Infusing Simulation into the Occupational Therapy Curriculum: On the Cutting Edge
Simulation education is a specialized instructional method designed to create a safe and nonjudgmental space for learners to practice their skills, develop their professional identity and enhance their confidence in a realistic environment. Simulation education is considered the gold standard for training in medicine and has expanded to other healthcare and non-healthcare professions. Depending on the learning objectives, educators can choose from a variety of simulation modalities, including peer-to-peer role play, role-play, manikins and standardized patients in order to craft an experience that the student is prepared for and able to perform successfully. Simulation encounters provide students with real-time feedback so they can modify their interactions with the client. After the learning experience, faculty-led debriefing provides additional opportunities to learn more about how to navigate different circumstances and highlight strengths and areas for growth.
Despite the clear utility of simulation education and standardized patients, it took until 2018 for it to be incorporated into the Accreditation Council for Occupational Therapy Education Standards as an option for Level I Fieldwork. Late in the first decade of the 21st century, Thomas Jefferson University was ahead of the curve with the establishment of the Robert and Dorothy Rector Clinical Skills and Simulation Center on the Center City Campus. With University leadership’s support for all health professions to utilize the resources within the Simulation Center, Dr. Janice Burke, then chair of the Department of Occupational Therapy (and currently professor emeritus), encouraged faculty to learn the specialized training method in hopes of better preparing students for the complexities and dynamics of clinical practice. Faculty participation in the simulation center led to many occupational therapy-based and interprofessional simulation experiences.
The Department of Occupational Therapy, led by, Dr. Audrey Zapletal (Assistant Professor), Dr. E. Adel Herge (Professor), Dr. Tina DeAngelis (Professor), Dr. Tracey Earland (Associate Professor), Dr. Arlene Lorch (Adjunct Assistant Professor), Dr. Kimberly Mollo, (Associate Professor) and Dr. Susan Santalucia, embraced simulation as part of the curriculum in several courses and co-authored an article in the Journal for Allied Health Professions in 2013. One of the first simulation encounters was developed for “Jefferson’s Student Clinic Day” in the Center City Interventions: Enhancing Human Performance. This half-day simulated hospital experience consisted of students completing a 30-minutetreatment session with a SP with a chronic condition, receiving constructive feedback from their SP, and participating in a debriefing session with clinical lab instructors and peers. It also had students using a schedule to locate patients on different floors and gathering equipment from the rehab gym between patients, real-world tasks that were new to many students. After the simulation, faculty and the SP team held a debriefing session. Many SPs commented how occupational therapy students were unique in their approach, encouraging and supportive.
Simulation experiences are a mainstay in the Center City entry-level program curricula and are intentionally being added in specific competencies and courses in the East Falls’ MSOT program. These simulations go beyond what can be practiced in traditional labs and classes, giving students their first experiences of being healthcare practitioners in a safe controlled environment. In collaboration with other simulation-certified OT educators and professionals, Dr. Audrey Zapletal and Dr. E. Adel Herge began to lead simulation workshops for educators at national and international conferences. They gained invaluable expertise and skills through these collaborations, sharing this knowledge through a recently published book, Clinical Simulation for Healthcare Professionals, an instrumental tool for establishing and implementing effective simulation encounters within healthcare education. Dr. Zapletal, as lead author, collaborated with Drs. E. Adel Herge, Joanne Baird, Tracy Van Oss, Maureen Hoppe and Jean Prast from various institutions across the US. The book is a comprehensive resource for designing, implementing and evaluating a single simulation-learning encounter or an entire simulation-based curriculum. Contents of the book include examining the differences among low and high-fidelity simulation modalities, budgeting, training-guides for simulated/standardized patients, debriefing templates and more. This manual consists of sample simulations and worksheets for customizing simulation experiences in a variety of settings and professions as well as for various learning and teaching needs. The book operates as both a how-to guide and a collection of evidence-based research supporting the development and integration of simulation-based education into a new or existing curriculum.
Simulation education is a unique training method designed to enhance student performance and confidence prior to embarking on fieldwork. Using evidence-based approaches simulation education supports student growth and professional identity. For more information on simulation and how to become certified as a simulation educator, visit the Society for Simulation in Healthcare (SSH) and the International Nursing Association for Clinical Simulation and Learning websites. These organizations, SSH in particular, have affinity groups specific to rehabilitation professionals and educators.