Enhancing physiotherapy education through high-fidelity simulation: a case-based approach to critical care training

Abstract

Background: Simulation-based education is increasingly used in physiotherapy training to bridge the gap between classroom learning and clinical practice. High-fidelity simulation (HF-Sim) offers students a realistic yet safe environment to apply theoretical knowledge, practise complex decision-making, and develop the skills in managing critically ill patients. However, evidence on its structured application in physiotherapy curricula, especially for critical care learning, remains limited. Aim: To evaluate the impact of HF-Sim on perceived clinical reasoning and reflective practice in physiotherapy students managing a case in the intensive care setting (ICU). Methods : HF-Sim was structured around predefined objectives focusing on respiratory pathophysiology, airway/ventilator management, interpretation of investigations, and evidence-based physiotherapy. These guided an HF-Sim scenario where students assessed the patient, interpreted data, and performed interventions. The 26-item Self-Assessment of Clinical Reflection and Reasoning (SACRR) survey was administered pre-and post-simulation to measure the perceived changes in clinical reasoning and reflection. Results : SACRR analysis revealed significant improvements in self-perceived clinical reasoning and reflective skills. Post-test results showed increased confidence in patient assessment, interpretation of investigations, treatment planning, and reflective practice, aligning with the learning objectives and emphasising critical thinking and evidence-based decisions. Conclusion : HS-Sim shows promise in physiotherapy education by providing a structured, safe environment for managing complex ICU scenarios. It helped students apply theory to practice and increased perceived readiness. Future studies should include objective measures and comparative designs to evaluate their impact better.