The Operating Theatre Journal - Flipbook - Page 20
Simulation Based Education in Healthcare higher education:
In what ways does it impact perceived clinical confidence, knowledge,
and skills acquisition in student Operating Department Practitioners?
Hayley Queen RODP, BSc (Hons) MA ed, FHEA. Lecturer in ODP Education; School of Healthcare, University of Leicester
With special thanks to Dr Belinda Ferguson and Dr Alison Hardy, both of Nottingham Trent University.
Introduction
Student operating department practitioners (ODP) acquire a vast
range of knowledge and clinical skills throughout their degree. This
consists of both academic learning at the university as well as the
integration of clinical learning acquired in the operating theatres
at their placement hospitals. Literature and healthcare education
policy suggests that traditional classroom-based teaching alone is not
sufficient and simulation-based education (SBE) is advocated as part of
the curriculum, (CODP,2018). Whilst there is growing evidence amongst
healthcare education and social science literature of the effectiveness
of SBE, the true impact is difficult to measure. This study explored and
evaluated the impact of SBE on self-perceived clinical confidence, along
with acquisition of knowledge and skills in a cohort of ODP students at
a UK higher education institution (HEI). Within a healthcare context,
clinical confidence is defined as ‘the self-perceived ability to deal with
clinical scenarios’ (McNair et al ,2016 p1), and is considered critical
in providing quality healthcare and a successful outcome in a patient
centred and safety focused sector, (Usher et al, 2017). For student ODPs,
the requirement to become confident and competent practitioners
upon qualification, (who can perform within their scope of practice) is
obligatory, (CODP,2009). Confidence is also a significant factor of this
study, which seeks to find out the impact of SBE on confidence, as this
can translate towards better patient safety.
Literature review
Lateef, (2010) described SBE as a way to develop health professionals’
knowledge, skills and attitudes, whilst protecting patients from risks.
SBE is widely valued for its ability to replicate clinical scenarios in a
safe and controlled environment that can improve healthcare systems
(Lame & Dixon-Woods, 2018). SBE is mandated in healthcare education
curricula and policy, it is stated within the standards of education and
training for student ODP’s that we must ensure integration of theory
and practice as part of our course delivery, that we must keep our
curriculum up to date with current practice and our programme
delivery must support and develop autonomous and reflective
thinking, (HCPC, 2018). The argument for SBE as a more effective
and advantageous intervention than traditional clinical education is
debated amongst comparative studies, with questions arising about
how one can measure the ‘effectiveness’ of SBE. Some researchers
have chosen to measure perception of confidence after the use of SBE,
whilst others choose to compare other outcome variables to that of
traditional classroom teaching, (McGaghie et al, 2010; Harper et al
2016; McLaughlin, 2018). McGaghie et al (2010) hypothesised SBE as
a means of providing a more superior learning experience by carrying
out a quantitative, meta-analysis spanning twenty years (1990-2010) of
literature. Perhaps the most convincing argument for the use of SBE
is that it can ultimately improve patient safety, with suggestions that
this recent focus has led to a new paradigm of healthcare education,
(Motola et al, 2013). Patient safety, reduction of harm and reduction of
serious errors is a multidimensional concept that is central and crucial
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to healthcare education and can be promoted through simulation.
There is greater focus on enhancing patient safety through reduction
of medical errors (Issenberg & Scalese, 2008. Hughes, 2008) and wider
literature suggests a strong link between better clinical confidence,
better communication, and the positive impact this can have on patient
safety, (Usher et al, 2017).
The evidence suggests that SBE, if carefully implemented into the entire
curriculum of a healthcare course, can be seen as an advantageous
learning experience – one that can improve clinical confidence, level
of knowledge, and skills for healthcare professionals. However, it is
not without limitations; one key issue affecting the educational benefit
of SBE is that of realism or ‘fidelity’, which refers to ‘how accurately
or closely the simulation resembles the actual situation reproduced’,
(Department of Health, 2011. P13). Other implications are that of cost
and resources, which can be a burden.
Methodology, design, and data collection
The purpose of this study was to gain an in-depth understanding of the
perception of clinical confidence, knowledge, and skills of ODP students
after taking part in simulation as part of the taught content of their
degree. The study explored the thoughts, feelings, and perceptions of
human subjects. The study of human beings requires an interpretivist
rather than a positivist approach, interpretivism refers to theories
about how we can gain knowledge from the world, (O’Reilly, 2009) so it
was appropriate to adopt a qualitative approach. Given the qualitative
nature of the design of this study, it was rationalised that the most
effective way of collecting data whilst facing the disadvantages caused
by the Covid-19 global pandemic was to use online data collection
methods, these consisted of surveys and follow up interviews. After
ethics approval was granted from both the institutional ethics panel
and local gatekeeper, participants were invited to share their thoughts
on how a simulation session had influenced their perception. This
was done using pre and post simulation surveys and follow up semi
– structured interviews, with the aim of finding meaning in the ways
SBE impacts the way participants felt about their abilities to perform
their role in a clinical situation after taking part in a simulated life
– threatening scenario; the simulation session selected was that of a
cardiopulmonary resuscitation (CPR) scenario. 16 students took part in
the simulation session, and 11 in total completed both the pre and post
intervention survey. This was recognised as a limitation as the results
of the study could have varied if the other 5 students had decided to
take part, and it was felt that some valuable data could have been lost
because of this.
Discussion of results
Below are two tables showing the results of both the pre and post
simulation surveys. To provide clarity when referring to the results,
they have been presented in percentages of the total participants.
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