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An exploratory study considering the potential impacts of high-fidelity simulation based education on self-evaluated confidence of non-respiratory physiotherapists providing an on-call respiratory physiotherapy service: a mixed methods study
  1. Stephanie K Mansell1,2,3,
  2. Alex Harvey1,4,
  3. Amanda Thomas1,5
  1. 1 University College London, Institute of Child Health, London, UK
  2. 2 Ashford and St Peter’s Hospitals NHS Foundation Trust, Chertsey, UK
  3. 3 Royal Free London NHS Foundation Trust, London, UK
  4. 4 Department of Clinical Sciences, Brunel University, London, UK
  5. 5 Barts Health NHS Trust, London, UK
  1. Correspondence to Alex Harvey, Brunel University London, College of Health and Life Sciences, Department of Clinical Sciences, Uxbridge UB83PH, London, UK; alex.harvey{at}


Introduction Physiotherapists working on-call to provide emergency respiratory services report stress and lack of confidence in on-call scenarios. Simulation-based education (SBE) is a potential solution to improve confidence and reduce stress of on-call physiotherapists. In physiotherapy, use of SBE is sporadic. The aim of this study was to evaluate the addition of SBE to an on-call training programme on non-respiratory physiotherapists’ self-evaluated confidence. Additionally, the study aimed to evaluate if SBE facilitates identification of learning needs.

Methods This cohort study took a mixed methods approach. Participants were recruited from staff providing on-call respiratory physiotherapy services at a UK hospital. Participants received traditional on-call training over 1 year, with SBE added the subsequent year, in a pre-post analysis design. Self-evaluated confidence was assessed with the Association of Chartered Physiotherapists in Respiratory Care Acute Respiratory/On-call Physiotherapy Self-evaluation of Competence (ACPRC) questionnaire. Two focus groups were conducted post-SBE.

Results There were 10 participants. Thematic analysis of focus groups indicated participants found SBE provided coping strategies for on-call working. Using coping strategies taught in SBE reduced stress levels and increased confidence of non-specialist on-call physiotherapists. ACPRC questionnaire scores significantly improved following the addition of SBE (median change 5.5%, p=0.034, r=0.57). SBE assisted in identification of learning needs through recognition of unconscious incompetence and reinforcement of conscious and unconscious competence.

Conclusions SBE may improve self-evaluated confidence of non-specialist on-call physiotherapists. SBE assists in learning needs identification. SBE could enhance training of physiotherapists providing on-call respiratory services. Further larger trials investigating optimal methods of on-call physiotherapy postgraduate education are warranted.

  • simulation based education
  • on-call
  • physiotherapy

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  • Contributors SKM planned the study, obtained permissions, collected the data, analysed the data and prepared the manuscript. AH supervised all aspects of the study and prepared the manuscript. AJT supervised all aspects of the study and prepared the manuscript.

  • Funding This investigation was completed as part of the lead author’s (SMK) MSc studies. As such, financial support to cover student fees was received from Ashford and St Peter’s Hospitals NHS Foundation Trust (ASPH) and the Chartered Society of Physiotherapy. Additionally, funding was provided from the Association of Chartered Physiotherapists in Respiratory Care for the transcription of the focus groups conducted in this study. Supervising author (AJT) received payment from University College London for supervising the project.

  • Competing interests None declared.

  • Ethics approval Ethical approval for this study was obtained from the Ashford and St Peter’s NHS Foundation Trust Research and Development Committee (project ID: 2013SH01) and University College London Research Ethics Committee (project ID: 5152/001).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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