بررسی تاثیر برنامه آموزشی مبتنی بر بیمار استاندارد شده بر تصمیم گیری بالینی پرستاران شاغل در بخش های مراقبت ویژه

Aims: 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. Methods: This two-group pretest-posttest quasi-experimental study was conducted in ۲۰۱۴. 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, ۵۸ 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 ۴۵ days after the study intervention by employing the Participation Decision Activity Questionnaire. The study data were analyzed by using the SPSS۱۶ the statistical tests of paired- and independent-samples t, Chi-square, Mann-Whitney, and Wilcoxon. Results: Before the intervention, the means of the three steps of decision making in the experimental group (۳۲.۱±۱۰.۲, ۳۳.۴±۹.۳, and ۳۲.۱±۹.۷, respectively) did not differ significantly from the control group (۳۱.۱±۷.۸, ۳۲.۲±۶.۴, and ۳۱.۴±۶.۵ respectively). However, after the study, the differences between these groups regarding the means of the three steps of decision making were statistically significant (p<; ۰.۰۰۱). Moreover, in the experimental group, the pretest-posttest mean differences of the three steps of decision making (۱۷.۶±۷.۹, ۱۸.۰۷±۷.۵, and ۱۹.۱±۸.۱, respectively) were significantly higher than the control group (۳.۸±۴.۲, ۴.۰±۲.۹, and ۵.۶±۳.۵, respectively p<; ۰.۰۰۱). Conclusions: 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.