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Resuscitation. 2011 Sep;82(9):1224-30. doi: 10.1016/j.resuscitation.2011.04.014. Epub 2011 May 5.

Rescuing A Patient In Deteriorating Situations (RAPIDS): A simulation-based educational program on recognizing, responding and reporting of physiological signs of deterioration.

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Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, Singapore 117597 Singapore.



To describe the development, implementation and evaluation of an undergraduate nursing simulation program for developing nursing students' competency in assessing, managing and reporting of patients with physiological deterioration.


A full-scale simulation program was developed and implemented in a pre-registered nursing curriculum. A randomized controlled study was performed with 31 third year nursing students. After a baseline evaluation of all participants in a simulated environment, the intervention group underwent four simulation scenarios in a 6h education session. All participants were then re-tested. The baseline and post-test simulation performances were scored using a validated tool. The students completed a survey to evaluate their learning experiences.


The clinical performances mean scores for assessment and management of deteriorating patients improved significantly after the training program compared to baseline scores (t=9.26; p<0.0001) and to post-test mean scores of the control group (F=77.28; p<0.0001). The post-test mean scores of the intervention group in reporting deterioration was significantly higher than the baseline mean scores (t=4.24; p<0.01) and the post-test means scores of the control group (F=8.98; p<0.01). The participants were satisfied with their simulation experiences, rated positively on features of the simulation and valued the program in developing their self-confidence.


The nursing students' competency in assessing, managing and reporting of deteriorating patient can be enhanced through a systematic development and implementation of a simulation-based educational program that utilized mnemonics to help students to remember key tasks.

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