Effect of a proficiency-based progression simulation programme on clinical communication for the deteriorating patient: a randomised controlled trial
| dc.contributor.author | Breen, Dorothy | |
| dc.contributor.author | O'Brien, Sinead | |
| dc.contributor.author | McCarthy, Nora | |
| dc.contributor.author | Gallagher, Anthony | |
| dc.contributor.author | Walshe, Nuala | |
| dc.date.accessioned | 2019-09-09T09:22:59Z | |
| dc.date.available | 2019-09-09T09:22:59Z | |
| dc.date.issued | 2019-07-09 | |
| dc.description.abstract | Objective: This study aimed to determine the effectiveness of a proficiency-based progression (PBP) training approach to clinical communication in the context of a clinically deteriorating patient.Design This is a randomised controlled trial with three parallel arms.Setting: This study was conducted in a university in Ireland.Participants: This study included 45 third year nursing and 45 final year medical undergraduates scheduled to undertake interdisciplinary National Early Warning Score (NEWS) training over a 3-day period in September 2016.Interventions: Participants were prospectively randomised to one of three groups before undertaking a performance assessment of the ISBAR (Identification, Situation, Background, Assessment, Recommendation) communication tool relevant to a deteriorating patient in a high-fidelity simulation facility. The groups were as follows: (i) E, the Irish Health Service national NEWS e-learning programme only; (ii) E+S, the national e-learning programme plus standard simulation; and (iii) E+PBP, the national e-learning programme plus PBP simulation.Main outcome measures: The primary outcome was the proportion in each group reaching a predefined proficiency benchmark comprising a series of predefined steps, errors and critical errors during the performance of a standardised, high-fidelity simulation assessment case which was recorded and scored by two independent blinded assessors.Results: 6.9% (2/29) of the E group and 13% (3/23) of the E+S group demonstrated proficiency in comparison to 60% (15/25) of the E+PBP group. The difference between the E and the E+S groups was not statistically significant (χ2=0.55, 99% CI 0.63 to 0.66, p=0.63) but was significant for the difference between the E and the E+PBP groups (χ2=22.25, CI 0.00 to 0.00, p<0.000) and between the E+S and the E+PBP groups (χ2=11.04, CI 0.00 to 0.00, p=0.001).Conclusions: PBP is a more effective way to teach clinical communication in the context of the deteriorating patient than e-learning either alone or in combination with standard simulation.Trial registration number: NCT02886754; Results. | en |
| dc.description.status | Peer reviewed | en |
| dc.description.version | Published Version | en |
| dc.format.mimetype | application/pdf | en |
| dc.identifier.articleid | e025992 | en |
| dc.identifier.citation | Breen, D., O’Brien, S., McCarthy, N., Gallagher, A. and Walshe, N. (2019) 'Effect of a proficiency-based progression simulation programme on clinical communication for the deteriorating patient: a randomised controlled trial', 9(7), e025992. (8pp.) DOI: 10.1136/bmjopen-2018-025992 | en |
| dc.identifier.doi | 10.1136/bmjopen-2018-025992 | en |
| dc.identifier.eissn | 2044-6055 | |
| dc.identifier.endpage | 8 | en |
| dc.identifier.issued | 7 | en |
| dc.identifier.journaltitle | BMJ Open | en |
| dc.identifier.startpage | 1 | en |
| dc.identifier.uri | https://hdl.handle.net/10468/8468 | |
| dc.identifier.volume | 9 | en |
| dc.language.iso | en | en |
| dc.publisher | BMJ Publishing | en |
| dc.relation.uri | https://bmjopen.bmj.com/content/bmjopen/9/7/e025992.full.pdf | |
| dc.rights | ©Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. | en |
| dc.rights.uri | https://creativecommons.org/licenses/by-nc/4.0/ | en |
| dc.subject | ISBAR (Identification, Situation, Background, Assessment, Recommendation) communication tool | en |
| dc.subject | Proficiency-Based Progression (PBP) | en |
| dc.subject | Randomised Controlled Trial (RCT) | en |
| dc.subject | Clinically deteriorating patient | en |
| dc.title | Effect of a proficiency-based progression simulation programme on clinical communication for the deteriorating patient: a randomised controlled trial | en |
| dc.type | Article (peer-reviewed) | en |
