The Impact of Emerging Simulation-Based Technologies on the Management of Deteriorating Patients: Aiming for a Gold Standard Educational Evaluation

Background: Measuring the impact of patient safety interventions is challenging. This article aims to illustrate a gold standard'' model of program evaluation incorporating examples from two patient deterioration programs. Methods: Australian nurses were trained in primary responses to emergencies in four hospitals using either face-to-face (F2F) or screen-based simulation versions of a simulation program. Evaluation outcomes were measured using Kirkpatrick's evaluation hierarchy covering participant 'reaction', 'learning', 'behaviour' change and 'results'-based on 1,564 pre-post intervention vital signs chart reviews. Results: Seventy-four nurses participated. Reaction-participant confidence/competence ratings and Learning improved significantly in both modalities (p < .001). Behaviour-oxygen delivery systems were used more appropriately after training in the F2F group (p = .037). Applicable recording of oxygen saturation (SpO(2)) improved significantly (p <= .008) in both modalities. Results-at least a twofold increase in the overall initiation of a clinical review after training, in both modalities (p < .001; effect: d = 0.41 F2F and d = 0.35 screen-based simulation). Conclusions: Kirkpatrick's evaluation model enables a suitable template for gold standard education evaluations. (C) 2020 International Nursing Association for Clinical Simulation and Learning. Published by Elsevier Inc. All rights reserved.