The effect of standardized patients for physical therapy students on behaving and communicating as a professional: a systematic review

Abstract

Background

Previous systematic review and meta-analysis examining standardized patients (SPs) in Physical Therapy (PT) education yielded 14 articles describing 16 studies; 10 addressed professional behaviors (PB), and six reported providing SP feedback to students. Of those six studies, four were randomized controlled trials (RCTs) emphasizing SP feedback on clinical competencies. Only two studies examined PB or communication in PT students after receiving SP feedback. There appears to be a gap within the current literature to understand better SPs’ ability to impact PT students’ communication and PB as they prepare for clinical education. This systematic review aimed to synthesize and critically appraise the findings of empirical studies (qualitative or quantitative) evaluating the contribution of SPs on the student’s affective learning domain (professional behavior and/or communication) in PT entry-level education.

Methods

A systematic review was completed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines for Reporting Systematic Reviews on December 1, 2021, using the following electronic databases PubMed, Cochrane Central Register of Control Trials, CINAHL, ERIC, SCOPUS, and Web of Science. Article inclusion criteria: peer-reviewed, assess PT students, assess the affective learning domain, intervention using live, standardized patient learning experiences, and be written in the English language. Studies were excluded if they involved peer-role play as the (SP) or if the authors did not describe the SP process. The risk of bias was evaluated through the Critical Appraisal Skills Programme tool (CASP), given the heterogeneity of study types anticipated for this systematic review, and PEDro if the study design was a RCT.

Results

There were ten included studies in this review. Two studies were RCT designs that explored Immersive Simulation-Based Learning Experience (SBE) in the clinic’s impact on PB, and all used the Assessment of Physiotherapy Practice (AAP) outcome measure. The other seven studies examined SPs or SBE on PB within the classroom and had significant heterogeneity based on study design and outcomes reported.

Discussion

Summative results suggest that SP or SBE has some unique attributes, if applied in the clinical environment, may improve students’ PB and core values development, consistent with a PT practice. This systematic review may inform academic leadership and clinical educators in physical therapy education delivery. Integrating experiential and simulated learning experiences into a program may increase efficiency by allowing students to demonstrate clinical competence skills sooner.

Limitations

Heterogeneity of study design and reported outcomes limited the results and pooling of data.

Keywords:

• Professional behaviors
• simulation experience
• clinical education
• physical therapy

Disclosure statement

No potential conflict of interest was reported by the authors.

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Additional information

Notes on contributors

M. B. Donaldson

Megan Donaldson is Associate Professor and Program Director for the Doctor of Physical Therapy Program at Tufts University School of Medicine in Boston, MA. She is a Fellow American Academy of Orthopaedic Manual Physical Therapists. She has been a faculty for 14 years. She has 30 peerreviewed publications, two book chapters, and over 50 presentations nationally on musculoskeletal health and manual therapy-related topics. She serves nationally as the Conference Coordinator/Chair and Executive Board member of the American Academy of Orthopaedic Manual Physical Therapists (AAOMP T) and the American Physical Therapy Association (AP TA) as an Ohio's Chief Delegate. Dr. Donaldson has earned numerous awards for research, education, and professional service, including being named Ohio Physical Therapy Association Outstanding P T Award and Chamber of Commerce Award Top 20 under 40.

K. Tyler

Kimberly Tyler is an assistant professor at Doctor of Physical Therapy Program at Tufts University School of Medicine in Boston, MA where she also serves as the Director of Clinical Education. Dr. Tyler received her master's degree in physical therapy from the University of Texas Southwestern Medical Branch in Dallas, Texas in 2022 and her Doctorate in Physical Therapy from A.T. Still University in 2019. Dr. Tyler's research and teaching interests include neurology, spinal cord injury, professional behaviors, and clinical education.

A. Carroll

Anthony Carrollis an assistant professor and the Assistant Director of Clinical Education at Doctor of Physical Therapy Program at Tufts University School of Medicine in Boston, MA. Dr. Carroll completed his Doctor of Physical Therapy degree in 2010 and Orthopedic Residency in 2011 at the University of Delaware. He then completed a Manual Fellowship at Kaiser Permanente and became a Fellow of the American Academy of Orthopedic Manual Physical Therapists in 2012. Dr. Carroll serves nationally as a Conference Committee member of the American Academy of Orthopedic Manual Physical Therapists (AAOMP T). Dr. Carroll's research and teaching interests include manual therapy, orthopedics, pain science and clinical education.