O'Rourke Laura A, Morrison Megan, Grimsley Amy, Cotter Valerie T
Mayo Clinic Health System, Lake City, Minnesota, USA.
Johns Hopkins School of Nursing, Baltimore, Maryland, USA.
J Clin Nurs. 2023 May;32(9-10):1549-1555. doi: 10.1111/jocn.16028. Epub 2021 Aug 27.
The aim of this review was to synthesise current knowledge of high-fidelity simulation practices and its impact on nurse clinical competence in the acute care setting.
There is no consensus or standardisation surrounding best practices for the delivery of high-fidelity simulation in the acute care setting. This is an understudied area.
An integrative review using Johns Hopkins Nursing Evidence-Based Practice Model.
Medical subject heading terms 'Clinical Competence', AND 'High Fidelity Simulation Training', AND 'Clinical Deterioration' were systematically searched in PubMed, CINAHL and Embase databases for peer-reviewed literature published through September 2020. The current study was evaluated using PRISMA checklist.
Seven studies met the inclusion criteria. Three main concepts were identified: modes of delivery, approach to learner participation and outcome measurement.
This review substantiated the use of high-fidelity simulation to improve acute care nurses' early identification and management of clinical deterioration. Global variations in course design and implementation highlight the need for future approaches to be standardised at the regional level (i.e., country-centric approach) where differing scopes of practice and sociocultural complexities are best contextualised.
These findings add to the growing body of evidence of simulation science. Important considerations in course planning and design for nursing clinical educators were uncovered. This is especially relevant given the current COVID-19 pandemic and urgent need to train redeployed nurses safely and effectively from other units and specialties to acute care.
本综述旨在综合当前有关高保真模拟实践及其对急症护理环境中护士临床能力影响的知识。
在急症护理环境中，关于高保真模拟的最佳实践尚无共识或标准化。这是一个研究不足的领域。
采用约翰霍普金斯循证护理实践模型进行综合综述。
在PubMed、CINAHL和Embase数据库中系统检索医学主题词“临床能力”、“高保真模拟训练”和“临床恶化”，以查找截至2020年9月发表的同行评审文献。本研究使用PRISMA清单进行评估。
七项研究符合纳入标准。确定了三个主要概念：授课方式、学习者参与方式和结果测量。
本综述证实了使用高保真模拟来提高急症护理护士对临床恶化的早期识别和管理能力。课程设计和实施的全球差异凸显了未来需要在区域层面（即以国家为中心的方法）进行标准化，因为不同的实践范围和社会文化复杂性在该层面能得到最佳的情境化处理。
这些发现增加了模拟科学的证据。揭示了护理临床教育工作者在课程规划和设计中的重要考虑因素。鉴于当前的COVID-19大流行以及迫切需要安全有效地培训从其他科室和专业重新调配到急症护理的护士，这一点尤为重要。
