Simulation-Based Acute Care Elective Enhances DPT Student Confidence and Interest in Acute Care Without Improving Clinical Decision-Making

Introduction: Low student interest and confidence in acute care skills contribute to acute care physical therapy workforce shortages. Simulation-based learning experiences (SBLEs) may enhance readiness for acute care. This study explored the effects of a simulation-based acute care elective on Doctor of Physical Therapy (DPT) student confidence, clinical decision-making, and desire to work in acute care. Review of Literature: SBLEs improve confidence and decision-making across health professions. In DPT education, simulation is linked to increased preparedness, though most studies focus on required coursework. Limited evidence suggests simulation fosters interest in acute care. This study extends prior work by examining the effects of an elective course. Subjects: Fifteen third-year DPT students self-selected into an 8-week acute care elective, with 9 consenting to participate in the study. Methods: This quasi-experimental, 1-group pretest-posttest study evaluated the effects of a simulation-based elective on DPT students’ confidence, clinical decision-making, and desire to work in acute care. Data collection tools included the Acute Care Confidence Survey (ACCS), the Clinical Decision-Making (CDM) tool, and a single-item Likert scale measuring students’ desire to work in acute care. Results: Total ACCS scores increased post-elective by 27%, with significant improvements in the Mobility (35%), Instruct (36%), and Manual (11%) subscales. The Judgment subscale increased by 37%, but this change was not statistically significant. CDM increased by 1 point, but this improvement was not significant. Desire to work in acute care significantly increased from 4 to 5 on a 5-point Likert scale. Discussion and Conclusion: Students who participated in the acute care elective showed increased confidence and interest in acute care; however, clinical decision-making abilities did not significantly improve. Further research is needed to determine the optimal course duration and design for enhancing clinical decision-making.