Teaching Crisis Co-Regulation in Occupational Therapy: A Pilot Study of a Simulation-Based Role-Play

Document Type (Journals)

Educational Innovations

Abstract

Health professions educators have identified a need for tools to assess student competence in de-escalation and co-regulation. Despite the importance of proficiency with these clinical skills, there is little evidence examining effective approaches for teaching and assessing these skills in occupational therapy students. This pilot study utilized a simulation-based role-play experience to determine the feasibility of a teaching method for occupational therapy students to apply these skills in psychosocial scenarios. Activities were conducted as a required component of a Psychosocial and Community Practice course. Prior to the simulation, students completed instruction addressing emotional regulation and co-regulation. Students then practiced these skills through peer role play using structured case scenarios. Student performance on the assessment portion was rated by a trained faculty member. Student confidence data was also gathered. The mean overall performance score (n = 34) on the simulation-based assessment was 90.32% (SD = 8.11%), with a small-to-moderate positive association (r_s = 0.30) between student confidence and graded performance. The mean student confidence rating had a statistically significant increase from pre-assessment to post-assessment t(12) = 6.42, p < 0.001, Cohen’s d = 1.78. Findings suggest that there is potential benefit to simulation-based role-play assessments in building skills and confidence related to crisis co-regulation. Although situated within a psychosocial course, this activity may fit within multiple areas of occupational therapy curricula. This systematic approach demonstrates a feasible method for assessment within a laboratory environment and aligns with accreditation expectations related to student preparation for safe, ethical, and effective practice and clinical interactions.

Biography

Carli DiMeo, OTD, OTR/L, BCP is an Assistant Clinical Professor of Occupational Therapy at Bowling Green State University. She has clinical experience in inpatient and community mental health, neurorehabilitation, and pediatric settings. Her scholarship and advocacy interests prioritize preparing students for psychosocial practice and expanding the role of occupational therapy in mental health practice settings.

Allen Keener, PhD, OTD, OTR/L, ATP, FAOTA is an Associate Clinical Professor of Occupational Therapy at Bowling Green State University. His clinical experience includes adult and geriatric mental health, physical dysfunction, and various other areas. His scholarship interests include psychosocial aspects of practice, health literacy, and innovative teaching and learning.

Elizabeth G. Hunter, PhD, MS, OTR/L is an Associate Professor of Occupational Therapy at Bowling Green State University. She has extensive experience in conducting research and has served as the AOTA Evidence Based Practice programs research methodologist for over 8 years. In that position, she has completed and facilitated many systematic reviews and AOTA practice guidelines.

Declaration of Interest

The authors report no declarations of interest.

Recommended Citation

DiMeo, C., Keener, A., & Hunter, E. G. (2026). Teaching Crisis Co-Regulation in Occupational Therapy: A Pilot Study of a Simulation-Based Role-Play. Journal of Occupational Therapy Education, 10 (3). Retrieved from https://encompass.eku.edu/jote/vol10/iss3/19