Examining the Effect of a Simulation-Based Activity on Learner Comfort and Confidence With Challenging Communication Scenarios for Physical Therapy Students: A Mixed-Methods Analysis.

Purpose: We described physiotherapy (PT) learner confidence and comfort in engaging in challenging conversations before and after a simulation-based lab and explored how learners found the activity helpful. Method: Quantitative data were collected through three online surveys (before, immediately after, and 3 months after the lab) and analyzed via descriptive statistics. Qualitative data were collected through open-ended survey questions and reflection papers, and analyzed via thematic content analysis. Results: Twenty-two, predominantly female (72.7%) second year entry-level PT learners participated (mean age 25.7 [SD 2.9] years). Learners' confidence or comfort increased 16%-100% after the lab. Learners found the lab to be a valuable learning experience and reported that feedback and observation, realism, and preparation influenced their learning. The lab reinforced and provided new learning about several communication skills like developing a connection and reading non-verbal cues. Some learners had difficulty integrating communication into their perception of PT skills and felt the need to resolve or "fix" the issue. Conclusions: A simulation-based Challenging Conversations Lab was perceived to be a valuable learning experience that may have increased comfort and confidence in engaging in challenging communication scenarios for entry-level PT students.