Are Final Year Physiotherapy Students Able To Independently Recognise Errors Encountered In Their Own Simulated Practice?

AIMS:
The aim of this study was to explore the error recognition ability of final year physiotherapy students when reviewing their own high-fidelity cardio-respiratory simulated learning experience.

BACKGROUND:
Innovations in teaching and learning within physiotherapy education have included various forms of simulation based education including the use of simulated or standardized patients, clinical training wards and video vignettes. Only one video analysis study has provided an insight into how qualified physiotherapists communicate with patients about errors of performance. No published studies have explored error recognition abilities of physiotherapy students with regards to their own simulated experience.

METHODS:
A sequential explanatory mixed methods strategy was designed to explore the application of SBE within cardio-respiratory physiotherapy. The overarching methodology drew inferences from both action research and (video) ethnography. The Think Aloud Review (TAR) method was chosen as a method to stimulate the participants to review their SLE experience, with an emphasis on error recognition. All 12 TAR video interviews and simulated practice videos were transcribed verbatim and analysed using a thematic framework approach.

RESULTS:
All twenty-seven volunteer physiotherapy students (34% of the maximum available sample) participated in 12 simulation and TAR interviews. Students were able to independently identify ‘active failure’ error types from their video. Student typically identified more errors and in much more detail whilst/after reviewing their video. Despite using the TAR method, students were not always able to identify all errors made during the simulation. Although students independently reflected on their actions, the detail provided was mainly superficial during the TAR (without faculty facilitation, pre-debrief). Thematic and video analysis identified active failures (e.g. violations including infection control measures), error producing factors (e.g. individual knowledge and skill deficits) and latent errors.

CONCLUSIONS:
Whilst students were able to identify some errors in their simulated practice, they required further facilitative probing to explore the nature and reasons for their errors. The use of TAR method alone was not enough to stimulate deep reflection relating to errors. This session will present an overview of the findings in relation to error recognition, whilst exploring students’ reflections ‘in and on action’ within a simulated environment.

REFERENCES
1. Parry R. A video analysis of how physiotherapists’ communication with patients about errors of performance: insights for practice and policy. Physiotherapy. 2005;91(4):204–214.

2. Van Someren, MW, Barnard, YF., Sandberg JAC. The Think Aloud Method. A practical guide to modelling cognitive processes. London: Academic Press, 1994.

3. Ritchie J, Spencer L. Analyzing qualitative data. In Bryman, A and Burgess, R.G (Eds) Qualitative data analysis for applied policy research. London: Routledge, 1994; pp.173–194.

4. Reason, J.T. Human error. New York, Cambridge University Press, 1999.