My PhD research sought to develop and evaluate a program of peer simulation, and construct preliminary evidence-based recommendations for the design of future peer simulation programs.

 We hoped that this research would increase our knowledge about the potential benefits to students of being formally trained to portray simulated participant roles with each other.

The paper for this month’s “article of the month” is one of the studies arising from this work, titled “‘It’s the ultimate observer role. . .you’re feeling and seeing what’s happening to you’: students’ experiences of peer simulation”.

This study sought to deeply explore students’ perspectives and experiences of both portraying simulated participant (SP) roles, and interacting with their peers who portrayed SP roles.

We conducted focus groups with students who participated in a blended learning program of peer simulation, and analysed the data with an inductive thematic analysis approach.

We found that students thought that peer simulation was a valuable learning approach, as it was unexpectedly realistic, revealed knowledge and skill deficits, and improved their clinical skills.

In addition, (and what we found most exciting), students described that being the patient in peer simulation gave them unique and powerful insight into patients’ experiences of healthcare and healthcare interactions.

Specifically, students described increased insight into the impacts of patient-related safety (such as attachments and manual handling), what it feels like to experience specific symptoms (such as shortness of breath and movement restriction), and of how health conditions, hospital admissions, and prolonged recovery can significantly impact a person’s life. This was reflected by students to be profoundly relevant and important in their development of clinical and empathy skills.

Some illustrative quotes from students include:

“The oxygen mask we had on, she was moving me, but almost choking me at the same time because she wasn’t moving it…in a real-life situation, if you are moving a patient, you need to make sure that IV drips and everything get out of the way.”

“When I was the patient, something that I really started thinking about is. . .how it impacts your life, how you’re going to get from A to B, how you’re going to get into your car. . .I should be asking these things, I should be finding out what this person is doing in their daily life and how this disorder or injury is really impacting them.”

Interestingly, these insights relating to the patient perspective largely originated from portraying the patient role. We know that most SBE in health professional education settings involves the learner as the practitioner, rather than as the patient. In the context of these findings, achieving similar learning about patient experiences is unlikely to be possible with SBE that only involves the learner predominantly simulating a practitioner role.

Therefore, we’ve since incorporated regular, formal peer simulation experiences as part of the core education sessions within our undergraduate physiotherapy program.

The development of detailed patient scenarios (with real patient input), formal education on core portrayal skills, feedback and guidance regarding patient portrayal, and setting up a simulation environment that (somewhat) replicates the clinical environment has been helpful for achieving this.

We’ve anecdotally noticed a significant acceleration of students’ interpersonal and empathy skills since increasing the frequency and formality of peer simulation sessions in the curriculum (with the sacrifice of informal role play and other practical-based activities). 

We would be interested to know your thoughts on this paper and its potential applications to your context.

Authored by Dr Shane Pritchard

PhD, BPhysio, APAM, MACP
APA Research Physiotherapist
Adjunct Lecturer

Monash University
Department of Physiotherapy
School of Primary and Allied Health Care
Faculty of Medicine, Nursing and Health Sciences

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