Simulation (SIM) provides a controlled learning environment where students can safely experience new clinical situations, stop if they need help and make (or correct) patient-care errors without any concern of negatively affecting actual patients. It enables the replication of a clinical experience within the educational context. For students, SIM is an ‘experience’ where they are ‘immersed’ in a clinical situation as if it is real. It allows them to practice the clinical skills and reasoning needed in that situation and to learn by doing.
The inclusion of simulation in the training of students in medical, nursing and other allied health professions is effective for student learning and has been documented in the training of medical students for over forty years with positive results. An evaluation of the use of SIM in speech-language pathology programs throughout Australia found that simulated learning environments can complement and even replace a portion of traditional placements within clinical programs. Furthermore, SIM in fact can result in superior learning outcomes for students in areas such as development of clinical reasoning skills and working with other professions.
Previous research investigating the use of simulation in speech-language pathology education has determined that it is valued by students and assists in confidence-building and knowledge and skill development.Hall et al., 2020
Designing for SIM
The design and development of a 5-day Mixed SIM Placement in the Master of Speech Pathology was funded by a successful UTS Postgraduate Strategic Grant and led by Professor Bronwyn Hemsley. The funding allowed the employment of a Project Officer (Dr Liss Brunner), who worked with the Speech Pathology academic team and co-ordinated the collaborative effort involved in producing the SIM. The Postgraduate Learning Design Team provided learning design and media production expertise and also worked alongside the Speech Pathology Simulation Coordinator (Dr Amy Freeman-Sanderson) and subject matter experts to ensure the SIM provided an authentic learning experience.
The project involved the design of a placement for students which provides a ‘mixed’ experience of working with both adults and children in clinical areas that are ‘rare’ for students to encounter in a real-world placement. Key elements requiring filming were meticulously scripted and professional actors were engaged and trained to bring these simulated cases to life. Students could play and replay the video materials, as well as complete authentic learning activities and reflections on different branching scenarios that evolve as they managed the SIM client case.
With the shift to COVID-safe online teaching in 2020, speech pathology delivered the five days of simulation to students in an immersive online experience. Leveraging the learning resources already designed for the project, the team was well equipped to make the necessary adjustments to translate the station-based activities into the online mode. For some of these activities, the simulation also provided a faithful representation of engaging professionally online as is needed now in telepractice service models.
Learning through SIM
So, what is it like to be immersed in SIM?
The online resources for students were set up with a carefully considered modular format. Students work through six simulations within each module, and all of these follow a common structure – prebriefing, simulation and debriefing.
In total, 30 simulations were developed cover focus areas in speech pathology:
- Infants with feeding/swallowing disorders (e.g., premature babies, cleft palate), set in the neonatal ward
- Adolescents with language disorders, set in a language clinic
- Adults who use augmentative and alternative communication systems, setting in an acute hospital ward and home living room
- Adults and children who stutter, set in a community clinic
- Adults and children with voice disorders, set in a community clinic
This gave the students exposure to a breadth of clinical areas that they may not necessarily encounter as a student in traditional clinical placements. A formal evaluation of the online SIM placement in 2020 found that the program was a vital consolidation exercise, bringing together students’ knowledge and clinical competencies. The students applied themselves well to the adapted online delivery and reported several benefits of accessing clinical educators from a variety of areas of expertise, aiding their learning and growth in competence and confidence in working with these clinical populations.
In 2021, COVID19 permitting, the 5-day Mixed SIM Placement will be provided in an in-person mode on campus, providing an important avenue for comparing delivery mode and improving the students’ SIM learning experience.