Recognizing and managing a deteriorating patient: a randomized controlled trial investigating the effectiveness of clinical simulation in improving clinical performance in undergraduate nursing students

J Adv Nurs. 2015 Nov;71(11):2563-74. doi: 10.1111/jan.12722. Epub 2015 Jul 6.

Abstract

Aims: To report the results of a randomized controlled trial which explored the effectiveness of clinical simulation in improving the clinical performance of recognizing and managing an adult deteriorating patient in hospital.

Background: There is evidence that final year undergraduate nurses may lack knowledge, clinical skills and situation awareness required to manage a deteriorating patient competently. The effectiveness of clinical simulation as a strategy to teach the skills required to recognize and manage the early signs of deterioration needs to be evaluated.

Design: This study was a two centre phase II single, randomized, controlled trial with single blinded assessments.

Method: Data were collected in July 2013. Ninety-eight first year nursing students were randomized either into a control group, where they received a traditional lecture, or an intervention group where they received simulation. Participants completed a pre- and postintervention objective structured clinical examination. General Perceived Self Efficacy and Self-Reported Competency scores were measured before and after the intervention. Student satisfaction with teaching was also surveyed.

Results: The intervention group performed significantly better in the post-objective structured clinical examination. There was no significant difference in the postintervention General Perceived Self Efficacy and Self-Reported Competency scores between the control and intervention group. The intervention group was significantly more satisfied with their teaching method.

Conclusion: Simulation-based education may be an effective educational strategy to teach nurses the skills to effectively recognize and manage a deteriorating patient.

Keywords: clinical performance; critical illness; nursing education; patient deterioration; patient simulation; randomized controlled trial; self-efficacy.

Publication types

  • Clinical Trial, Phase II
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Clinical Competence / standards*
  • Critical Illness / nursing*
  • Disease Progression
  • Education, Nursing / methods*
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Self Efficacy
  • Simulation Training / methods*
  • Single-Blind Method
  • Students, Nursing / psychology
  • Teaching / methods
  • Young Adult