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Impact of simulated patients on physiotherapy students' skill performance in cardiorespiratory practice classes: a pilot study.

Walker, Craig A.; Roberts, Fiona E.


Craig A. Walker

Fiona E. Roberts


Purpose: To date, no evidence exists that high-fidelity simulation improves skill development among physiotherapy students in the university setting. With pressures to reduce costs and maintain or improve the quality of the learning experience, and with pressures on clinical placement, it is essential to investigate methods that might improve students’ skill performance before they undertake clinical practice. Our study set out to investigate (1) the impact of using simulated patients (SPs) in a practical class on physiotherapy students’ skill acquisition and (2) the students’ reflections on the intervention. Method: We devised a pilot study using a single-centre randomized controlled trial. A total of 28 undergraduate physiotherapy students, matched using previous practical examination grades, undertook a 2-hour practical class in which they practised their core cardiorespiratory skills. Pre-session resources were identical. The control group practised on peers; the intervention group practised on SPs. The students’ skill performance was assessed 2 weeks later using the Mini-Clinical Evaluation Exercise (MiniCEX), including gathering qualitative data from the students’ reflections. Twenty-eight students undertook the practical class and subsequent MiniCEX assessment. Results: A statistically significant difference was found for all aspects of the MiniCEX except medical interview ( p = 0.07) and physical interview (p = 0.69), and a large effect size was found for all areas except physical interview (0.154) and medical interview (0.378). The students’ reflections focused on three key themes: behaviours and attitudes, teaching the active cycle of breathing technique, and feedback. Conclusions: Our findings suggest that interacting with SPs improves student skill performance, but further research using a larger sample size and an outcome measure validated for this population is required to confirm this.


WALKER, C.A. and ROBERTS, F.E. 2020. Impact of simulated patients on physiotherapy students' skill performance in cardiorespiratory practice classes: a pilot study. Physiotherapy Canada [online], 72(3), pages 314-322. Available from:

Journal Article Type Article
Acceptance Date Jun 11, 2019
Online Publication Date Jul 13, 2020
Publication Date Aug 31, 2020
Deposit Date Jun 14, 2019
Publicly Available Date Jul 14, 2021
Journal Physiotherapy Canada
Print ISSN 0300-0508
Electronic ISSN 1708-8313
Publisher University of Toronto Press
Peer Reviewed Peer Reviewed
Volume 72
Issue 3
Pages 314-322
Keywords Simulation; Standardised patients; Physiotherapy; Undergraduate education; Skill development
Public URL


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