Comparison of standardized patients with high-fidelity simulators for managing stress and improving performance in clinical deterioration: A mixed methods study

Ignacio, Jeanette, Dolmans, Diana, Scherpbier, Albert, Rethans, Jan-Joost, Chan, Sally and Liaw, Sok Ying (2015) Comparison of standardized patients with high-fidelity simulators for managing stress and improving performance in clinical deterioration: A mixed methods study. Nurse Education Today, 35 12: 1161-1168. doi:10.1016/j.nedt.2015.05.009


Author Ignacio, Jeanette
Dolmans, Diana
Scherpbier, Albert
Rethans, Jan-Joost
Chan, Sally
Liaw, Sok Ying
Title Comparison of standardized patients with high-fidelity simulators for managing stress and improving performance in clinical deterioration: A mixed methods study
Journal name Nurse Education Today   Check publisher's open access policy
ISSN 0260-6917
1532-2793
Publication date 2015-12
Year available 2015
Sub-type Article (original research)
DOI 10.1016/j.nedt.2015.05.009
Open Access Status Not Open Access
Volume 35
Issue 12
Start page 1161
End page 1168
Total pages 8
Place of publication Kidlington, United Kingdom
Publisher Churchill Livingstone
Collection year 2016
Language eng
Formatted abstract
Background

The use of standardized patients in deteriorating patient simulations adds realism that can be valuable for preparing nurse trainees for stress and enhancing their performance during actual patient deterioration. Emotional engagement resulting from increased fidelity can provide additional stress for student nurses with limited exposure to real patients. To determine the presence of increased stress with the standardized patient modality, this study compared the use of standardized patients (SP) with the use of high-fidelity simulators (HFS) during deteriorating patient simulations. Performance in managing deteriorating patients was also compared. It also explored student nurses' insights on the use of standardized patients and patient simulators in deteriorating patient simulations as preparation for clinical placement.

Methods

Fifty-seven student nurses participated in a randomized controlled design study with pre- and post-tests to evaluate stress and performance in deteriorating patient simulations. Performance was assessed using the Rescuing A Patient in Deteriorating Situations (RAPIDS) rating tool. Stress was measured using salivary alpha-amylase levels. Fourteen participants who joined the randomized controlled component then participated in focus group discussions that elicited their insights on SP use in patient deterioration simulations.

Results


Analysis of covariance (ANCOVA) results showed no significant difference (p = 0.744) between the performance scores of the SP and HFS groups in managing deteriorating patients. Amylase levels were also not significantly different (p = 0.317) between the two groups. Stress in simulation, awareness of patient interactions, and realism were the main themes that resulted from the thematic analysis.

Conclusions

Performance and stress in deteriorating patient simulations with standardized patients did not vary from similar simulations using high-fidelity patient simulators. Data from focus group interviews, however, suggested that the use of standardized patients was perceived to be valuable in preparing students for actual patient deterioration management.
Keyword Simulations
Stress
Performance
Patient deterioration
Nursing education
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Non HERDC
School of Nursing, Midwifery and Social Work Publications
 
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Created: Fri, 25 Sep 2015, 10:49:17 EST by Vicki Percival on behalf of School of Nursing, Midwifery and Social Work