The use of simulation-based learning experiences to decrease anxiety and increase confidence and preparedness for clinical placements for speech pathology students

Author Identifier

Teresa Petrich

Date of Award


Document Type



Edith Cowan University

Degree Name

Master of Medical and Health Science by Research


School of Medical and Health Sciences

First Supervisor

Natalie Ciccone

Second Supervisor

Brennen Mills


Background: Clinical placements provide an essential opportunity for speech pathology (SP) students to learn and practice the skills of their profession in real-world environments. They are also the primary opportunity for them to be assessed on the clinical and professional competencies required for graduation and entry into the profession. Increasing student enrolments and health workforce demands are making high-quality, equitable clinical placements increasingly difficult for universities to source. Therefore it is crucial that students are as prepared as possible to optimise their learning experience and maximise their chance of success on clinical placements. However, clinical placements are an acknowledged source of significant anxiety for students, which can have detrimental effects on their capacity to learn and ability to deliver optimal performance on assessment tasks. Simulation-based learning (SBL) experiences, where aspects of real-life scenarios are replicated in a learning environment, are already used for a range of purposes in health student education. Their use for decreasing student anxiety and increasing readiness for clinical placements is well established across a range of health disciplines, particularly nursing. However, evidence remains limited for the use of SBL for the purpose of decreasing anxiety and increasing confidence to improve clinical placement readiness for SP students. There are also barriers to the implementation of SBL programs, including financial costs and resource constraints which hinder their increased adoption in the university setting.

Research Aims: This research project aimed to investigate the use of an existing 5-day SBL program, and a modified 2-day version of the program, to decrease SP student clinical placement anxiety, and to increase their confidence and sense of preparedness for clinical placements. The student perceptions on the key features of the SBL program which contributed to these affective changes were also explored.

Method: A convergent mixed methods design was used with two consecutive cohorts of third year SP students (n = 33). The first cohort completed the original 5-day SBL program, and the subsequent cohort completed the 2-day version of the program. All participants completed pre- and post-program quantitative ratings of anxiety, confidence and preparedness for clinical placements, and participated in focus groups discussions. Qualitative data in the form of focus groups and interviews was also collected from three clinical educators; two who were involved in facilitating the SBL program and subsequent student supervision on clinical placements, and one who was involved in student supervision only.

Results: Participants in both versions of the SBL program demonstrated significant decreases in their ratings of anxiety, and significant increases in their ratings of confidence and sense of preparedness. No significant differences were found between changes in each measure between the two groups. These quantitative findings were corroborated with qualitative data from both students and clinical educators, who described the affective changes observed and experienced following completion of the SBL program. Two additional affective changes experienced by students also emerged in focus group discussions; stress and anxiety experienced as a result of participation in the SBL program, and a positive change in relationships with peers and clinical educators during the SBL program. Six key features of the SBL program were identified by students as contributing to overall affective changes.

Conclusion: Findings suggest both 5-day and 2-day versions of this SBL program can be used to improve SP student perceptions of readiness for clinical placements with decreased anxiety, increased confidence and increased sense of preparedness. Comparable outcomes can be achieved for students using a shorter, less resource-intensive version of the SBL program to overcome barriers to implementation, with the retention of key features identified by student participants as contributing to the affective changes they experienced.



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