University Clinical Skills & Simulation Center
Physical Therapy Program
The Department of Physical Therapy has integrated the use of standardized patients into the entry level graduate curriculum. Department faculty collaborate with the UCSSC team to develop and produce realistic but safe learning experiences for the physical therapy students. The actors serving as standardized patients learn how to simulate weakness, poor motor control, spasticity, non-responsiveness to certain stimuli, as well as learning lines. The simulated experiences include a more realistic hospital environment than students experience in the physical therapy lab, including hospital beds, foley catheters, and a variety of other lines and attachments, depending on the scenario being simulated.
Key Points in Department of Physical Therapy Simulation Experiences
Physical therapy students currently engage in three different learning experiences using standardized patients.
- During PT 601: Rehabilitation: Continuum of Care, standardized patients are trained to present with a pattern of muscle weakness and sensory loss consistent with a certain level of spinal cord injury. They present in a simulated ICU setting with foley catheters, IV’s, and other paraphernalia common in an ICU setting. Students work in pairs to do an initial PT evaluation of these standardized patients.
- During PT 616: Neuromuscular Physical Therapy I, standardized patients are trained to simulate a pattern of loss of selective motor control common for patients with stroke. Students individually administer a standardized assessment tool (Fugl Meyer) to practice evaluating selective motor control. Some of the standardized patients start in a hospital bed and the students must safely transfer the patient into different positions in order to complete all the components of the test.
- During PT 716: Neuromuscular Physical Therapy II, standardized patients are taught to simulate patients who are just starting to emerge from coma. They are minimally responsive, and present with a pattern of motor deficits, sensory deficits, and spasticity that changes with position. Students work in pairs to do an evaluation of this patient, and to position this dependent patient in bed in a way that minimizes risk of contractures.
Students receive feedback regarding their interpersonal and physical handling skills from the standardized patient.
Student-standardized patient encounters are videotaped. Each student receives a DVD recording of his or her encounter. Students view these recordings to assess their own professional behavior, body mechanics, and competence at performing the appropriate examination techniques. Self assessment and reflection help students strengthen their clinical reasoning skills, interpersonal skills and body mechanics.
Examples of Student & Faculty Evaluation of the Simulation Experience
“It was much more applicable to a real life scenario than performing the lab on our peers. It was great to not only be with standardized patients who were trained how to respond (or not respond) but it was great to be in a setting that really seemed like an inpatient hospital room. Our patient did a great job acting out spasticity, clonus, and non-responsiveness. I pulled her eyelid open and she did NOTHING! Amazing. I wouldn’t have been able to do that!”
“I liked that at the end of the lab they were able to give us constructive feedback about what things worked or didn’t work. It answered a lot of questions that I am asking myself when treating a patient. It is a unique experience that allows you to see through the eyes of the person being treated.”
“It was helpful to be able to practice our evaluation skills in a real setting, making sure to be careful of the various tubes, lines, and foley catheter when transferring a patient.”
“When students act like patients for each other they find it hard to stay in role. Students treat the standardized patients like real patients, and therefore are better able to practice problem solving on the spot while maintaining professional behavior.”
“When students are playing a comatose patient, they manage to help their partners reposition them as needed, whereas standardized patients act more like real patients and force students to practice realistic dependent transfers and repositioning”.
Adel Herge, OTR