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Undergraduate nursing students' performance in recognising and responding to sudden patient deterioration in high psychological fidelity simulated environments: an Australian multi-centre study

Bogossian, Fiona, Cooper, Simon, Cant, Robyn, Beauchamp, Alison, Porter, Joanne, Kain, Victoria, Bucknall, Tracey and Phillips, Nicole M. 2014, Undergraduate nursing students' performance in recognising and responding to sudden patient deterioration in high psychological fidelity simulated environments: an Australian multi-centre study, Nurse education today, vol. 34, no. 5, pp. 691-696.

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Title Undergraduate nursing students' performance in recognising and responding to sudden patient deterioration in high psychological fidelity simulated environments: an Australian multi-centre study
Author(s) Bogossian, Fiona
Cooper, Simon
Cant, Robyn
Beauchamp, AlisonORCID iD for Beauchamp, Alison orcid.org/0000-0001-6555-6200
Porter, Joanne
Kain, Victoria
Bucknall, Tracey
Phillips, Nicole M.ORCID iD for Phillips, Nicole M. orcid.org/0000-0002-6821-4983
Journal name Nurse education today
Volume number 34
Issue number 5
Start page 691
End page 696
Total pages 6
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2014-05
ISSN 0260-6917
1532-2793
Keyword(s) education
nursing
patient deterioration
simulation
clinical performance
clinical decision making
situation awareness
team work
Summary Objectives
This paper reports the quantitative findings of the first phase of a larger program of ongoing research: Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends (FIRST2ACTTM). It specifically aims to identify the characteristics that may predict primary outcome measures of clinical performance, teamwork and situation awareness in the management of deteriorating patients.

Design
Mixed-method multi-centre study.

Setting
High fidelity simulated acute clinical environment in three Australian universities.

Participants
A convenience sample of 97 final year nursing students enrolled in an undergraduate Bachelor of Nursing or combined Bachelor of Nursing degree were included in the study.

Method
In groups of three, participants proceeded through three phases: (i) pre-briefing and completion of a multi-choice question test, (ii) three video-recorded simulated clinical scenarios where actors substituted real patients with deteriorating conditions, and (iii) post-scenario debriefing. Clinical performance, teamwork and situation awareness were evaluated, using a validated standard checklist (OSCE), Team Emergency Assessment Measure (TEAM) score sheet and Situation Awareness Global Assessment Technique (SAGAT). A Modified Angoff technique was used to establish cut points for clinical performance.

Results
Student teams engaged in 97 simulation experiences across the three scenarios and achieved a level of clinical performance consistent with the experts' identified pass level point in only 9 (1%) of the simulation experiences. Knowledge was significantly associated with overall teamwork (p = .034), overall situation awareness (p = .05) and clinical performance in two of the three scenarios (p = .032 cardiac and p = .006 shock). Situation awareness scores of scenario team leaders were low overall, with an average total score of 41%.

Conclusions
Final year undergraduate nursing students may have difficulty recognising and responding appropriately to patient deterioration. Improving pre-requisite knowledge, rehearsal of first response and team management strategies need to be a key component of undergraduate nursing students' education and ought to specifically address clinical performance, teamwork and situation awareness.
Language eng
Field of Research 111003 Clinical Nursing: Secondary (Acute Care)
139999 Education not elsewhere classified
080399 Computer Software not elsewhere classified
Socio Economic Objective 920210 Nursing
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2013, Elsevier
Persistent URL http://hdl.handle.net/10536/DRO/DU:30057518

Document type: Journal Article
Collections: School of Nursing and Midwifery
Population Health
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Citation counts: TR Web of Science Citation Count  Cited 28 times in TR Web of Science
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Created: Thu, 07 Nov 2013, 12:48:18 EST by Jane Moschetti

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