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Simulation program unmasks the reality of clinical interactions

APA Neurological Physiotherapist Narelle Dalwood
1 August 2017

Simulation provides excellent learning opportunities for students. It is used in a range of clinical health programs and is a promising way to prepare students for their release ‘into the wild’, working with real people in the clinical setting. However, the financial costs of simulation may be prohibitive for sustained inclusion in curricula. Large cohorts and geographical, time and staffing constraints may also limit the time each student can spend working with a simulated patient. As a result, simulation programs may be run infrequently, with students working in groups and individuals only performing one isolated aspect of the patient interaction.

Recognising the value of simulation, but all too aware of the potential barriers, Monash University’s Physiotherapy Department decided to use the most valuable and abundant resource they have for their simulation program—the students themselves.

In third year, undergraduate students at Monash participate in a weekly peer simulation program, using each other as patients. This program runs in the pre-clinical semester with the aim of providing awareness of the realities of impending clinical placements. Each student has the opportunity to portray both the physiotherapist and the patient role for each of the sessions, and tutors circulate the room portraying the role of clinical supervisors.

Students enjoy the process of practising their developing skills on each other but commonly report difficulties creating a realistic patient portrayal. In an effort to minimise familiarity when working with their student peers, masks and costumes are worn by those playing the role of patient. Concealing patient identity seems to increase student engagement and enhances all participants’ ability to suspend disbelief. Those portraying the physiotherapist role are often unsure exactly who is behind the mask and are able to engage in their professional role more readily than when working with an easily identifiable and familiar fellow student.

Additionally, the use of masks appears to change patient behaviour, with students appearing to portray the role more authentically when their identity is visually altered. Overall, the program has been a great success with common feedback such as ‘I really enjoy the experience. Every student tries their best to fulfil their role and it is great at identifying the strengths and weaknesses in our knowledge.’ Students and tutors alike express surprise that elements of the clinical interaction can be so readily replicated in a relatively inexpensive and sustainable way.


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