Comparison of Peer Role-Playing-Based Simulation With Case-Based Learning in Physical Therapy Education

A Semi-Experimental Comparison of Peer Role-Playing-Based Simulation With Case-Based Learning in Physical Therapy Undergraduate Education

This study primarily aims to evaluate the impact of a 12-week peer role-play simulation model on the professional development of undergraduate physiotherapy students. Unlike traditional teacher-led case discussions, this study explores the effect of active participation in clinical scenarios, in which students alternate between the roles of 'clinician' and 'patient', on their academic achievement, self-efficacy and perceived clinical readiness. Specifically, the study aims to determine whether this interactive, low-cost pedagogical approach is a superior alternative to conventional lecture-based methods for preparing students for real-world clinical environments, particularly in high-enrolment academic settings.

Study Overview

• Status: Not yet recruiting
• Conditions: Clinical Reasoning; Physiotherapy and Rehabilitation; Student Education; Simulation Based Learning
• Intervention / Treatment: Behavioral: Peer Role-Play Simulation (PRPS); Behavioral: Traditional Case-Based Learning (CBL)

Detailed Description

The rapid expansion of physiotherapy education in Turkey has led to a number of significant systemic challenges, including limited clinical placement opportunities and a lack of standardised clinical supervision. Although simulation-based education (SBE) is recognised worldwide as an effective way of bridging the gap between theoretical knowledge and hands-on practice, its integration into Turkish physiotherapy curricula is inconsistent.

Peer role-play simulation offers a sustainable and cost-effective solution for large student cohorts. By simulating complex or high-risk clinical encounters in a controlled environment, students can practise decision-making and communication skills without endangering patient safety. Furthermore, experiencing the 'patient' perspective is hypothesised to enhance empathy and foster a patient-centred mindset.

This comparative study evaluates a 12-week 'Clinical Problem Solving' course delivered through two instructional models.

Experimental Group: Utilises a structured, multi-session peer role-play simulation framework, followed by formal debriefing sessions.

Control group: Receives traditional, case-based lecture instruction, focusing on passive learning and theoretical discussion.

The research seeks to determine whether peer simulation leads to statistically significant improvements compared to traditional methods. The investigation focuses on three key areas:

Academic performance: Assessed via end-of-term written examinations to measure knowledge retention and application.

Self-efficacy: This is measured through validated scales to track changes in students' confidence in their clinical abilities.

Clinical Readiness: This is measured through validated scales to track changes in students' confidence in their clinical abilities.

Clinical Readiness: Evaluated via pre- and post-intervention testing to determine students' perceived preparedness for clinical internships.

It is hypothesised that the interactive nature of peer simulation combined with reflective debriefing will result in higher self-efficacy and superior clinical readiness than conventional case-based teaching.

• Study Type: Interventional
• Enrollment (Estimated): 200
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Gizem Yılmaz Babacan; Phone Number: +905359635038; Email: gizem.yilmaz1@medipol.edu.tr

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Current enrollment as a senior (4th-year) undergraduate student in the Department of Physiotherapy and Rehabilitation at Istanbul Medipol University.
• Active participation in the "Clinical Problem Solving" course.
• Voluntary agreement to participate and signing of the informed consent form.

Exclusion Criteria:

