Virtual versus laboratory simulation training for nursing students : improving recognition and management of acute deterioration

Abstract

Overview of the topic: In newly graduated nurses it could be recognised that there is a lack of competence in identifying and subsequently managing acute deterioration. Independent practice of students within the clinical setting with regards to deterioration is limited. To address this gap in training, simulation is considered as one of the possible strategies. The research question: When compared to lab-based simulation training, does virtual simulation training enhance the competence of student nurses in recognising and managing acute deterioration? PICO elements: The population comprised of student nurses undergoing, virtual or lab-based simulation training. Elements that enhance competence in recognising and managing acute deterioration were looked at as outcomes. Methods: Pertinent keywords in combination with search tools were utilised to systematically search the literature. The PRISMA diagram provided a clear audit trail for selection of studies. Inclusion criteria consisted of studies which focused on undergraduate nursing students, participating in the intervention or comparison, looking at outcomes of knowledge or clinical performance. This resulted in six key studies for appraisal. The CASP and JBI tools were used to appraise the four NRCTs, one systematic review and meta-analysis and one RCT. Results: Due to the quality of the research available, the research question could not be accurately answered. This could be explained due to the study design limitations and methodological differences. Despite lack of conclusive results, there is support for further research within the area. The implications and most important recommendations: The use of longitudinal studies with larger sample sizes, was one of the recommendations. Higher quality study designs that compare directly the two different simulation methods would also support reaching more concrete conclusions. Conduction of cost-analysis is essential to identify lowest possible costs that need to be allocated as finances within universities.