"From Classroom to Clinic": Enhancing Physiotherapy Education with Simulation and Applied Learning Pedagogies

<p dir="ltr">BACKGROUND: The transition from academic to clinical training is often challenging. While academic modules are well-structured, students on clinical placement education (CPE) must demonstrate competencies in a hyper-dynamic work environment. To address these challenges, a Simulated Practice Education (SPE) module was developed. SPE mimics the activities students will encounter during CPE in three sequential steps: gathering information from medical records, conducting physiotherapy assessments and interventions, and documenting in medical records. This abstract discusses our pedagogical approach, implementation experiences, and outcomes. </p><p dir="ltr">METHOD: Simulation-based education forms the cornerstone of SPE's instructional design. The learning activities were guided by evidence-based applied learning pedagogies. To ensure authenticity, we crafted scenarios that mimic the prototypical patients that students will encounter during CPE. The importance of active, engaged, reflective, and collaborative learning was emphasized throughout each learning activity. Peer role-play, where learners act out roles in case scenarios, was introduced to address the cognitive, psychomotor, and affective competencies. We incorporated three typologies of role-play: Role switch, Acting, and Almost Real-life. To activate metacognition, we designed two layers of feedback after role-play: a peer-led debrief within the subgroups followed by a faculty-led debrief in the large group. Students were also tasked to re-analyze their role-play video footage, write a personal reflection incorporating the feedback from the debrief, and individually document the role-play activities mimicking an electronic medical record. We evaluated SPE using end module feedback centrally administered by the university and qualitative analysis of reflection writings. </p><p dir="ltr">RESULTS: After establishing feasibility with five students in 2023, SPE was offered to 157 Year-3 physiotherapy students in 2024, supported by 14 teaching faculties. Barring a low module feedback response rate (n=23, 15%), 78.3% agreed or strongly agreed that the learning activities were engaging, and 82.6% agreed or strongly agreed that the SPE was effective for their learning. Half of the respondents provided comments appreciating SPE in preparing them for CPE. The reflection writings were insightful and some even transformative, suggesting that reflection after feedback can foster deeper understanding and growth. The writings also affirmed that students can play realistic patient roles and provide meaningful feedback. We encountered multiple technical hiccups during the implementation. We identified five critical factors: 1) ensuring cybersecurity and stress testing the technology to support a large cohort, 2) orienting students to new technology and learning strategies (e.g., acting and debriefing), 3) roles rostering to ensure everyone experiences 'Role switch' and 'Acting', 4) designing high-fidelity simulation with acting scripts for the patient and observer, and 5) organizing structured orientation for faculty. </p><p dir="ltr">CONCLUSION: The SPE module effectively prepares physiotherapy students for CPE by simulating real-world scenarios and emphasizing active, reflective learning. Despite technical challenges, the module's success highlights the importance of structured, evidence-based pedagogical approaches in healthcare education.</p>