Rescuing A Patient In Deteriorating Situations (RAPIDS): A simulation-based educational program on recognizing, responding and reporting of physiological signs of deterioration

Resuscitation. 2011 Sep;82(9):1224-30. doi: 10.1016/j.resuscitation.2011.04.014. Epub 2011 May 5.


Aim: To describe the development, implementation and evaluation of an undergraduate nursing simulation program for developing nursing students' competency in assessing, managing and reporting of patients with physiological deterioration.

Method: A full-scale simulation program was developed and implemented in a pre-registered nursing curriculum. A randomized controlled study was performed with 31 third year nursing students. After a baseline evaluation of all participants in a simulated environment, the intervention group underwent four simulation scenarios in a 6h education session. All participants were then re-tested. The baseline and post-test simulation performances were scored using a validated tool. The students completed a survey to evaluate their learning experiences.

Results: The clinical performances mean scores for assessment and management of deteriorating patients improved significantly after the training program compared to baseline scores (t=9.26; p<0.0001) and to post-test mean scores of the control group (F=77.28; p<0.0001). The post-test mean scores of the intervention group in reporting deterioration was significantly higher than the baseline mean scores (t=4.24; p<0.01) and the post-test means scores of the control group (F=8.98; p<0.01). The participants were satisfied with their simulation experiences, rated positively on features of the simulation and valued the program in developing their self-confidence.

Conclusion: The nursing students' competency in assessing, managing and reporting of deteriorating patient can be enhanced through a systematic development and implementation of a simulation-based educational program that utilized mnemonics to help students to remember key tasks.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Chi-Square Distribution
  • Computer Simulation
  • Curriculum*
  • Disease Progression*
  • Education, Nursing, Baccalaureate / organization & administration*
  • Educational Measurement
  • Female
  • Humans
  • Male
  • Models, Educational
  • Multivariate Analysis
  • Nursing Diagnosis
  • Patient Simulation
  • Professional Competence*
  • Program Evaluation
  • Reference Values
  • Singapore
  • Students, Nursing / statistics & numerical data
  • Vital Signs*
  • Young Adult