1. Does Immersive Simulation Training Improve Self-Confidence of Junior Physiotherapists Performing ICU Clinical Skills? D Seller, L Beavers, K Brock, R O’Brien St Vincent’s Hospital, Melbourne

2. Disclosures and Acknowledgements No conflicts of interest to declare Study tour undertaken 2009, funded by Victorian Government Department of Health “Improving care for older people and people with complex needs” scholarship

3. Background St Vincent’s Physiotherapy Department been using simulation training for ICU Skills Training since 2010 – To address staff training issues Growing research base for simulation training in physiotherapy education – Currently limited to undergraduate education

4. Aims of project To investigate the effect of: A modular, immersive simulation training program On self-confidence Of qualified junior physiotherapists

5. Method Junior Physiotherapists at St Vincent’s Hospital (n=13) Purpose-designed survey (SurveyMonkey) – Demographics (i.e. previous experience) – Self-rated confidence – Perceived ongoing learning needs Multiple different aspects of physiotherapy in ICU

6. Method: Confidence Survey 5 point Likert Scale 3 domains, multiple components each domain: Independent Practice in ICU 7 Components Patient Assessment in ICU 6 Components Physiotherapy Treatment Techniques in ICU 17 Components

7. Participant Flow Pre-program survey: n = 13 ICU Skills Program for Junior Physiotherapists 1-4 modules, based on clinical scenarios Post-program survey: n = 11 Within 2 weeks of start of program Within 2 weeks of end of program

8. ICU Skills Program for Junior Physiotherapists Module 1: Introduction to Simulation + General Assessment of an ICU Patient Module 1: Introduction to Simulation + General Assessment of an ICU Patient Module 2: Cardiovascular Assessment of an ICU Patient Module 2: Cardiovascular Assessment of an ICU Patient Module 3: Tracheostomy Management Module 3: Tracheostomy Management Module 4: Acute Respiratory Failure Module 4: Acute Respiratory Failure

9. Module design Structured Debrief Scenario B Participants : 3 + 4Observers:1 + 2 Structured Debrief Scenario A Participants : 1 + 2Observers:3 + 4 20-30mins 5-10mins 20-30mins 5-10mins

10. Results - Data analysis 11/13 (85%) completed follow-up survey Matched pairs design Wilcoxon’s Signed Rank Test for Related Samples Significance at p <.05 Scores for each domain combined to provide aggregate score Domain IndependenceAssessmentTreatment Total 353085

11. Results - Independence Significant increase: p =.005 Formal competency assessment done as part of 1:1 weekend training Our junior physiotherapists work alone on weekends Med (IQR) 23 (23-27)28 (26.5-29.5)

12. Results - Assessment Significant increase: p =.007 Med (IQR)20 (17.5-22)24 (22.5-25)

13. Results - Treatment Significant increase: p =.007 Med (IQR)50 (45-58.5)59 (57.5-68)

14. Conclusion A modular, immersive simulation program targeting specific ICU clinical skills improved confidence in a group of relatively inexperienced physiotherapists.