Akselbo I, Olufsen V, Ingebrigtsen O, Aune I. Simulation as a learning method in public health nurse education. Public Health Nurs.. 2019; 36:(2)226-232

Baillie L, Curzio J. Students' and facilitators' perceptions of simulation in practice learning. Nurse Educ Pract.. 2009; 9:(5)297-306

Blackstock FC, Watson KM, Morris NR Simulation can contribute a part of cardiorespiratory physiotherapy clinical education: two randomized trials. Simul Healthc.. 2013; 8:(1)32-42

Bogossian FE, Cant RP, Ballard EL Locating ‘gold standard’ evidence for simulation as a substitute for clinical practice in prelicensure health professional education: a systematic review. J Clin Nurs.. 2019; 28:(21–22)3759-3775

British Dietetic Association. A curriculum framework for the pre-registration education and training of dietitians. 2013. (accessed 8 June 2021)

British Dietetic Association. COVID-19/coronavirus advice for BDA accredited education providers. 2020. (accessed 8 June 2021)

Cant R, Aroni R. From competent to proficient; nutrition education and counselling competency dilemmas experienced by Australian clinical dietitians in education of individuals. Nutr Diet.. 2008; 65:(1)84-89

Coombs S, Smith I. Designing a self-organized conversational learning environment. Educational Technology.. 1998; 38:(3)17-28

Costello M, Huddleston J, Atinaja-Faller J, Prelack K, Wood A, Barden J, Adly S. Simulation as an effective strategy for interprofessional education. Clin Simul Nurs.. 2017; 13:(12)624-627

Farahat E, Rice G, Daher N, Heine N, Schneider L, Connell B. Objective structured clinical examination (OSCE) improves perceived readiness for clinical placement in nutrition and dietetic students. J Allied Health.. 2015; 44:(4)208-214

Fitzgerald K, Denning T, Vaughan B. Simulated learning activities as part replacement of clinical placements in osteopathy: a case study. Int J Osteopath Med.. 2017; 26:44-48

Concern over student placement hours lost to pandemic. 2020. (accessed 8 June 2021)

Gibson SJ, Golder J, Cant RP, Davidson ZE. An Australian mixed methods pilot study exploring students performing patient risk screening. Nurs Health Sci.. 2016; 18:(2)203-209

Gordon RM. Debriefing virtual simulation using an online conferencing platform: lessons learned. Clin Simul Nurs.. 2017; 13:(12)668-674

Health and Care Professions Council. Guidance on conduct and ethics for students. 2016. (accessed 9 June 2021)

Health Education England. Health Education England to invest up to £10m in clinical placements across England. 2020. (accessed 8 June 2021)

INACSL Standards Committee INACSL standards of best practice: SimulationSM debriefing. Clin Simul Nurs.. 2016; 12:S21-S25

Lioce L, Lopreiato J, Downing D Healthcare simulation dictionary, Second edition. (eds). Rockville (MD): AHRQ Publication no 20–0019; 2020

MacDonald-Wicks L, Levett-Jones T. Effective teaching of communication to health professional undergraduate and postgraduate students: a systematic review. JBI Library Syst Rev.. 2012; 10:(28)1-12

Miles A, Friary P, Jackson B, Sekula J, Braakhuis A. Simulation-based dysphagia training: teaching interprofessional clinical reasoning in a hospital environment. Dysphagia.. 2016; 31:(3)407-415

Milkins L, Moore C, Spiteri J. Simulation based education: professional entry student education and training.Gladesville, New South Wales: Health Education and Training Institute; 2014

Mills BW, Carter OB, Rudd CJ, Ross NP, Claxton LA. Clinical placement before or after simulated learning environments? A naturalistic study of clinical skills acquisition among early-stage paramedicine students. Simul Healthc.. 2015; 10:(5)263-269

O'Shea MC, Palermo C, Rogers GD, Williams LT. Simulation-based learning experiences in dietetics programs: a systematic review. J Nutr Educ Behav.. 2020; 52:(4)429-438

