Background/context When dealing with acutely ill patients, confidence and competence are likely to be important. Without confidence, efficient clinical reasoning and decision-making may not occur. Self-confidence is an important resource that sustains a nurses’ ability to problem solve.1 Little is known about the confidence of on-call physiotherapists despite their frequency of lone working and important clinical decision making.
In this study we aimed to assess the effect on self-reported confidence following a package of ‘on-call’ training using different methods including high-fidelity simulation.
Methodology A programme was devised using a stepwise approach to identify key features of the educational process such as learners’ needs, technical/non-technical skills and learning objectives. This has since been developed further as a process guide.
The programme consisted of four common or important on-call scenarios employing high-fidelity simulation (SimMan 3G, Laerdal); a recently extubated post-operative patient with retained secretions, a respiratory compromised tetraplegic with complex psychological issues, an unstable patient in multiple-organ failure and a patient with a blocked tracheostomy. A further paediatric scenario utilised a part-task trainer. All participants were qualified, ‘On-call’, physiotherapists.
Pre and post confidence was assessed using a modified ‘ACPRC On-call Clinical Competency Questionnaire’.2 All participants completed one simulation in small groups. All simulations were viewed remotely. De-briefing was video-assisted.
Results/outcomes 24 on-call competent Physiotherapists participated. 81% had been on-call competent for over a year. 42% had been qualified for over 3 years.
34% were confident in common on-call problems prior to training, post training this was 93%.
Potential impact Our study suggests that a high-fidelity simulation training programme improves the confidence of on-call Physiotherapists. This programme is simple to implement, relevant to on-call problems, and may impact on patient outcomes and safety. The process guide devised will require implementation and evaluation.
Fry M, MacGregor C. Confidence and impact on clinical decision-making and behaviour in the emergency department. Australasian Emerg Nurs J 2014;17(3):91–97
Thomas S, Gough S, Broad MA, Cross J, Harden B, Ritson, P, Quint M. On call competence: developing a tool for self-assessment. Physiotherapy 2008;94: 204–211
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.