Simulation to Teach Patient Transfers: The Role of Self-Efficacy

Transferring patients is a complex activity that can result in injury to the patient and healthcare professional. There is currently no widespread standard method to teach therapy students patient transfer skills. Simulation is one method to educate students to safely transfer patients, however, research examining the use of simulation to teach and evaluate patient transfer skills is limited. For this study we developed acute care scenarios with embedded critical events to teach transfer skills to occupational therapy students in the context of a medical theatre and with the use of a simulator, SimMan®. Scenarios mimicked common situations encountered when treating a medically complex patient. These situations included management of respiratory equipment, management of external lines, drains and tubes, and management of medical instability during the patient encounter. Performance assessment forms for each scenario provided objective criteria to assess student learning and performance. Using cognitive learning theory, the relationship between active participation and active observation was examined. Knowledge, skill, and safety self-efficacy data were collected. Over time, students with a combination of observation and participation experiences reported no difference in self-efficacy ratings when compared to students with participation experiences only. However, after the second exposure to SimMan®, skills self-efficacy ratings were greater for students who actively participated twice and observed once. Self-efficacy ratings after transfer experiences were not predictive of future performance of transfer tasks. Self-efficacy declined between the classroom and the medical theatre, and increased with repeated exposures to SimMan® scenarios. Ratings for knowledge and skills self-efficacy were closely related to each other over time and across classroom, simulation center and clinical environments. In contrast, safety self-efficacy ratings were more closely associated with environmental changes