Padilha JM, Machado PP, Ribeiro A, Ramos J, Costa P. Clinical virtual simulation in nursing education: randomized controlled trial. J Med Internet Res.. 2019; 21:(3)

Quail M, Brundage SB, Spitalnick J, Allen PJ, Beilby J. Student self-reported communication skills, knowledge and confidence across standardised patient, virtual and traditional clinical learning environments. BMC Med Educ.. 2016; 16:(1)

Reidlinger DP, Lawrence J, Thomas JE, Whelan K. Peer-assisted learning and small-group teaching to improve practice placement quality and capacity in dietetics. Nutr Diet.. 2017; 74:(4)349-356

Roberts NJ, Brockington S, Doyle E Innovative model for clinical education in dietetics. Nutr Diet.. 2009; 66:(1)33-38

Rogers GD, Mey A, Chan PC. Development of a phenomenologically derived method to assess affective learning in student journals following impactive educational experiences. Med Teach.. 2017; 39:(12)1250-1260

Ross LJ, Mitchell LJ, Williams LT. Is it possible to enhance the confidence of student dietitians prior to professional placements? A design-based research model. J Hum Nutr Diet.. 2017; 30:(5)588-595

Watson K, Wright A, Morris N Can simulation replace part of clinical time? Two parallel randomised controlled trials. Med Educ.. 2012; 46:(7)657-667

Weller JM, Nestel D, Marshall SD, Brooks PM, Conn JJ. Simulation in clinical teaching and learning. Med J Aust.. 2012; 196:(9)594-594

Diet COMMS. 2015. (accessed 8 June 2021)

Student engagement with online resources and its impact on learning outcomes. 2013. (accessed 8 June 2021)

Developing and piloting a simulated placement experience for students

08 July 2021
Volume 30 · Issue 13


COVID-19 and rising student numbers are affecting healthcare education, particularly access to clinical placements. As healthcare education is increasingly supported by technology and non-traditional teaching methods, educational experiences gained through clinical placement also require new approaches. This article explores and discusses the use of a simulated clinical placement for a dietetic student cohort. During this virtual placement, students were able to explore and experience a virtual clinical setting and immerse themselves in a placement experience. A vast range of virtual resources were linked to the online placement portal, including statutory and mandatory training, dietetic resources, patient journeys and interprofessional communication. Advantages of this approach include that all students experience a given situation, unlike in traditional placements where workloads, variety and engagement vary; there is also no risk to patient safety. The aim is to enhance the learning experience to create effective, efficient clinicians. This virtual placement for dietetics is part of a bigger project to develop and evaluate the use of a virtual placement framework in a range of professions. The concept of virtual placement may have been brought forward by the COVID-19 crisis but was inevitable with the move to more technology-enhanced learning tools.

Simulation is a component of healthcare education and can be used successfully for collaboration between professions to develop interprofessional skills (Costello, 2017). Alongside online simulation sits virtual simulation, which can be defined as ‘not physically existing but made to appear [so] by software’ (Lioce et al, 2020). Virtual simulation builds on the foundations of online simulation and incorporates individual resources into a coherent set of experiences based around a collective group of learning objectives. An example of this is the use of 360° field-of-view (FOV) cameras to produce interactive images, which enable students to explore a virtual clinical setting and immerse themselves in a placement experience. Previous use of virtual simulation in nursing education has shown there is a positive correlation between its use and enhanced knowledge retention and student satisfaction (Padilha et al, 2019).

Simulated clinical experience engagement with and between students can be synchronous, which occurs in real time, or asynchronous, where the material is available and can be accessed by students at a time that suits them. Wong (2013) showed that students engage better with material that is available asynchronously and they spend varying amounts of time using the resource, allowing for a more adaptable student learning experience across a range of engagement styles. Analysing a previous event allows better retention, deeper learning and a greater likelihood of knowledge transfer (INACSL, 2016). This can be done online and, to maximise its effectiveness, should be carried out one-to-one or in small groups (Gordon, 2017).

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