91AV

When the novel coronavirus pandemic forced students in the 91AV’s Master of Science in Occupational Therapy (M.S.O.T.) program to forgo their traditional field work placements this fall, Jessica Walton, M.S., OTR/L, BCG, assistant clinical professor and academic fieldwork coordinator for the program, knew what to do.

She called Dawne-Marie Dunbar, M.S.N./Ed., RN, CNE, CHSE, director of 91AV’s Interprofessional Simulation and Innovation Center (ISIC) and clinical professor of nursing, to devise a way for the students to complete their level-one Mental Health field work requirements using simulated patient actors.

“A lot of organizations opted for prefabricated, online computer program simulations, but we really wanted to go above and beyond that because we know our students were excited about those in-person experiences,” Walton said. “We wanted to try to do our best to meet their needs and their desires.”

Walton and Dunbar worked with Associate Professor of Occupational Therapy Jan Froehlich, M.S., OTR/L, and Assistant Professor Carol Lambdin-Pattavina, OTD/OTRL, who, together, developed case studies for the patient actors to simulate, to lead first year M.S.O.T. students in a simulated field work experience — a first for the program.

In the simulation center, and working in pairs or small groups, students spent five days compiling their clients’ occupational profiles and identifying their needs, conducting formalized assessments of their patients’ symptoms, and developing interventions for treatment — a process, Walton said, that likely was more hands-on than the students’ work in the field would have been.

“The students were able to do an activity with the simulated patients based on all of that information in the occupational profile. At our actual field work sites, the students probably would not have gone through that entire process or be as actively involved,” she remarked.

Class of 2022 student Julie Geldner agreed.

“The amount of time and support that was available to us to be able to take charge and be responsible for a client would not be as available in a workplace field work experience, and I feel fortunate to have had this opportunity,” she said.

Samantha Auriemma (M.S.O.T., ’22), one of Geldner’s groupmates, said the experience made her more comfortable with the administrative side of her chosen profession.

“This simulation allowed us our first real opportunity to complete the therapeutic process from start to finish, and the simulated environment put me at ease and I was not scared to fail or ask questions because I was surrounded by peers and faculty who were all there to help me succeed,” said the Kennebunk native. “The simulation helped me better the therapeutic process and the documentation involved in planning an intervention activity for a client.”

Joining Geldner and Auriemma was Samantha Binnie, who said an added benefit of the simulation was the ability for them to view their interactions, which were recorded, after each session.

Unique to ISIC is the ability for students to view their interactions after each session, critique themselves and each other, and use those recordings for their final field work reflection papers.

“The recordings allowed us to reflect on what we did really well — both as a group and individually — and evaluate what we should do better in following sessions,” Binnie said. “This simulation allowed me to practice my therapeutic use of self-skills, being a reflective listener, collaborating with my team, and being innovative and thinking on the spot.”

While all three students said the experience was not the same as working with real-life patients who struggle with their mental health, they agreed that the simulation prepared them well for future experiences with such clients. Dunbar said the fact the sessions were recorded helped bolster the students’ confidence in working in clinical settings.

“We can teach students in the classroom about all the different skills and different tactics they can use to help their clients. But if we send them out to an actual clinical site to see real clients, we have no control over how that interaction is going to take place. The beauty of simulation is that we could take our time and provide a really rich learning experience,” said Dunbar. “And, if we send them out to clients, they don’t get to see their interactions and have that self-assessment of their own performance. The impact that has on students’ learning and self-confidence is huge.”

The simulated field work experience is being incorporated into other areas of the OT curriculum, Lambdin-Pattavina said. In the spring, students in the Children and Youth field work exploration will meet as groups in the Simulation Center and use telehealth to meet with real clients via Zoom. Their sessions will be recorded, as well, to provide the same learning outcomes as the mental health simulation.

“This is something that we’re definitely going to embed in our curriculum,” Lambdin-Pattavina explained. “We’re really thrilled that we can be involved in this process of actively engaging students in these scenarios. And, for them, the ability to interact with their teammates is invaluable.”

Froelich said the benefits of simulation drive a two-way street.

“We got to do quite a bit of mentoring of students along the way as well, and it was enjoyable to see their clinical reasoning process really unfold across the week in a way that we don't normally see in the classroom,” she said.