The effects of teaching by using standardized patients on critical care nurse's clinical decision making

Patients’ unstable clinical conditions require critical care nurses to be competent decision makers. Standardized patient is a new teaching strategy which can enhance nurses’ decision making ability. The purpose of this study was to examine the effects of teaching by using standardized patients on critical care nurses’ decision making ability. This two-group pretest-posttest quasi-experimental study was conducted in 2014. The study setting was Shahid Kamyab and Imam Reza Hospitals, Mashhad, Iran. These two hospitals were randomly allocated to either control or experimental groups. Then, several intensive care units were randomly selected from each hospital. Nurses were recruited from the selected units. In total, 58 nurses were studied. The study intervention consisted of educations about clinical decision making. Educations in the control and the experimental groups were provided by using the lecture and the standardized patient strategies, respectively. Nurses’ clinical decision making ability was evaluated both before and 45 days after the study intervention by employing the Participation Decision Activity Questionnaire. The study data were analyzed by using the SPSS v. 16 the statistical tests of paired- and independent-samples t, Chi-square, Mann-Whitney, and Wilcoxon. Before the intervention, the means of the three steps of decision making in the experimental group (32.1±10.2, 33.4±9.3, and 32.1±9.7, respectively) did not differ significantly from the control group (31.1±7.8, 32.2±6.4, and 31.4±6.5 respectively). However, after the study, the differences between these groups regarding the means of the three steps of decision making were statistically significant (p<0.001). Moreover, in the experimental group, the pretest-posttest mean differences of the three steps of decision making (17.6±7.9, 18.07±7.5, and 19.1±8.1, respectively) were significantly higher than the control group (3.8±4.2, 4.0±2.9, and 5.6±3.5, respectively; p < 0.001). Teaching through standardized patients can significantly enhance nurses’ clinical decision making ability. This strategy can be used for developing in-service continuing education programs and improving nurses’ clinical decision making ability.