• Students who have previously taken the "Clinical Problem Solving" course or a similar simulation-based elective.
• Failure to attend more than 20% of the 12-week course sessions.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Peer Role-Play Simulation (PRPS); Participants will engage in a 12-week structured peer role-play simulation program. The intervention focuses on neurological pathologies using scenarios. Each weekly session (120 minutes) follows a three-phase experiential learning model: Pre-briefing (30 min): Facilitator-guided case analysis and clinical reasoning setup using structured forms. Simulation (60 min): Active role-playing in a simulated clinic. Groups of 10 are split into subgroups (n=5) where students rotate through roles: Lead Therapist, Assistant, Patient, and Observer. Rotations occur every 15 minutes to ensure multi-perspective exposure. Debriefing (30 min): Reflective discussion involving self-assessment, peer feedback, and facilitator guidance focusing on clinical reasoning, safety, and professional communication.	Behavioral: Peer Role-Play Simulation (PRPS); A 12-week educational intervention where students rotate through roles of therapist, patient, and observer in simulated neurological clinical scenarios, followed by structured debriefing sessions.
Active Comparator: Traditional Case-Based Learning (CBL); Participants in the control group will follow a standardized Case-Based Learning (CBL) methodology. To ensure comparability, this group will address the same clinical neurological scenarios as the experimental group but through a traditional pedagogical framework. Students will receive the written clinical cases one week in advance to conduct literature reviews, identify problem lists, set therapeutic goals, and justify intervention plans. During the weekly session, students will present their case analyses. The instructor will facilitate structured discussions to refine clinical reasoning. Students will supplement their presentations with video recordings of practical physiotherapy intervention demonstrations. These demonstrations will then be reviewed and discussed in a classroom setting.	Behavioral: Traditional Case-Based Learning (CBL); A 12-week pedagogical approach involving independent case analysis of written scenarios, classroom presentations, and video-assisted demonstrations of physiotherapy skills.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Physiotherapist Self-Efficacy (PSE) Scale Score	Evaluation of students' perceived competence in clinical problem-solving, planning, and communication across three domains: neurological, musculoskeletal, and cardiopulmonary. The scale consists of 13 items scored on a 5-point Likert scale (1 = "very little confidence" to 5 = "very much confidence"). Higher scores indicate higher self-efficacy.	Baseline (Week 0) and Post-Intervention (Week 12).

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Perception of Clinical Readiness and Simulation Experience	Measured using a 10-item self-report questionnaire focusing on communication, clinical reasoning, and preparedness for practice. Items are scored on a 0-10 Visual Analog Scale (VAS) (0 = "strongly disagree" to 10 = "strongly agree").	Baseline (Week 0) and Post-Intervention (Week 12).
Case-Based Written Examination:	A standardized written examination will be administered at the end of the semester to assess students' ability to apply theoretical knowledge (knowledge application) and their clinical reasoning skills. The examination will be based on a novel clinical case scenario that has not been previously discussed in class. Students will be required to demonstrate their ability to assess the patient, select appropriate measurement methods, interpret clinical findings, and plan evidence-based physiotherapy interventions in written form.	Post-Intervention (Week 13, during finals week).
Practical Examination / OSCE (Objective Structured Clinical Examination)		Post-Intervention (Week 14, during finals week)
Clinical Performance (End of Clinical Placement)	To evaluate the extent to which students transfer their acquired knowledge and skills to real clinical settings (transfer to practice), the Assessment of Physiotherapy Practice (APP) will be used in accordance with approaches recommended in the literature (Ryall et al., 2022; Jones & Sheppard, 2011). Students' overall clinical performance-including communication, professionalism, patient assessment, and treatment planning-will be evaluated using the APP by independent clinical supervisors responsible for the students at the end of their 4-6 week clinical placements.	Post-Intervention (Week 13, during finals week).

Collaborators and Investigators

• Sponsor: Istanbul Medipol University Hospital

Study record dates

Study Major Dates

• Study Start (Estimated): May 1, 2026
• Primary Completion (Estimated): May 15, 2026
• Study Completion (Estimated): July 1, 2026

Study Registration Dates

• First Submitted: April 14, 2026
• First Submitted That Met QC Criteria: April 14, 2026
• First Posted (Actual): April 21, 2026

Study Record Updates

• Last Update Posted (Actual): April 21, 2026
• Last Update Submitted That Met QC Criteria: April 14, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Self-Efficacy; Clinical Competence; Clinical Reasoning; Physiotherapy Education; Simulation-Based Learning; Peer Role-Play; Health Profession Students
• Other Study ID Numbers: E-10840098-50.04-2152

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No