Fifty-one students attended. The mean knowledge score was 74% (range 46 -100%) and the mean skill performance score across both scenarios was 60% (range 30 - 78%). Age and experience had no significant effect on skill performance.
Skill performance declined significantly as the patient’s condition deteriorated. The mean situational awareness score across both scenarios was 59% (range 38% - 82%). Age and experience did not influence situational awareness.
Participants were able to identify physiological indicators of deterioration (77%) but had low comprehension scores (44%). There were no significant associations between measures of knowledge, skill performance and situational awareness measures.
The majority of students appeared to aggregate single findings to stimulate a response e.g. dropping oxygen saturations equates to oxygen mask being applied to the patient. Fewer seemed able or confident to aggregate more than three discrete elements of the physiological change. Student self ratings of pre-post knowledge levels indicated a significant improvement in understanding of patient deterioration following the simulation exercise.
Knowledge scores suggest, on average, a satisfactory academic preparation, but there were significant deficits in students’ ability to manage patient deterioration. Routine assessment tasks became less frequent as deterioration worsened, highlighting the need for a systematic approach to patient assessment (such as primary and secondary survey) to be embedded in nursing curricular.
Simulation techniques appear to be a good way of assessing skill and situation awareness and may improve performance when integrated into curricula.