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

Aims To report the results of a randomised controlled trial which explored the effectiveness of clinical simulation in improving the clinical performance of recognising and managing an adult deteriorating patient in hospital. Background There is evidence that final year undergraduate nurses may lack the knowledge, clinical skills and situation awareness required to competently manage a deteriorating patient in hospital. The effectiveness of clinical simulation as an educational strategy to teach the skills required to recognise and effectively manage the early signs of clinical deterioration needs to be evaluated. Method This was a two centre, randomised, controlled trial with single blinded assessments. Data were collected in July 2013. Ninety- eight first year nursing students were randomised either into a control group where they received a traditional classroom lecture, or an intervention group where they received simulation training. Participants completed a pre and post- intervention 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 surveyed after the teaching intervention. Results The intervention group performed significantly better in the objective structured clinical examination after their simulation training. General Perceived Self Efficacy and Self-Reported Competency were not correlated with performance. There was no significant difference in the post intervention General Perceived Self Efficacy and Self-Reported Competency scores between the control and intervention group. The intervention group were significantly more satisfied with their teaching method. Conclusion Simulation based education may be an effective educational strategy to teach nurses the necessary skills to effectively recognise and manage a deteriorating patient.