in an ambulatory care setting with patients with musculoskeletal disorders. A simulated learning programme was developed as a replica for clinical education in musculoskeletal practice to replace 1 week of a 4-week clinical education placement. Two SLE models were designed. Model 1 provided 1 week in the SLE, followed by 3 weeks in clinical immersion; Model 2 offered training in the SLE in parallel with clinical immersion during the first 2 weeks of the 4-week placement. Two single-blind, multicentre RCTs (RCT 1, Model 1; RCT 2, Model 2) were conducted using a non-inferiority design to determine if the clinical competencies of students part-educated in SLEs would be any worse than those of students educated fully in traditional clinical immersion. The RCTs were conducted simultaneously, but independently. Within each RCT, students were stratified on academic score and randomised to either the SLE group or the control (‘Traditional’) group, which undertook 4 weeks of traditional clinical immersion. The primary outcome measure was a blinded assessment of student competency conducted over two clinical examinations at week 4 using the Assessment of Physiotherapy Practice (APP) tool.Results: Students’ achievement of clinical competencies was no worse in the SLE groups than in the Traditional groups in either RCT (Margin [Δ] ≥ 0.4 difference on APP score; RCT 1: 95% CI − 0.07 to 0.17; RCT 2: 95% CI − 0.11 to 0.16). Conclusions: These RCTs provide evidence that clinical education in an SLE can in part (25%) replace clinical time with real patients without compromising students’ attainment of the professional competencies required to practise.

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