The Effect of High-Fidelity Multi-Patient Emergency Simulation on Emergency Nursing Knowledge, Clinical Judgment, and Clinical Performance among Undergraduate Nursing Students: A quasi experimental design

Description

This project aims to evaluate the effectiveness of a high-fidelity multi-patient emergency simulation in improving nursing students’ knowledge of emergency recognition and management and their ability to demonstrate clinical judgment and coordinated clinical performance during rapidly changing emergency situations. Undergraduate nursing students will participate in a structured simulation involving three patients with evolving emergencies: unstable ventricular tachycardia, internal hemorrhage progressing to hemorrhagic shock, and neurological deterioration. The multi-patient format is designed to reflect the complexity of emergency nursing practice, where nurses must recognize subtle signs of deterioration, establish priorities, communicate effectively, initiate appropriate interventions, and continually reassess patients as clinical conditions change. The study will use a quasi-experimental pretest–posttest design. Before the intervention, students will individually complete a knowledge assessment and then participate in the first five-member team simulation, during which baseline team clinical judgment, clinical performance, and completion of safety-critical actions will be evaluated using standardized observation tools. Immediately afterward, students will participate in a structured debriefing that focuses on recognition of deterioration, prioritization and reprioritization, emergency management, teamwork, communication, and reflection on performance. Approximately five to seven days later, students will complete the knowledge posttest and participate in a different but equivalent multi-patient simulation to evaluate transfer of learning. The project is expected to provide evidence on whether realistic, structured simulation and debriefing can strengthen nursing students’ emergency knowledge and improve team-based clinical judgment and performance when caring for multiple deteriorating patients.