Does The Use Of Simulation Enhance The Development Of Registered Physiotherapist’s Respiratory ‘On-Call’ Skills – A Literature Review

Background and aim: On-call respiratory physiotherapy is utilized when an acutely unwell patient could deteriorate without immediate assessment and treatment overnight. Education related to this topic varies greatly and is often of poor quality. Simulation-based education (SBE) has been increasingly used within other areas of healthcare yet, Gough et al. [1] completed a study in 2013, which found only 39% of acute trusts used simulation for respiratory on-call training.

Aim: To determine from existing research, whether SBE can enhance the development of registered physiotherapists respiratory ‘on-call’ skills in order to impact future practice.

Methods: A qualitative literature review was completed as part of a PgCert in Health Simulation at Coventry University, in March 2023. Ethical approval was gained from Coventry University (P149952). Studies included were found by searching AMED, CINAHL Embase and Medline databases. Figure 1-A20 presents the PRISMA flow diagram [2]. Final reports included were critically analysed using the Critical Appraisal Skills Programme framework [3] and data extracted and formatted into a table. General themes were identified using an inductive approach.

Results: Eleven papers were selected to be reviewed after the removal of duplicates, screening and the exclusion criteria were applied. The main themes identified were the use of high-fidelity simulation, the measure of confidence and/or competence, and findings of positive implications for practice. SBE is widely used for other healthcare professions with positive outcomes; however, its use within respiratory physiotherapy is limited. Most studies chose to measure self-reported levels of competence and confidence, which is an example of Kirkpatrick level-one evaluation. These measures have only casual links to transfer of knowledge and behaviour change, which are key requirements when applying training to clinical settings. Interestingly, the review also demonstrates favourable use of high-fidelity manikins within this population. Although this was not discussed by the researchers, this may be a barrier for further implementation due to cost and technical knowledge required to use the equipment.

Conclusion: The use of SBE has been beneficial in other healthcare professions and similar positives were found for its use with respiratory physiotherapists. However, much of the research is of low quality, and further research is required to review other confounding factors that may influence the outcomes and longitudinal staff behaviour.

Ethics statement: Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.