1. The future: the full spectrum of simulation
The role of simulation as a teaching and learning tool within the future of occupational therapy education
What is simulation?
Simulation is an umbrella term to describe the technique for practice and learning that replaces and amplifies real experience with guided ones. Varying in forms, simulation encompasses many experiences, each with varying levels of fidelity or perceived realism of the simulation by the learner.
Gibbs et al, 2017, used a mixed methods study to conclude that high fidelity simulation can positively impact students’ perceptions of their knowledge, comfort and confidence from their study examining the impact of an inter-professional simulation experience among occupational therapy doctorate students when handling an acutely ill patients in an ICU setting.
The benefits
The barriers
Protects patients from unnecessary risks, and students from liability, blame and guilt
Bridges the theory practice gap – a solution to practice placement shortages
Allow repetition and practice at varying pace
Provides opportunity for immediate feedback
Lack of guidance and parameters for use from the College of Occupational Therapists.
Lack of conclusive empirical evidence on the impact of simulation
Expensive and time consuming to develop, implement and maintain
The theoretical underpinnings of simulation
Simulation is based upon the principles of experiential learning theory. Founded upon the work of Dewey, Knowles and Kolb, experiential learning suggests knowledge and meaning are constructed through real-life experience. Simulation creates opportunities to build knowledge through the transformation of experience. Underpinned by adult learning principles, simulation draws upon the learners critical reflection of their own actions and experiences. Therefore, it is founded upon learning being a dynamic, active and reflexive process; focusing on the construction of professional identity as much as skill acquisition. Simulation promotes active learning, encouraging students to be self-directed and self-motivated
Knecht-Sabres, 2013, found that experiential learning had a positive impact on occupational therapy students perceived preparedness to perform clinical skills. This finding is backed up by Coker, 2010, who found occupational therapy students felt experiential learning had a positive impact both their clinical reasoning and critical thinking skills required for practice.
The evidence base for simulation in the occupational therapy curricula is growing
The use of simulation is growing in popularity within healthcare. Having historically used case studies, role-plays and mock environments within its curricula, simulation has long been recognised within occupational therapy education, although arguably not always under this label. This may account for the historic lack of literature surrounding the topic, and the rapidly increasing evidence based.
The use of simulation is evolving
A broader spectrum of simulation applications coupled with advances in technology has led to the use of simulation as a teaching and learning tool changing.
The roots of simulation in healthcare education lie in the use of mannequins, actors or simulated environments (e.g mock wards / therapeutic kitchen), which has limited application within occupational therapy (Bradley et al, 2013). Consequently examples of simulation scenarios within mental health are scare.
Today simulation is being used in teaching reflective and integrative practice, which is relevant to complex crisis management, de-escalation of behaviours and the therapeutic use of self (Brown, 2008). The use of technology e.g. virtual learning environments and immersive technology opens new opportunities for a broader application of simulation.
The future of simulation in occupation therapy education offers opportunities to broaden the scope of in which simulation is used. Incorporating innovative ways of developing clinical reasoning skills, decision-making, interpersonal communication skills and team-based competencies in a range of scenarios
The future: the full spectrum of simulation
References
Bradley, G., Whittington, S. and Mottram, P., Enhancing occupational therapy education through simulation. British Journal of Occupational Therapy, 76(1), pp
Brown, J.F., Applications of simulation technology in psychiatric mental health nursing education. Journal of psychiatric and mental health nursing, 15(8), pp
Coker, P., Effects of an experiential learning program on the clinical reasoning and critical thinking skills of occupational therapy students. Journal of allied health, 39(4), pp
Gibbs, D.M., Dietrich, M. and Dagnan, E., Using high fidelity simulation to impact occupational therapy student knowledge, comfort, and confidence in acute care. The Open Journal of Occupational Therapy, 5(1), p.10.
Knecht-Sabres, L.J., Kovic, M., Wallingford, M. and St Amand, L.E., Preparing occupational therapy students for the complexities of clinical practice. The Open Journal of Occupational Therapy, 1(3), p.4.
The spectrum of simulation is broadening – so to should the imagination of how it could be used…….