On-Call Simulation - The Student Perspective

As students about to graduate into the scary world of Physiotherapy, we have come across many horror stories and a common theme is on-call.

To set the scene, it’s raining outside… its 2am… you’ve had no sleep and the phone goes. There’s a rapidly deteriorating patient on ITU, who needs physiotherapy input immediately and it’s down to you – a relatively inexperienced 21 yr old newly qualified physiotherapist. GULP!

However terrifying it seemed initially, the patient was treated successfully with the support of the surrounding MDT and you get home safe and dry. But why was it so terrifying? And could it have been done better?

We graduate on the basis that we are competent physiotherapists and are able to apply our knowledge to any patient; but this does not necessarily come with a high level of confidence.

So how do we build this…

There has recently been many links made between healthcare and aviation, as they are both safety critical industries. This has highlighted the need for simulation in healthcare, which can create situations where learning can take place in a zero risk environment.

We recently completed a respiratory on-call simulation day in partnership with the ACPRC. In one room lay a SimMan controlled by a technician and in the other room a live feed for the rest of the cohort to watch, learn and feedback.

For each scenario, two students worked together to assess and treat the patient. Following the assessment, they clinically reasoned and carried out their treatments and were able to see immediate effects, through monitoring vital signs and physical symptoms.

After the not-so- stressful simulation, the students returned to the rest of their cohort to debrief with peers and senior lecturers. This was incredible as this allowed immediate feedback through watching the simulation again and consolidated our decisions. This facilitated shared practice through mutual learning.

For us, however terrifying it was going in to treat a plastic patient, the ability to fail without repercussions in a supportive environment was invaluable. The on-call simulation boosted our confidence levels to mirror that of our competence.

Through the wider practical application of simulation in our current healthcare system, significant avoidable mistakes due to human factors could be drastically reduced, as we change our culture of hiding from our mistakes to learning from them.

If every one person walks away from simulation having learnt from one mistake, which saves one life, the impact on our healthcare system could be huge. So now, when it is 2am and we get that call, we bounce out of bed in the knowledge that we’ve got this.

Hilary Smith and Becca Knowles, Student Physiotherapists

Twitter contact:

@Hi_lary90  @Becca_Knowles_  @emaroids1  @RobynStiger