Patient deterioration simulation experiences: impact on teaching and learning
- Authors: Buykx, Penny , Cooper, Simon J. , Kinsman, Leigh , Scholes, Julie , McConnell-Henry, Tracy , Cant, Robyn
- Date: 2012
- Type: Text , Journal article
- Relation: Collegian: Journal of the Royal College of Nursing Australia Vol. 19, no. 3 (2012), p. 125-129
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- Description: Early recognition and management of patient deterioration are essential nursing skills, and can be improved through education and experience. However, both nursing students and registered nurses may have few opportunities to develop and maintain the emergency management skills necessary to ensure patient safety. Using both theory and empirical evidence, we have developed a simulation-based educational model, ‘FIRST2ACT’ (Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends), to provide nurses with a high-fidelity learning experience. The model has been tested in three different settings: it is highly acceptable to learners, adaptable to different training needs, and shows promise in improving actual clinical performance.
Final -year nursing student's ability to assess, detect and act on clinical cues of deterioration in a simulated environment
- Authors: Endacott, Ruth , Cooper, Simon J. , Scholes, Julie , Kinsman, Leigh , McConnell-Henry, Tracy
- Date: 2010
- Type: Text , Journal article
- Relation: Journal of Advanced Nursing Vol. 66, no. 12 (2010), p. 2722-2731
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- Description: Aim. This is a report of a study investigating processes used by final-year nursing students to recognize and act on clinical cues of deterioration in a simulated environment. Background. Initial decisions about patients who are deteriorating in medical and surgical wards are often made by newly qualified nurses and doctors, increasing the risk of clinical error. There has been an emphasis on the use of teams in simulation; however, signs of deterioration are missed by individual clinicians. Methods. During July 2008, final-year undergraduate nursing students in Australia attended a simulation laboratory for 1Æ5 hours and completed a knowledge questionnaire and two (mannequin-based) scenarios simulating deteriorating patients with hypovolaemic and septic shock. Scenarios were video-recorded and reflective interviews conducted. Additionally, scenarios were stopped around the midpoint to ascertain students’ level of Situation Awareness. Results. Fifty-one students participated in the study, providing a total of 102 videoed scenarios and 51 interviews. Thematic analysis of video data and reflective interviews identified considerable differences in processes used by students to identify cues. Four aspects of cue recognition were evident: initial response, differential recognition of cues, accumulation of signs and diversionary activity. Conclusion. Nursing skills training should emphasize the importance of trends in identifying and acting on deterioration and the need for systematic assessment in stressful situations. Nursing curricula should focus on enhancing the ability to piece information together, including linking pathophysiology with patient assessment, and identify trends, rather than seeing observations as parallel to each other.