Randomized, controlled trial of the effectiveness of simulation education : a 24-month follow-up study in a clinical setting

Abstract

<div lang="en" class="abs"><p class="abs_header">Abstract</p><p><em>Background:</em> Critical care nurses’ knowledge and skills in adhering to evidence-based guidelines for avoiding complications associated with intubation and mechanical ventilation are currently limited. We hypothesized that single simulation education session would lead to a long-lasting higher level of skills among critical care nurses.</p><p><em>Material and methods:</em> A randomized controlled trial was conducted in a 22-bed adult mixed medical-surgical intensive care unit in Finland during the period February 2012–March 2014. Thirty out of 40 initially randomized critical care nurses participated in a 24-month follow-up study. Behavior and cognitive development was evaluated through a validated Ventilator Bundle Observation Schedule and Questionnaire at the baseline measurement and repeated 3 times during simulation and real-life clinic settings.</p><p><em>Results:</em> After simulation education, the average skills score increased from 46.8%–58.8% of the total score in the final postintervention measurement (<em>P</em>_time < .001, <em>P</em>_{time × group} = .040, and <em>P</em>_group = .11). The average knowledge scores within groups did not change significantly. The average between-group difference in skills scores was significant only at the measurement taken at 6 months (<em>P</em> = .006).</p><p><em>Conclusions:</em> Critical care nurses’ skills in adhering to evidence-based guidelines improved in both groups over time, but the improvements between the study groups was significantly different only at 6 months and was no longer evident after 2 years following a single simulation education.</p></div>