Simulation in a Culminating Physical Therapy Clinical Decision Making Course


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Clinical decision making is a critical component of developing entry level competency in Physical Therapy (PT). To provide realistic and challenging clinical scenarios for Doctorate in PT students, two simulation activities were implemented in a final didactic semester clinical decision making course. The first entailed a simulation in the Intensive Care Unit in which students worked in teams to mobilize a critical patient (Sim Man) on a ventilator. The second scenario included the use of Standardized Patients (SP) as a final Objective Structured Clinical Examination (OSCE) in which each student evaluated an SP to determine if the presentation was within the scope of practice of PT. Each student was then required to contact a Standardized Physician via telephone to discuss the patient using the SBAR (Situation-Background-Assessment-Recommendation) model of communication. Both scenarios required higherlevel decision making and communication with at least one other simulated health professional.

Therese E. Johnston, PT, PhD, MBA

Dr. Johnston is Associate Professor in the Department of Physical Therapy at Thomas Jefferson University, Philadelphia, PA. Her research interests include interventions to improve the health, fitness, and function of children and adults with spinal cord injury or cerebral palsy, with a special focus on the use of functional electrical stimulation. She also has expertise in biomechanics. Dr. Johnston teaches within the neuromuscular sequence and teaches the culminating clinical decision making course at the end of the physical therapy curriculum.

Brian Wolfram, PT, DPT

Dr. Wolfram is an Advanced Clinician at Thomas Jefferson University Hospital where he practices in acute care, primarily with the cardiopulmonary patient population. He has also treated patients in various other areas including acute neurologic, medical surgical, orthopedic and outpatient rehabilitation. Dr. Wolfram graduated from Rutgers University/University of Medicine and Dentistry of New Jersey with the MPT and received the transitional DPT from Thomas Jefferson University.

E. Adel Herge, OTD, OTR/L, FAOTA

Dr. Herge is an Associate Professor and Director of the Combined BSMS OT Program in the Department of Occupational Therapy in the Jefferson School of Health Professions. Dr. Herge also serves as the Director of Health Professions Simulation in the University Clinical Skills and Simulation Center. In this role she is responsible for supporting simulation activities developed and led by faculty champions in JSHP.



1. Describe the use of simulation to develop higher level activities for teaching and assessment.

2. Compare and contrast the use of simulation with models such as Sim Man and the use of Standardized Patients to achieve course objectives.

Presentation: 43 minutes

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