Collaborative Simulation-Based Learning to Develop Competencies in Physical Therapy Students: Randomized Controlled Trial

Abstract Background Although the implementation of simulation-based learning has progressed substantially in medicine, physical therapy education shows a lower level of development regarding standardized collaborative models. Objective This study aims to determine the effectiveness of collaborative versus individual simulation-based learning in developing clinical competence in undergraduate physical therapy students in the care of standardized patients with low back pain flare-ups. Methods A parallel-group randomized controlled trial was conducted. Thirty-one physical therapy undergraduate students were randomized (1:1) to a collaborative or individual simulation-based learning group. Students underwent 3 weeks of clinical simulation training. Standardized patient assessments were performed before and after the simulation-based learning intervention. Clinical competence was evaluated as the primary outcome, while effective communication and therapeutic alliance were evaluated as secondary outcomes. Results For clinical competence, a significant main effect of time was observed ( η p 2 =0.739; P <.001), with equivalent pre-to-post improvements in both the collaborative ( Δ =+6.17; P Bonf <.001) and individual simulation-based learning groups ( Δ =+5.39; P Bonf <.001); the interaction effect was nonsignificant ( P =.61). For communication, no significant time ( P =.91) or group × time interaction ( P =.83) effects were observed. Therapeutic alliance scores demonstrated a significant main effect of time ( η p 2 =0.294; P =.008), indicating an overall decrease, though group-specific pre-to-post declines did not survive Bonferroni correction (both P Bonf ≥.11). Conclusions Collaborative simulation-based learning effectively develops physical therapy clinical competencies, and its effects are comparable to those of individual simulation-based learning with a standardized patient. However, there were no differences between the groups for effective communication or therapeutic alliance. Further research is warranted to assess the efficacy of these modalities in diverse clinical settings.