When COVID-19 cut off hospital placements, universities had to experiment with new ways of learning. Now, RCSI’s experience in simulated training is informing physiotherapy educators worldwide.
COVID-19 led to major changes in teaching and learning. Most significantly, online education leaped forward and more courses became virtual or hybrid.
There was another big – perhaps less unspoken – change: courses with a large practical or placement element had to adapt rapidly. Nowhere was this more pronounced than in the health sciences.
In Ireland, physiotherapy students must complete 1,000 hours of clinical placement across their degree. At RCSI, students must complete a module in clinical placement before moving into second year. Until the pandemic, this had always been a week working in a hospital.
In 2020, however, hospitals across the world were struggling to stay afloat and treat the overwhelming number of patients with severe COVID-19 symptoms. Important surgeries and treatments were being cancelled. In normal times, it can be challenging to find placement opportunities but, with a global pandemic raging, supporting students on a placement week in hospital simply wasn’t possible.
This left physiotherapy educators in a bind. Students still had to engage in practical experience; universities couldn’t simply decide to cancel their placements.
Improved outcomes
Dr Orlagh O’Shea, a Lecturer at RCSI School of Physiotherapy, and Helen Heery, Practice Education Manager at the School, had an idea. RCSI already had one of the most advanced medical simulation labs in Europe – so could they organise a simulated placement?
O’Shea and Heery are among the contributing authors to a recent paper in Physiotherapy Practice and Research, where they outline how the idea of a simulated placement came about, how it was implemented, what can be learned from it and how students and staff feel these placements could be improved for future learners.
There wasn’t a huge amount of academic literature for them to draw from. O’Shea had previously been awarded a research grant to visit Australia – where simulated physiotherapy placements are more common – but COVID-19 restrictions put an end to that.
A safe space
RCSI had to consider a new learning methodology and pedagogy for physiotherapy students at the same time as ensuring physical distance between students. How could the simulation training cover the widest possible range of scenarios?
Personal protective equipment (PPE) had to be sourced. Then there was the question of how this would be assessed. And would they have all the equipment needed?
While simulation training could not fully replace a clinical placement, it does allow students a chance to practice in a safe space without fear of making mistakes that could potentially harm real patients.
The team at RCSI developed a number of scenarios for students to work on, using both manikins and real humans, acting as simulated patients, over five days to explore musculoskeletal, neurological and respiratory conditions. Students spent one day working on care of the older person and, on the fifth day, they participated in a clinical reasoning tutorial and delivered group presentations.
Improving outcomes
In post-training debriefs, students said that the experience increased their confidence, but they also pointed out some ways in which simulation training could improve. One suggestion, for instance, was that students could receive briefing materials earlier.
From this work, RCSI now delivers a one-week simulation placement for second year physiotherapy students, ensuring they are as prepared as possible for their in-person hospital placement.
The RCSI School of Physiotherapy’s research paper provides guidance, learning and insights for other educators who want to deliver simulation education.
RCSI is committed to achieving a better and more sustainable future through the UN Sustainable Development Goals.
