J. Med. Internet Res. - Comparison of virtual patient simulation with mannequin-based simulation for improving clinical performances in assessing and managing clinical deterioration: randomized controlled trial.


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CKGROUND: Virtual patient simulation has grown substantially in health care education. A virtual patient simulation was developed as a refresher training course to reinforce nursing clinical performance in assessing and managing deteriorating patients.OBJECTIVE: The objective of this study was to describe the development of the virtual patient simulation and evaluate its efficacy, by comparing with a conventional mannequin-based simulation, for improving the nursing students' performances in assessing and managing patients with clinical deterioration.METHODS: A randomized controlled study was conducted with 57 third-year nursing students who were recruited through email. After a baseline evaluation of all participants' clinical performance in a simulated environment, the experimental group received a 2-hour fully automated virtual patient simulation while the control group received 2-hour facilitator-led mannequin-based simulation training. All participants were then re-tested one day (first posttest) and 2.5 months (second posttest) after the intervention. The participants from the experimental group completed a survey to evaluate their learning experiences with the newly developed virtual patient simulation.RESULTS: Compared to their baseline scores, both experimental and control groups demonstrated significant improvements (P<.001) in first and second post-test scores. While the experimental group had significantly lower (P<.05) second post-test scores compared with the first post-test scores, no significant difference (P=.94) was found between these two scores for the control group. The scores between groups did not differ significantly over time (P=.17). The virtual patient simulation was rated positively.CONCLUSIONS: A virtual patient simulation for a refreshing training course on assessing and managing clinical deterioration was developed. Although the randomized controlled study did not show that the virtual patient simulation was superior to mannequin-based simulation, both simulations have demonstrated to be effective refresher learning strategies for improving nursing students' clinical performance. Given the greater resource requirements of mannequin-based simulation, the virtual patient simulation provides a more promising alternative learning strategy to mitigate the decay of clinical performance over time.

Resumo Limpo

ckground virtual patient simul grown substanti health care educ virtual patient simul develop refresh train cours reinforc nurs clinic perform assess manag deterior patientsobject object studi describ develop virtual patient simul evalu efficaci compar convent mannequinbas simul improv nurs student perform assess manag patient clinic deteriorationmethod random control studi conduct thirdyear nurs student recruit email baselin evalu particip clinic perform simul environ experiment group receiv hour fulli autom virtual patient simul control group receiv hour facilitatorl mannequinbas simul train particip retest one day first posttest month second posttest intervent particip experiment group complet survey evalu learn experi newli develop virtual patient simulationresult compar baselin score experiment control group demonstr signific improv p first second posttest score experiment group signific lower p second posttest score compar first posttest score signific differ p found two score control group score group differ signific time p virtual patient simul rate positivelyconclus virtual patient simul refresh train cours assess manag clinic deterior develop although random control studi show virtual patient simul superior mannequinbas simul simul demonstr effect refresh learn strategi improv nurs student clinic perform given greater resourc requir mannequinbas simul virtual patient simul provid promis altern learn strategi mitig decay clinic perform time

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