Measuring and Describing Occupational Therapists' Perceptions of the Impact of High-Fidelity, High-Technology Simulation Experiences on Performance.

IMPORTANCE: As the use of simulation in occupational therapy education continues to increase, so too does the need for continued research on its impact on clinical practice performance and the value of simulation as a pedagogic method. OBJECTIVE: To develop a survey to measure the perceived impact of high-fidelity, high-technology simulation experiences during occupational therapy education on occupational therapists' performance and to describe occupational therapists' perceptions of the impact of simulation on clinical skills. DESIGN: Cross-sectional descriptive study. SETTING: Online survey administration. PARTICIPANTS: Occupational therapists completed an online survey to measure their perceptions of the impact of high-fidelity, high-technology simulation experiences on essential skills in four performance domains: confidence, knowledge, clinical skills, and patient safety skills. RESULTS: Sixty-seven occupational therapists perceived participation in simulation experiences during occupational therapy education had more impact on transferring clients and using safe body mechanics than on communicating with clients, assessing vital signs, or applying clinical reasoning. The survey items had evidence of content validity, and scores showed good internal consistency reliability. CONCLUSIONS: Survey results suggested high-fidelity, high-technology simulation during occupational therapy education may affect clinical practice performance. Additional research is needed to determine the effectiveness of simulation education in preparing occupational therapists for clinical practice. WHAT THIS ARTICLE ADDS: The survey developed in this study is a reliable measure of the impact of simulation experiences on clinical practice performance of occupational therapists.

Wheelchair Transfer Simulations to Enhance Procedural Skills and Clinical Reasoning.

OBJECTIVE: We describe an educational intervention that involved simulation scenarios of medically complex patients to teach transfer training and promote clinical reasoning. METHOD: Scenarios were developed with practitioner input that described (1) a patient who was acutely ill, (2) a critical medical management event that occurred during a bed-to-wheelchair transfer of the patient, and (3) an occupational need. Transfer training, using the scenarios, occurred in a high-technology laboratory with SimMan(®) and a mock hospital suite. Evaluation was based on student performance and perceptions of simulation effectiveness. RESULTS: On average, students completed 66%-88% of the transfer items correctly. Student performance suggested that the simulation scenarios were more difficult than practitioners rated them. Students rated the simulation scenarios as effective teaching tools. CONCLUSION: Scenario use in simulations for transfer training makes a positive curricular contribution to teaching procedural skills and clinical reasoning simultaneously.

Simulation Strategies to Teach Patient Transfers: Self-Efficacy by Strategy.

OBJECTIVE: We evaluated the effects of transfer training-after training in the classroom and in the high-technology simulation laboratory (WISER Center)-on students' perceptions of their self-efficacy for knowledge, skill, and safety in executing dependent transfers. METHOD: After classroom training, occupational therapy students were randomized to three teaching groups on the basis of the amount of participation and observation opportunities provided at the WISER Center-observation dominant, participation dominant, and participation only. RESULTS: The participation-dominant group reported an increase in knowledge self-efficacy over time compared with the observation-dominant and participation-only groups. Over time, self-efficacy ratings increased for all students, regardless of group. CONCLUSION: Simulation scenarios implemented at the WISER Center provided a useful adjunct to classroom training in transfer skills. Both participatory and observational experiences contributed to the development of students' perceptions of their ability to manage acutely ill and medically complex patients.

Therapeutic horseback riding outcomes of parent-identified goals for children with autism spectrum disorder: an ABA' multiple case design examining dosing and generalization to the home and community.

We examined whether different doses of therapeutic riding influenced parent-nominated target behaviors of children with autism spectrum disorder (ASD) (a) during the session (b) at home, and (c) in the community. We used a single subject multiple Baseline, multiple case design, with dosing of 1, 3, and 5 times/week. Three boys with ASD, 6-8 years of age participated, and counts of target behaviors were collected in each setting and phase of the study. Compared to Baseline, 70% of the target behaviors were better during Intervention and improvement was retained in 63% of the behaviors during Withdrawal. Increased doses of therapeutic riding were significant for magnitude of change, and the effect of the therapeutic riding sessions generalized to home and community.