Abstract:

INTRODUCTION: The use of simulation as a teaching methodology has increased in the last decades in different disciplines. Physiotherapy is not an exception. The literature is extensive in relation to isolated experiences in simulation in physiotherapy. However, there are few publications that outline the strategic deployment carried out at the curricular level in general (Alinier, 2010) and in Physiotherapy in particular. The benefits of simulation are widely known (Cook, 2013, Issenberg and Scalese, 2008). These include: competences practice in safe environments, development of specific clinical and non-clinical skills, learning to deal with errors without harm to the patient, dealing/coping with feedback from peers and experts/facilitators, critical thinking and clinical reasoning development, among others described in the literature (Hope, Garside & Prescott, 2011). The added value of a curricular or transversal implementation versus an isolated and focused implementation (Graham, Woodfield and Harrison, 2013) of the simulation would imply a better orientation and compliance with the standards that are requested in simulation as well as an efficient development of simulation itself.
In health sciences, clinical training/placement is constituted as the fundamental pillar of undergraduate studies. Clinical training brings together all the competences included in the curriculum. During the 4 years of physiotherapy degree at Faculty of Health Sciences at Manresa – University of Vic- University of Central Catalonia, students must complete a total of 42 credits according to the European Credit Transfer System (ECTS) equivalent to 840 hours of external clinical training. Clinical training begins at the 4th semester of studies. Prior to this, students perform a combination of theoretical and practical peer-to-peer subjects in the university environment without having contact in real environments such as hospitals and/or physiotherapy consultations.
The simulation prior to the realization of clinical practices with real patients would seek: (i) to provide experiences in safe and real environments to the students and (ii) to facilitate the transfer of theoretical knowledge in the practical field. All this also looking for to increase the safety and confidence of students for better performance at the time of beginning clinical training.

APPROACH AND METHODS: Simulation program in the Physiotherapy Degree at faculty of Health Sciences at Manresa before practice was linked to strategically chosen subjects. In them, transversal skills are developed in health sciences (verbal and non-verbal communication or clinical interview) and specific competences of physiotherapy (first phases of clinical reasoning: evaluation and diagnosis in physiotherapy) as well as other competences. Throughout the 2015-2016 and 2016-2017 academic years a cohort of 181 students performed 12 simulations before beginning clinical practices. All cases were designed considering specific learning outcomes for subsequent performance in clinical practice. An ad hoc questionnaire was designed. It was self-administered after the simulation sessions to assess student’s impressions regarding the first simulation sessions carried out in the Degree of physiotherapy at Faculty of Health Sciences at Manresa.

RESULTS AND IMPLICATIONS: The feedback of the questionnaires suggests that simulation is a very good methodology to generate learning security spaces. Students have the possibility not only to "land" the theoretical concepts worked in class but to experiment in a simulated real environment and gain professional confidence.
Simulation as a teaching methodology in the first semesters of a physiotherapy curricular program without initial clinical training allows students to improve self-confidence and it also favours the integration of basic practical skills worked in the classroom.

Keywords:

Simulation, physiotherapy, undergraduate, higher education, curricula development.