Simulated Learning in the Clinical Education of Novice Physiotherapy Students

  • Julia Blackford University of Sydney
  • Lindy McAllister University of Sydney
  • Jennifer Alison University of Sydney
Keywords: clinical simulation, competence, confidence, physiotherapy, standardised patients


Clinical simulation is well established in nursing and medical education. It provides an effective learning opportunity for students to develop confidence to apply their skills in the clinical setting. Using simulation in physiotherapy education is less well established. The aim of the pilot study reported on in this article was to determine if a simulated clinical experience for physiotherapy students could: 1) increase student confidence before commencing a traditional clinical placement; and 2) replace part of the traditional clinical placement without compromising the student's ability to attain competency. The study consisted of replacing the first week of a five-week physiotherapy clinical placement with a simulated learning experience using standardised patients. Other structured learning activities such as peer learning, feedback sessions and opportunities for self-reflection were incorporated into the simulation week. Confidence to undertake clinical placement was measured at the beginning and end of the week and compared with a control group who undertook a five week traditional clinical placement. Assessment of student competence using the Assessment of Physiotherapy Practice, a standardised valid competency assessment tool, was compared between the two groups. Results indicated that the simulated learning experience significantly increased students' confidence to apply their professional and clinical skills. One week of clinical simulation did not compromise students' ability to achieve competency at the completion of their five-week placement. The power of the associated learning activities during the simulation week was evident from the students’ feedback. This study highlights the benefits of incorporating simulated learning experiences and well-structured learning activities as part of all clinical experiences.

Author Biography

Julia Blackford, University of Sydney
Faculty of Health Sciences, University of Sydney, AUSTRALIA


Australian Physiotherapy Council (2006) Australian Standards for Physiotherapy. [on-line] available from: <> [accessed 15 June 2015]

Bambini, D, Washburn, R and Perkins, R (2009) ‘Outcomes of Clinical Simulation for Novice Nursing Students: Communication, Confidence, Clinical Judgment’. Nursing Education Research (30), 79-82

Bokken, L., Rethans, J., Scherbier, A. and van der Vleuten, C. (2008) ‘Strengths and Weaknesses of Simulated and Real Patients in the Teaching of Skills to Medical Students: A Review. Simulation in Healthcare (3), 161-169

Creswell, J. W., and Plano Clark, V.L. (2010) Designing and Conducting Mixed Methods Research. Thousand Oaks US: SAGE Publications Inc.

Dalton, M., Davidson, M. and Keating, J. (2011). ‘The Assessment of Physiotherapy Practice (APP) is a Valid Measure of Professional Competence of Physiotherapy Students: a Cross-sectional Study with Rasch Analysis. Journal of Physiotherapy 57(4), 239-246

Dalton, M., Davidson, M. and Keating, J. (2012). ‘The Assessment of Physiotherapy Practice (APP) is a Reliable Measure of Professional Competence of Physiotherapy Students: a Reliability Study’. Journal of Physiotherapy 58 (1), 49-56

Eraut, M. (2004) ‘Informal Learning in the Workplace’. Studies in Continuing Education 26 (2) 247-272

Gordon, J., Wilkerson, W., Scaffer, D and Armstrong, E. (2001). ‘"Practicing" Medicine without Risk: Students' and Educators' Responses to High-fidelity Patient Simulation’. Academic Medicine 76 (5), 469-472

Jones, A. and L. Sheppard (2011). ‘Developing a Measurement Tool for Assessing Physiotherapy Students' Self-efficacy: a Pilot Study’. Assessment & Evaluation in Higher Education: First published on: 18 March 2011 (iFirst)

Kleehammer, K., Hart, L. and Keck, J. (1990). ‘Nursing Students' Perceptions of Anxiety-Producing Situations in the Clinical Setting’. Journal of Nursing Education 29 (4), 183-187

Kneebone, R. and Nestel, D. (2005). ‘Learning Clinical Skills – the Place of Simulation and Feedback’. The Clinical Teacher 2 (2), 86-90

McCallum, J. (2007). ‘The Debate in Favour of Using Simulation Education in Pre-registration Adult Nursing. Nurse Education Today 27(8), 825-831

McGraw, R. C. and O’Connor, H.M. (1999). ‘Standardized Patients in the Early Acquisition of Clinical Skills’. Medical Education 33 (8), 572-578

Morris, M., Crosbie J., Sullivan, J., Rivett., D., Ruston, S., Vujnovich, A., Jull, G., Sheppard, L., Wright. A., Webb, G., Gass, E. (2002). ‘Sustainable Undergraduate Education and Professional Competency. – Editorial’. Australian Journal of Physiotherapy 48(1), 5-7

National Health Workforce Taskforce (2008). Health Education and Training. Clinical Placements across Australia: Capturing Data and Understanding Demand and Capacity. [on-line] available from <> [accessed 15 June 2015]

Nestel, D., Tabak, T., Layat-Burn, C., Robb, A., Clark, S., Morrison, N.J., Ellis, R., Smith, C., McNaughton, N., Knickle, K., Higham, J., and Kneebone, R. (2011). ‘Key Challenges in Simulated Patient Programs: An International Comparative Case Study’. BMC Medical Education . on-line] available from <> [accessed 15 June 2015]

Parry, R. H. and K. Brown (2009). ‘Teaching and Learning Communication Skills in Physiotherapy: What is done and how should It be done?’ Physiotherapy 95 (4), 294-301

Patton, M. Q. (2002). Qualitative Research and Evaluation Methods3rd edn. Thousand Oaks US: SAGE Publications Inc.

Voelker, R. (2009). ‘Medical Simulation gets Real’. JAMA 302 (20), 2190-2192

Watson, K., Wright, A., Morris, N., McMeeken., J. Rivett, D., Blackstock, F., Jones, A., Haines, T., O’Connor, V., Watson, G., Peterson, R., Jull, G. (2012). ‘Can Simulation Replace Part of Clinical Time? Two Parallel Randomised Controlled Trials’. Medical Education 46 (7), 657-667

Yoo, M. S. and Yoo, I. Y. (2003). ‘The Effectiveness of Standardized Patients as a Teaching Method for Nursing Fundamental. Journal of Nursing Education 42 (10), 444-448

How to Cite
Blackford, J., McAllister, L., & Alison, J. (1). Simulated Learning in the Clinical Education of Novice Physiotherapy Students. International Journal of Practice-Based Learning in Health and Social Care, 3(1), 77-93.

Most read articles by the same author(s)