A quasi-experiential pilot study exploring the perception and performance of nursing students using a second-generation version of rapid cycle deliberate practice simulation

Background and Aim
It is critical that nurses are competent and confident to recognise patient deterioration and respond. Developing requisite skills is challenging and there are concerns that nurses’ knowledge to expediently recognise patient deterioration are insufficient. Simulation has been widely used to deliver patient deterioration education. In this study, we have tested an innovative simulation approach called Rapid Cycle Intentional Simulation (RCIS), which differs from other simulation approaches by using intentional interruptions to provide immediate feedback with the objective of re-aligning behaviour.

The project investigated the impact of RCIS on undergraduate nurses’ knowledge and performance in recognising and responding to the deteriorating patient, compared to standard simulation.

Methods
A prospective, quasi-experimental design evaluated two simulation approaches (Standard versus RCIS). Second year (n=138) undergraduate nursing students participated in the study. Participants completed surveys at pre and post simulation and post clinical placement. Researchers documented observations of RCIS and conducted a one-hour reflective discussion to explore the perceived impact of RCIS on student learning.

Results
Knowledge, perceived confidence, and satisfaction between standard and RCIS did not significantly increase from baseline (p=0.67) to post clinical placement (p=0.26). Yet four qualitative themes identify lessons learnt and explain RCIS’s impact on student performance, simulation experience, and patient assessment. Key findings were students hiding behaviour to minimise discomfiture and inattentiveness …