Decision-making skills improve with critical care training: Using simulation to measure progress

J Crit Care. 2018 Oct:47:133-138. doi: 10.1016/j.jcrc.2018.06.021. Epub 2018 Jun 25.


Purpose: Health care professionals are expected to acquire decision-making skills during their training, but few methods are available to assess progress in acquiring these essential skills. The purpose of this study was to determine whether a simulation methodology could be used to assess whether decision-making skills improve during critical care training.

Materials and methods: Sixteen simulated scenarios were designed to assess a critical care provider's ability to make decisions in the care of a critical ill patient. Seventeen (17) critical care providers managed 8 of the scenarios early during their training and then managed a second set of 8 scenarios (T2) at the conclusion of their training.

Results: Provider's mean global scenario scores (0-9) increased significantly fromT1 and T2 (5.64 ± 0.74) and (6.54 ± 0.64) with a large effect size (1.3). Acute care nurse practitioners and fellows achieved similar overall scores at the conclusion of their training (ACNP 6.43 ± 0.57; Fellows 6.64 ± 0.72).

Conclusions: These findings provide evidence to support the validity of a simulation-based method to assess progress in decision-making skills. A simulation methodology could be used to establish a performance standard that determined a provider's ability to make independent decisions.

Keywords: Critical care; Diagnostic skills, acute care nurse practitioners; Educational measurement; Intensive care units; Simulation.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Clinical Competence / standards*
  • Clinical Decision-Making*
  • Critical Care / standards*
  • Educational Measurement
  • Humans
  • Patient Care Team / standards*
  • Simulation Training*