The Effect of Digital-Based Simulation on Physiotherapy Students

Study Overview
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Brief Summary
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In physiotherapy and rehabilitation education, basic medical courses, clinical information, rehabilitation approaches, special teachings of the profession, clinical problem solving and analysis in their fields are taught during university education. Musculoskeletal problems will be selected for the patient scenarios to be used in the simulation and algorithms will be arranged for the simulation. After the algorithms are created, a website with patient scenarios containing these algorithms will be established with the support of a software company. In addition to the website, a database will be created and the applications made on the site will be recorded. In our study, stepped wedge design will be used. 100 volunteer students participating in the study will start face-to-face training after preliminary evaluations are made. Afterwards, every two weeks, a randomized group of 20 people will be included in the hybrid training, which includes both face-to-face and simulation training. In the face-to-face education group, the educational content prepared in parallel with the patient scenarios in the hybrid education group will be applied in the classroom environment by the students together with the educators themselves. In the hybrid training group, one case analysis will be done every week on the website designed under the supervision of researchers, and one case analysis will be done through face-to-face training. The self-efficacy and clinical reasoning levels of the students included in the study will be evaluated with the Physiotherapist Self-Efficacy Questionnaire and the Clinical Reasoning Assessment Tool. The same evaluations will be repeated after the students in both groups have completed their 10-week education. Afterwards, students' satisfaction levels and suggestions from the simulation will be evaluated with qualitative questions, and opinions and suggestions about simulation will be collected by creating themes.

Detailed Description
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Clinical reasoning is one of the most fundamental skills in health professions education and is essential for engaging in clinical practice. In many studies, it is stated that the learning of the clinical reasoning process in undergraduate students should be included in the curricula and learning objectives. Self-efficacy is a concept that is effective in shaping one's behavior. Academic self-efficacy is the individual's belief in himself about how successful he will be in the face of the academic tasks he will face throughout his academic life and at what level he can fulfill these tasks. In recent years, digital learning designs have been increasingly used in teaching practices in higher education. Various designs offer opportunities to improve self-regulation abilities, facilitate active learning, and make the learning process more transparent. It covers a variety of technologies such as digital learning designs, virtual reality, podcasts, apps, educational games, 360° video and animations. These technologies can be applied directly in learning activities or combined with other planned learning activities. In studies, digital learning designs in physiotherapy education have been criticized because they are not based on a theoretical learning perspective. A systematic review on the role of computer-assisted learning in physiotherapy education concluded that it has been substantially less researched compared to other health professions education.

Official Title
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The Effect of Digital-Based Simulation Education on Self-Efficacy and Clinical Reasoning Skills in Physiotherapy and Rehabilitation Students

Conditions
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Self-efficacy, Clinical Reasoning

Intervention / Treatment
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* Device: Digital based simulation
* Other: Face to face education


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Being an undergraduate student at Marmara University Faculty of Health Sciences Physiotherapy and Rehabilitation Department Having agreed to participate in the study Being in the 6th semester of their studies Exclusion Criteria: Refusing to participate in the study

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 25 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Crossover Assignment
Interventional Model Description: Stepped wedge design
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Hybrid Education<br>100 volunteer students participating in the study will start face-to-face training after preliminary evaluations are made. Afterwards, a randomized group of 20 people will be included in the simulation training every two weeks. In the face-to-face education group, a case analysis will be applied by the students themselves together with the educators in the classroom environment. In the simulation group, one case analysis will be made every week on the website designed under the supervision of researchers. | Device: Digital based simulation<br>* Algorithms will be created for various musculoskeletal diseases and these algorithms will be controlled by taking the opinions of physiotherapists and physicians who are experts in their fields. After the algorithms are created, a website with patient scenarios containing these algorithms will be established with the support of a software company. In addition to the website, a database will be created and the applications made on the site will be recorded. In this way, the data of users using the website will be collected.<br>|
| Active Comparator: Face to Face Education<br>100 volunteer students participating in the study will start face-to-face training after preliminary evaluations are made. Afterwards, a randomized group of 20 people will be included in the simulation training every two weeks. In the face-to-face education group, a case analysis will be applied by the students themselves together with the educators in the classroom environment. In the simulation group, one case analysis will be made every week on the website designed under the supervision of researchers. | Other: Face to face education<br>* In the face-to-face education group, two case analyzes will be applied by the students together with the educators themselves in the classroom environment, with the educational content prepared in parallel with the patient scenarios in the simulation-based education group.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Self-efficacy will be measured using a Turkish version of Physiotherapist Self-Efficacy Questionnaire-musculoskeletal area. | The questionnaire consists of 13 items. The participants will asked to indicate their confidence to perform the described task (1 = very little confidence; 5 = a lot of confidence). Higher scores are related more confidence self-efficacy. Outcomes will be evaluated before and after the intervention. | 10 weeks | 
| The 'Clinical Reasoning Assesment Tool (CRAT)' will be used in clinical reasoning assessment. | The CRAT, a rubric scale, is scored by the evaluator marking on the Visual Analog Scale. CRAT aims to assess students' readiness to enter the clinical setting and facilitate student self-monitoring. The tool aims to actively participate in the student's development by identifying strong or weak areas in three areas (content knowledge - procedural knowledge and psychomotor skill - conceptual reasoning). Outcomes will be evaluated before and after the intervention. | 10 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Digital based simulation, Face to face education, Physiotherapy and rehabilitation students