Developing Hospital Nurses' Clinical Reasoning Abilities in Assessing and Managing Clinical Deterioration Using a Virtual Patient Simulation: A Quasi-Experimental Study

Background: Poor clinical reasoning has often led to the failure of nurses to recognize and respond to patient deterioration. This study aimed to evaluate the effectiveness of virtual patient simulation in developing clinical reasoning among nurses when assessing and managing clinical deterioration.Method: A quasi-experimental design was conducted with 124 hospital nurses who were assigned to an experimental or a control group. The experimental group received the virtual simulation while the control group attended conventional online didactic learning. Both groups were evaluated for knowledge application and perceived transfer of learning at various time points.Results: The knowledge application scores of the experimental group improved significantly from the baseline scores. However, there was a significant decrease in the retention of knowledge in the second posttest. Compared to the control group, the experimental group had significantly higher immediate and retention of knowledge application scores, as well as perceived transfer of learning scores. Conclusions: Virtual simulations not only provide an effective learning strategy for the development of clinical reasoning, but they also have an impact on nurses' perceived training transfer to the clinical workplace.