Is simulation training effective in increasing podiatrists’ confidence in foot ulcer management?

Lazzarini, Peter A., Mackenroth, Elizabeth L., Régo, Patricia M., Boyle, Frances M., Jen, Scott, Kinnear, Ewan M., PerryHaines, Graham M. and Kamp, Maarten (2011) Is simulation training effective in increasing podiatrists’ confidence in foot ulcer management?. Journal of Foot and Ankle Research, 4 16: 16.1-16.13. doi:10.1186/1757-1146-4-16

Attached Files (Some files may be inaccessible until you login with your UQ eSpace credentials)
Name Description MIMEType Size Downloads

Author Lazzarini, Peter A.
Mackenroth, Elizabeth L.
Régo, Patricia M.
Boyle, Frances M.
Jen, Scott
Kinnear, Ewan M.
PerryHaines, Graham M.
Kamp, Maarten
Title Is simulation training effective in increasing podiatrists’ confidence in foot ulcer management?
Journal name Journal of Foot and Ankle Research   Check publisher's open access policy
ISSN 1757-1146
Publication date 2011-06
Sub-type Article (original research)
DOI 10.1186/1757-1146-4-16
Open Access Status DOI
Volume 4
Issue 16
Start page 16.1
End page 16.13
Total pages 13
Place of publication London, United Kingdom
Publisher BioMed Central
Collection year 2012
Language eng
Formatted abstract
Foot ulcers are a frequent reason for diabetes-related hospitalisation. Clinical training is known to have a beneficial impact on foot ulcer outcomes. Clinical training using simulation techniques has rarely been used in the management of diabetes-related foot complications or chronic wounds. Simulation can be defined as a device or environment that attempts to replicate the real world. The few non-web-based foot-related simulation courses have focused solely on training for a single skill or "part task" (for example, practicing ingrown toenail procedures on models). This pilot study aimed to primarily investigate the effect of a training program using multiple methods of simulation on participants' clinical confidence in the management of foot ulcers.


Sixteen podiatrists participated in a two-day Foot Ulcer Simulation Training (FUST) course. The course included pre-requisite web-based learning modules, practicing individual foot ulcer management part tasks (for example, debriding a model foot ulcer), and participating in replicated clinical consultation scenarios (for example, treating a standardised patient (actor) with a model foot ulcer). The primary outcome measure of the course was participants' pre- and post completion of confidence surveys, using a five-point Likert scale (1 = Unacceptable-5 = Proficient). Participants' knowledge, satisfaction and their perception of the relevance and fidelity (realism) of a range of course elements were also investigated. Parametric statistics were used to analyse the data. Pearson's r was used for correlation, ANOVA for testing the differences between groups, and a paired-sample t-test to determine the significance between pre- and post-workshop scores. A minimum significance level of p < 0.05 was used.

An overall 42% improvement in clinical confidence was observed following completion of FUST (mean scores 3.10 compared to 4.40, p < 0.05). The lack of an overall significant change in knowledge scores reflected the participant populations' high baseline knowledge and pre-requisite completion of web-based modules. Satisfaction, relevance and fidelity of all course elements were rated highly.


This pilot study suggests simulation training programs can improve participants' clinical confidence in the management of foot ulcers. The approach has the potential to enhance clinical training in diabetes-related foot complications and chronic wounds in general.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published:5 June 2011. Article # 16

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Public Health Publications
School of Medicine Publications
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 4 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 3 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Tue, 09 Aug 2011, 16:56:38 EST by Dr Patricia M Rego on behalf of School of Medicine