what is the impact of clinical simulation on the clinical competence of undergraduate nursing students in recognising and managing deteriorating patients?

Abstract

Background: the late detection of a deteriorating patient has an impact on clinical outcomes. Several studies have highlighted issues regarding the mismanagement of the deteriorating patient in general wards. Moreover, delayed admission of deteriorating patients in critical care units is associated with high mortality and morbidity. Nursing Students are expected to be sufficiently knowledgeable and skilled to deal with clinical situations; however, various studies reported that a number of students were unable to recognise a deteriorating patient. This has raised awareness of the need for an improved educational strategy to enhance nursing students’ competence. Clinical simulation is a teaching and learning strategy that has shown many benefits such as improve communication competency, self-efficacy and knowledge among nursing students.

Objective: This systematic review evaluates the impact of clinical simulation on nursing students’ competence in recognising and managing deteriorating patients

Method: the PICO method was used to formulate the review question. CINHAL, EMBASE, and MEDLINE databases were used to conduct an extensive literature search utilising relevant keywords. The search was limited to English language publications and included studies that used clinical simulation as an intervention. Randomised controlled trails, non-randomised controlled trails, quasi-experimental and pre- and -post-test design were included. The Joanna Briggs Institute critical appraisal checklist was used to appraise the papers in this review.

Result: nine papers were included in this review. The included studies reported that clinical simulation could provide opportunities for nursing students to improve their competence in a safe environment in the recognition and management of the deteriorating patient.

Conclusion: the evidence demonstrates that the use of clinical simulation could be a useful educational tool. It provided a safe and effective environment to support nursing students in learning about clinical deterioration; however, most studies had methodological weaknesses, indicating for further research to ensure the effective of clinical simulation and the sustainability of the acquired knowledge and skills.