Simulated Learning Experiences Impact on Acute Care Confidence Development in Students with Low Resiliency

ABSTRACT

PURPOSE/HYPOTHESIS: The COVID-19 pandemic has taken a toll on the psychological resilience of healthcare workers across the world but has also had a significant impact on healthcare professionals in training. The pandemic has required educators to adapt how they teach but also to take into consideration innovative learning activities to increase students' resiliency. The purpose of this study was to assess the impact of high-fidelity human simulation (HFHS) sessions on acute care confidence in a critical care setting in physical therapy students' who rate their resiliency at low levels. NUMBER OF SUBJECTS: Eighty-one DPT students. MATERIALS AND METHODS: One week prior to the HFHS sessions each subject completed the Acute Care Confidence Survey (ACCS) and the Brief Resiliency Scale (BRS). All subjects participated in 2 HFHS sessions in a 3-member team and were given objectives and a case history 1 week prior to each HFHS experience. The HFHS used the Laerdal's SimMan 3G manikin equipped with an oxygen delivery system, lines and tubes and a monitor displaying vitals. The format for each simulation lab included a 15-minute pre-brief session, a 20-minute SimMan encounter and an immediate 15-minute debrief session. Following the completion of the HFHS learning experience each student completed a second ACCS. RESULT(S) A Kruskal-Wallis test was used to compare confidence score across low, normal, and high resilience groups. Low and normal resiliency level students had significantly lower confidence in manual skills prior to simulation (P< 05) compared to their high resiliency counterparts. Following simulation, all resiliency groups demonstrated confidence improvement that resulted in no significant differences between the groups. A Wilcoxon Signed Ranks Test revealed significant improvement in all confidence scores for each group following simulation. CONCLUSION(S) Resiliency levels did not impact students' ability to gain confidence from simulation training. HFHS when graded has been shown to increase stress and decrease confidence in students. These HFHS learning activity exposures were not graded which may have allowed those students with lower resiliency to learn in a less stressful environment and still develop confidence. A positive change in student confidence may be more related to a graded exposure to an acute care setting that allows skill development in a low stress environment. CLINICAL RELEVANCE The simulation sessions increased student confidence by providing a realistic clinical environment and expectations, with confidence being less impacted by a student's resiliency. This low stake learning environment provided a valuable opportunity for students to improve clinical confidence regardless of their self-rated resiliency level.