Student actors as patients can teach patience

What do you get when you put a class of budding athletic therapists together with a group of theatre students acting as patients? If you’re the instructor for the Advanced Athletic Therapy and Rehabilitation course (KIN 4590) at York University, you anticipate the experience will yield athletic therapy students with a better grasp of the uncertainties of examining and evaluating patients.

Loriann Hynes

Loriann Hynes, an assistant professor in the School of Kinesiology and Health Science and her co-teacher, assistant lecturer Michael Boni, began incorporating the use of simulated patients into KIN 4590 last year in collaboration with Eva Peisachovich, an assistant professor at the School of Nursing and the Simulated Person Methodology [SPM] Lab director. Hynes says this experiential learning methodology is perfect for practicing orthopedic assessments and rehabilitation, an important feature of the Athletic Therapy Certificate program’s capstone course.

Michael Boni

“We use computerized mannequins on the field of play to simulate emergencies, because people can’t imitate the blood pressure drop and increased heart rate of someone in shock,” Hynes said. “However, mannequins can’t move for you or demonstrate and discuss their injuries.”

The Simulated Person Methodology Lab team recruits and provides training to simulated persons who are individuals trained in simulation methodology to portray a client or person in a specific encounter. The simulated patients [SPs] were trained to learn their roles and scripts for all of the scenarios written by Hynes. With the support of the SPM Lab team Hynes and Boni conducted training for the SPs to ensure that they knew what was required of them as “patients.”

“We prepped the SPs to look out for certain things and they were excellent at giving our students feedback on whether they felt comfortable and heard and whether the examiners applied too much [physical] pressure during the exams,” Hynes said.

The simulated patients attended Hynes and Boni’s class twice during the semester: once for a mini-scenario to allow the athletic therapy students to get “patient” feedback and become accustomed to the methodology, and again as part of the course’s final evaluation. The final evaluation required each athletic therapy student to conduct a complete assessment of one of the “patients” and devise an appropriate rehabilitation plan for his or her injury.

The simulated patients attended Hynes and Boni’s class twice during the semester: once for a mini-scenario to allow the athletic therapy students to get “patient” feedback and become accustomed to the methodology, and again as part of the course’s final evaluation

“We make the students feel as if they are really in a clinic with a patient they have never met,” Hynes said. “They have to think like clinicians and follow up with more questions. It’s the closest thing to preparing them for the real world that we could get in a classroom setting.”

Her students regularly do roleplay in class, Hynes noted, but they are likely to anticipate the questions their fellow students will pose and to feel comfortable examining classmates. Working with an outsider is a very different experience.

“By providing the students with feedback from the ‘patients,’ we give them a chance to work on their weaknesses and reflect about what they have learned from examining someone who isn’t a classmate,” Hynes said.

Preparing the scenarios and doing the training takes a lot of work, but it’s rewarding to see the students grow as practitioners, Hynes said, and she now has a new resource in her portfolio of teaching tools.

“The fact that the students, themselves, recognized the value of the experience was the most incredible part,” Hynes said. “It was very enriching for them and was a great learning experience on my end, too. It was worth every minute of work.”

In a focus group conducted to assess the experiential project, students were also enthusiastic.

“What this helped us with – well, me in particular – is those fine skills, the soft skills our professors are talking about,” said one student.

Added another, “You definitely learn how to be more professional when working with simulated patients.”

Hynes hopes her experience will encourage other faculty members to incorporate simulated patients into their own curricula. “This methodology helps facilitate students’ critical thinking and self-reflection and prepares graduates to practice in complex and dynamic workplace environments,” Hynes said. “This type of teaching methodology can be used in any program; it can include things such as interview preparation, conflict management and crisis intervention. It is not limited to healthcare professions.”

The SPM Lab provides workshops at no cost to educators across the university who are interested to implement this form of experiential education tool into their teaching and learning context.  The next workshop is offered December 6 and 7 2018.

To learn more about SPM Lab go to spm.info.yorku.ca.

By Elaine Smith, special contributing writer

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