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Using human patient simulation (HPS) and standardized patients (SP) to teach electrocardiographic (ECG) rhythms: student perceptions of learning experiences.

(1) Smith, Nancy S.; (1) Prybylo, Sharon; (1) Conner-Kerr, Teresa. (1) Physical Therapy, Winston Salem State University, Winston Salem, NC, United States.

Purpose/Hypothesis: HPS is developing as a teaching method in physical therapy (PT), however, there is little data to support that its use translates to clinical practice, or that students prefer to learn with HPS. The purpose of this study was to differentiate students' preferred method for learning ECG using different approaches. Number of Subjects: Two cohorts (n = 24, n = 29) of PT students recruited by convenience sample were recruited for the study. Materials/Methods: Three educational methods were used to teach ECG recognition to two cohorts of novice PT students. First, all students had a traditional lecture on ECG. After this lecture, two problem-based learning (PBL) approaches were utilized with both cohorts. One approach used a standardized patient and paper ECG strips (SP method), and the second approach utilized HPS with simulated ECG monitoring (HPS method). Following these two PBL approaches, a survey was conducted to determine which method was perceived by the students to most effectively facilitate learning. Results: The overall return rate on the survey amongst the two cohorts was 77% (n = 41, first year 91%, second year 66%). The results demonstrate interesting trends that supported the use of both the SP method and the HPS method, with students identifying both advantages and disadvantages to each method. Advantages identified with the HPS method were the realistic aspect of the simulated ECG and physiological responses, with a secondary advantage of allowing the students to have immediate feedback. The disadvantages cited with the HPS method were that the simulator was not real and the simulated ECG appeared similar to one another on monitoring. An advantage to the SP method was identified was the consistent format of the ECG. The disadvantage of the SP method was that the ECG rhythms of the actor were not reflective of actual physiology when compared to HPS. Results of the Likert scale analysis showed that 78% (n = 32) of the responding students strongly agreed or agreed that the HPS method alone was the preferred for learning and 90% (n = 37) strongly agreed or agreed that the use of both the HPS method and the SP method was most beneficial to learning. Additionally, 75% (n = 30) either strongly agreed or agreed that they felt confident with their skill in interpretation of ECG rhythms as presented with HPS or with rhythm strips, and 90% (n = 37) either strongly agreed or agreed that they had a good understanding of ECG as it related to patient treatment. Conclusions: Data from the survey supports that the HPS method in combination with the SP method is the preferred modality for teaching ECG that improves student confidence, ECG recognition and interpretation. This combined method may be preferred in that it provides a mechanism to reinforce learning with the use of paper ECG strips. Further study is needed to validate this combined educational approach. Clinical Relevance: Improved recognition of critical ECG rhythms by PT students may lead to better patient management as they enter the clinic.
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Publication:Cardiopulmonary Physical Therapy Journal
Date:Dec 1, 2011
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