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0077 Does high-fidelity simulation improve the confidence of on-call physiotherapists?
  1. Abigail Hughes,
  2. Christopher Goddard
  1. Southport and Ormskirk Hospital NHS Trust, Merseyside, UK


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.


  1. 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

  2. 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

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