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BMC Med Educ. 2014 May 23;14:105. doi: 10.1186/1472-6920-14-105.

Senior physiotherapy students as standardised patients for junior students enhances self-efficacy and satisfaction in both junior and senior students.

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Division of Physiotherapy, School of Health & Rehabilitation Sciences, The University of Queensland, St Lucia, Brisbane QLD 4072, Australia.



Standardised patients are used in medical education to expose students to clinical contexts and facilitate transition to clinical practice, and this approach is gaining momentum in physiotherapy programs. Expense and availability of trained standardised patients are factors limiting widespread adoption, and accessing clinical visits with real patients can be challenging. This study addressed these issues by engaging senior students as standardised patients for junior students. It evaluated how this approach impacted self-reported constructs of both the junior and senior students.


Learning activities for undergraduate physiotherapy students were developed in five courses (Neurology, Cardiorespiratory and three Musculoskeletal courses) so that junior students (Year 2 and 3) could develop skills and confidence in patient interview, physical examination and patient management through their interaction with standardised patients played by senior students (Year 4). Surveys were administered before and after the interactions to record junior students' self-reported confidence, communication, preparedness for clinic, and insight into their abilities; and senior students' confidence and insight into what it is like to be a patient. Satisfaction regarding this learning approach was surveyed in both the junior and senior students.


A total of 253 students completed the surveys (mean 92.5% response rate). Across all courses, junior students reported a significant (all Pā€‰<ā€‰0.037) improvement following the standardised patient interaction in their: preparedness for clinic, communication with clients, confidence with practical skills, and understanding of their strengths and weaknesses in relation to the learning activities. Senior students demonstrated a significant improvement in their confidence in providing feedback and insight into their own learning (Pā€‰<ā€‰0.001). All students reported high satisfaction with this learning experience (mean score 8.5/10).


This new approach to peer-assisted learning using senior students as standardised patients resulted in positive experiences for both junior and senior students across a variety of physiotherapy areas, activities, and stages within a physiotherapy program. These findings support the engagement of senior students as standardised patients to enhance learning within physiotherapy programs, and may have application across other disciplines to address challenges associated with accessing real patients via clinical visits or utilising actors as standardised patients.

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