Can the Mega-Code Kelly High Fidelity simulator be used by Physical Therapy students to accurately and reliably assess heart rate and blood pressure.

Abstract

Background:High fidelity simulation(HFS) is an educational tool that allows educators to simulate patient cases and provides opportunity to perform assessments with decreased patient risk. To utilize HFS for student assessment validity and reliability need to be determined. Purpose:To investigate HFS for validity and reliability for students to assess heart rate(HR) and systolic (SBP)and diastolic blood pressure(DBP). Methods:Inclusion criteria for HR assessment included ability to assess HR within 5 beats and inclusion criteria for blood pressure included ability to assess SBP within 4 mm via æthe gold standard of assessment on human subject. Prior to validity assessment Intra-rater reliability of HR, SBP,and DBP was established using 4 students. Validity:20 students were included in SBP and DBP testing. 30 met the inclusion criteria for HR assessment. Students were surveyed after for their confidence with HR and SBP/DBP assessment utilizing the simulator. æResults:Intra-rater reliability was established. HR strong agreement ICC =0.85, SBP strong agreement ICC=0.97, DBPmoderate agreement æICC=0.66. Validity: HR mean difference of 5.25bpm with a SE of 2.59,SBP mean difference= 6.65 mmHG with an SE of 1.1,DBP mean difference= 4.1mmHG with a SE of 1.1 via Bland_Altman method. Survey results: 78% reported feeling confident with HFS for HR and 22% reported feeling confident with HFS for BP. Conclusions:Intra-rater reliability and validity were established determining wider ranges of norms than with human assessment. Survey results determined students were less confident with HFS for assessment of vital signs. æImplications:Further testing should be conducted due to the small sample size and limited population.