An integrative literature review on preparing nursing students through simulation to recognize and respond to the deteriorating patient

AIMS: To synthesize studies that explored simulation as preparation of nursing students for recognition and response to the deteriorating patient. BACKGROUND: New graduate nurses are expected to have the skills to recognize and respond to rapidly deteriorating patient conditions. To this end, education programmes have turned increasingly to simulation to assist students to gain the necessary skills. DESIGN: Integrative review. DATA SOURCES: CINAHL, Informit, ProQuest, Ovid MEDLINE, SAGE Journals and Web of Knowledge electronic databases, keywords and inclusion/exclusion criteria were searched. Eighteen studies published between 2004-2012 were found. REVIEW METHODS: Studies were appraised using recognized evaluation tools. Thematic analysis was undertaken and emergent themes were extracted with similar and divergent perspectives sought. RESULTS: Six themes were identified namely, 'transferability of simulation skills to clinical practice', 'exposure to broader range of experiences', 'confidence levels in relation to simulation training', 'competence/performance', 'clinical judgment' and 'student perceptions of preparedness for practice following simulation'. CONCLUSION: Simulation exposes students to a broader range of experiences whilst in a safe environment with transference of skills to clinical practice occurring. Confidence, clinical judgement, knowledge and competence, all vital in the care of a deteriorating patient, were enhanced. However, evidence of simulation used specifically to prepare nursing students to recognize and respond to the deteriorating patient appeared limited. This educational field appears rich for interprofessional collaboration and further research.