Department of Rehabilitation Science, University of Buffalo, 515 Kimball Tower, Buffalo, NY 14214, USA.
Phys Ther. 2013 Feb;93(2):216-28. doi: 10.2522/ptj.20110463. Epub 2013 Jan 17.
Rehabilitation of patients in critical care environments improves functional outcomes. This finding has led to increased implementation of intensive care unit (ICU) rehabilitation programs, including early mobility, and an associated increased demand for physical therapists practicing in ICUs. Unfortunately, many physical therapists report being inadequately prepared to work in this high-risk environment. Simulation provides focused, deliberate practice in safe, controlled learning environments and may be a method to initiate academic preparation of physical therapists for ICU practice.
The purpose of this study was to examine the effect of participation in simulation-based management of a patient with critical illness in an ICU setting on levels of confidence and satisfaction in physical therapist students.
A one-group, pretest-posttest, quasi-experimental design was used.
Physical therapist students (N=43) participated in a critical care simulation experience requiring technical (assessing bed mobility and pulmonary status), behavioral (patient and interprofessional communication), and cognitive (recognizing a patient status change and initiating appropriate responses) skill performance. Student confidence and satisfaction were surveyed before and after the simulation experience.
Students' confidence in their technical, behavioral, and cognitive skill performance increased from "somewhat confident" to "confident" following the critical care simulation experience. Student satisfaction was highly positive, with strong agreement the simulation experience was valuable, reinforced course content, and was a useful educational tool.
Limitations of the study were the small sample from one university and a control group was not included.
Incorporating a simulated, interprofessional critical care experience into a required clinical course improved physical therapist student confidence in technical, behavioral, and cognitive performance measures and was associated with high student satisfaction. Using simulation, students were introduced to the critical care environment, which may increase interest in working in this practice area.
在重症监护环境中对患者进行康复治疗可改善功能预后。这一发现促使重症监护病房（ICU）康复计划的实施增加，包括早期活动，这也导致对在 ICU 工作的物理治疗师的需求增加。不幸的是，许多物理治疗师报告称，他们在这种高风险环境中准备不足。模拟在安全、可控的学习环境中提供集中、刻意的实践，可能是为 ICU 实践启动物理治疗师学术准备的一种方法。
本研究的目的是考察参与 ICU 环境中危重病患者的基于模拟的管理对物理治疗学生的信心和满意度水平的影响。
使用单组、前测-后测、准实验设计。
物理治疗学生（N=43）参与了一项重症护理模拟体验，需要技术（评估床移动能力和肺部状况）、行为（患者和跨专业沟通）和认知（识别患者病情变化并启动适当反应）技能表现。在模拟体验前后对学生的信心和满意度进行了调查。
学生的技术、行为和认知技能表现的信心从“有些自信”增加到“自信”，随后进行了重症护理模拟体验。学生的满意度非常高，强烈认同模拟体验有价值、强化了课程内容，并且是一种有用的教育工具。
该研究的局限性在于来自一所大学的小样本量，并且没有纳入对照组。
将模拟的、跨专业的重症护理体验纳入必修临床课程可提高物理治疗学生在技术、行为和认知绩效方面的信心，并且与学生的高满意度相关。通过使用模拟，学生们接触到了重症监护环境，这可能会增加他们在这一实践领域工作的兴趣。
