Simulation training appears to improve nurses’ ability to recognise and manage clinical deterioration

Abstract

Implications for practice and research► Evidence suggests that simulation training improves nurses' clinical knowledge and performance in recognising and managing clinical deterioration in simulated environments. ► More research is required to establish the most effective models of simulation training and the impact on patient outcomes in real clinical settings. ► The development of a valid and reliable standardised evaluation tool could improve the comparability and consistency of simulation training in the recognition and management of clinical deterioration. ContextThe importance of education has been highlighted to support nurses' role in recognising and responding to clinical deterioration. 1 Simulation is increasingly used as a teaching modality in both academic and clinical settings to improve nurses' ability to recognise and manage clinical deterioration. 2 This meta-analysis is very timely in quantitatively synthesising the effectiveness of simulation education in the recognition and management of clinical deterioration. MethodsSix databases were searched until June 2016, including randomised controlled trials (RCTs) or quasi-experimental studies using pretestposttest designs that evaluated the effect of simulation-based interventions on student nurses' and/or nurses' knowledge and performances in recognising and managing clinical deterioration. For each study, a standardised mean difference (d) effect size was computed for the reported outcomes. Due to the vast heterogeneity across studies, random-effect analyses were conducted to examine the effect sizes for knowledge and performance. Moderator analyses were conducted to determine whether effect sizes were influenced by simulated-based intervention characteristics. FindingsThe meta-analyses included 19 empirical research studies. Although the effect sizes for both knowledge and performance increased significantly across both single-group pretest-posttest and two-group posttest analyses, simulation-based interventions have stronger effects on performance. In single-group pretest-posttest, moderator analysis suggested that length of session had a larger positive impact on knowledge scores as compared with increasing the number of clinical scenarios utilised during simulation. Face-to-face simulation was also observed to be significantly associated with an increase in effect size for knowledge compared with web-based simulation programs, but not so for performance. CommentaryThis is the first meta-analysis to examine the effectiveness of simulation on nurses' knowledge and performance in recognising and managing clinical deterioration. The findings suggest that simulated-based learning has a positive effect on nurses' knowledge and performance to recognise and manage clinical deterioration. However, the results must be interpreted with caution. As acknowledged by the authors, there was significant heterogeneity in each analysis. Heterogeneity was influenced by the considerable variability among simulation intervention characteristics and implementation p...

The analysis of pedagogical technologies efficiency in the professional training of medical specialists

“…The experience of implementing simulation training technologies has been applied in teaching pediatrics [4], propaedeutics of internal diseases [5], during the test tasks of various levels [6] and in the training of doctors [7]. Simulation of production situations and integration of high-tech skills modeling (HFS) into nursing education is a common strategy for professional development [8] and acquisition of clinical competencies of future specialists [9], modeling of production situations ensures the effectiveness of methods for knowledge improving of nurses and their productivity [10], has a strong educational effect, especially in the psychomotor sphere [11]. The researchers considered the contribution of integrated simulation-based learning as a learning tool on technical and nontechnical issues, as well as how this work can be done for patient safety through a standardized training plan [12].…”

Theoretical foundations of educational strategies used in e-learning environments for developing clinical reasoning in nursing students: A scoping review

“…Thus, examining the theoretical foundations underlying these educational strategies, as well as the educational strategies themselves, would allow characterization and mapping the principles of CC found in e-learning environments. In addition, as CR is traditionally assessed by methods well-suited for face-to-face assessment such as think-aloud methods or observation grids (Chua, 2017;Crowe et al, 2018;Forsberg et al, 2014), it remains unclear how assessment methods of CR have been translated to e-learning environments.…”

Reliability and validity of scenario-specific versus generic simulation assessment rubrics

“…[2] Well-designed clinical simulations allow all students to be exposed to a broader range of situations that may not occur during their clinical placements, can enhance nursing student critical thinking, and better prepare them to recognize and effectively respond to unfamiliar or emergency situations while witnessing the effects of their patient care decisions in a setting where they do not need to be anxious about inflicting patient harm. [3][4][5][6] Assessment is an important but often overlooked component of simulation education and research. [7] Simulation outcomes may be measured at the participant, patient or system level; key participant learning outcomes include changes in knowledge, skills, attitudes and behaviours.…”