Sean Morton

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

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.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.

Can a single brief intervention improve participants’ readiness for interprofessional learning?

Abstract Interprofessional learning (IPL) was introduced for University of Nottingham 3rd year medical and nursing students at the Lincoln County Hospital. An evaluation of the subsequently implemented IPL intervention allowed us to ask the research question: can a single brief IPL intervention improve attitudes to IPL? A low fidelity simulation intervention was chosen as the mode of IPL, focusing on teamwork in the context of the assessment of the acutely ill patient. To assess the intervention’s effect on students’ attitudes, a validated questionnaire (RIPLS) was completed before and after the session. Nine of the nineteen questions in RIPLS had significantly different responses following the intervention. This reflected a more positive attitude to IPL following the intervention. This evaluation of this intervention suggests that IPL is valued by students and significantly improves attitudes to IPL, at least in the immediate post-intervention period.

Managed Care:A structured approach

The authors developed a model of clinical nurse management based on the concept of managed care. This article, which describes the model, is intended to encourage nurses to consider their role as manager and engage in activities that support good management of clinical practice. The model presents several components that need to be monitored and controlled if best care is to be achieved. Specifying these components in the form of a model allows a visual representation of practice and supports contemporary thinking about healthcare management from the perspective of the nurse in clinical practice.