***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Introduction Virtual environments offer a variety of benefits and may be a powerful medium with which to provide nursing education . The objective of this study was to compare the achievement of learning outcomes of undergraduate nursing students when a virtual patient trainer or a traditional lecture was used to teach pediatric respiratory content . Methods This was a r and omized , controlled , posttest design . A virtual pediatric hospital unit was populated with four virtual pediatric patients having different respiratory diseases that were design ed to meet the same learning objectives as a traditional lecture . The study began in Spring 2010 with 93 Senior I , baccalaureate nursing students . Students were r and omized to receive either a traditional lecture or an experience with a virtual patient trainer .  Students ’ knowledge acquisition was evaluated using multiple-choice questions , and knowledge application was measured as timeliness of care in two simulated clinical scenarios using high-fidelity mannequins and st and ardized patients . Results Ninety-three students participated in the study , of which 46 were in the experimental group that received content using the virtual patient trainer . After the intervention , students in the experimental group had significantly higher knowledge acquisition ( P = 0.004 ) and better knowledge application ( P = 0.001 ) for each of the two scenarios than students in the control group . Conclusions The purpose of this project was to compare a virtual patient trainer to a traditional lecture for the achievement of learning outcomes for pediatric respiratory content . Although the virtual patient trainer experience produced statistically better outcomes , the differences may not be clinical ly significant . The results suggest that a virtual patient trainer may be an effective substitute for the achievement of learning outcomes that are typically met using a traditional lecture format . Further research is needed to underst and how best to integrate a virtual patient trainer into undergraduate nursing education The purpose of this study was to determine whether an innovative teaching approach , a student-led simulation , was effective in increasing students '  quality and safety knowledge , skills , and attitudes in the six Quality and Safety Education for Nurses competency areas . The sample included students ( N = 141 ) enrolled in a traditional and accelerated leadership course in the baccalaureate-nursing program at a midwestern public university during the fall 2009 semester . A quasi-experimental pretest and posttest design was used . Paired- sample s t tests were used to analyze the data . Overall scores on the self-inventory in the traditional ( p < 0.001 ) and accelerated ( p = 0.011 ) groups significantly increased . Knowledge and safety test scores in both the traditional ( knowledge : p < .001 ; safety : p = 0.028 ) and accelerated ( knowledge : p = 0.027 ; safety : p = 0.03 ) groups increased significantly . The innovation significantly improved students ' self-efficacy and knowledge related to the quality and safety competencies BACKGROUND There is a gap in the literature regarding learning outcomes linked to the use of high-fidelity simulators compared to that of traditional teaching methods . AIM To examine the effect of using high-fidelity simulators on knowledge and skills acquisition and retention with university students . METHODS A r and omized two-arm trial using two different educational approaches on 90 nursing students assigned r and omly to two groups was used at two points of time . FINDINGS The results showed significant differences in favor of the participants in the high-fidelity simulator group on both the acquisition and retention of knowledge and skills over time . However , a significant loss of cardiopulmonary resuscitation knowledge and skills occurred at 3 months after training in both groups . CONCLUSIONS The findings of this study may assist educators in integrating high-fidelity simulators in education and training . In addition , the findings may help nursing educators to arrange additional cardiopulmonary resuscitation training sessions in order to improve cardiac arrested patients ' outcomes . LINKING EVIDENCE TO ACTION High-fidelity simulation ( HFS ) provides students with interactive learning experiences in a safe controlled environment . HFS enables teachers to implement critical clinical scenarios , such as cardiac arrest , without risk to patients . Integrating the simulation training into nursing curricula will help to overcome the challenges that face many courses , specifically the shortage of clinical areas for training and the increase in numbers of nursing students Background The advantages of using simulators in skills training are generally recognized , but simulators are often too expensive for medical schools in developing countries . Cheaper locally-made models ( or part-task trainers ) could be the answer , especially when teachers are involved in design and production ( teacher-made models , TM ) . Methods We evaluated the effectiveness of a TM in training and assessing intravenous injection skills in comparison to an available commercial model ( CM ) in a r and omized , blind , pretest-posttest study with 144 undergraduate nursing students . All students were assessed on both the TM and the CM in the pre-test and post-test . After the post-test the students were also assessed while performing the skill on real patients . Results Differences in the mean scores pre- and post-test were marked in all groups . Training with TM or CM improved student scores substantially but there was no significant difference in mean scores whether students had practice d on TM or CM . Students who practice d on TM  performed better on communication with the patient than did students who practice d on CM . Decreasing the ratio of students per TM model helped to increase practice opportunities but did not improve student ’s mean scores . The result of the assessment on both the TM and the CM had a low correlation with the results of the assessment on real persons . Conclusions The TM appears to be an effective alternative to CM for training students on basic IV skills , as students showed similar increases in performance scores after training on models that cost considerably less than commercially available models . These models could be produced using locally available material s in most countries , including those with limited re sources to invest in medical education and skills laboratories Introduction Mastery of auscultatory blood pressure is challenging for pre registration nursing students . This phenomenon has been attributed to the psychomotor skills required , knowledge about blood pressure measurement , and the teaching modality type . Most studies focus on developing blood pressure proficiency without determining the measurement accuracy . We sought to determine the efficacy of simulation-based learning on blood pressure measurement accuracy in first-year pre registration nursing students . Methods First-year pre registration nursing students from a clinical subject were r and omly assigned to laboratory groups , which formed the control and intervention groups . Each group received identical blood pressure measurement education , with the intervention group undertaking 2 additional hours of tuition , using human patient simulators programmed with a wide range of blood pressure measurements to replicate patient ’s blood pressures observed in clinical setting s. At the end of the semester and after 40 hours of hospital clinical practice , participants were assessed for blood pressure accuracy on live subjects and completed a question naire on self-ratings of confidence and technical ability . Results Blood pressure accuracy was not significantly different between participants and assessors or between the control and intervention groups ( all P > 0.05 ) . The intervention group reported greater levels of confidence ( P = 0.02 ) and self-rated technical ability ( P = 0.01 ) in blood pressure measurement at week 14 of the semester ; however , these difference were not observed at the end of 40 hours of clinical practice ( P < 0.05 ) . Conclusions Accuracy in taking blood pressure was not enhanced by the use of a patient simulator , despite improvements in self-reported confidence and technical competency . Further research is required to evaluate the inclusion of simulation-based learning for blood pressure training in nursing students BACKGROUND An undergraduate nursing health assessment course provided three experiential modalities for practicing health assessment skills : high-fidelity human simulators ( HFS ) , st and ardized patients ( SP ) and community volunteers ( CV ) . Previous research has examined the impact of each distinct modality on learning outcomes . However , few studies have compared these learning strategies . This study investigates learners ' satisfaction , self-efficacy and performance behaviors among three learning approaches . METHOD Forty-four undergraduate nursing students were r and omly assigned to perform focused respiratory assessment s on a HFS , SP or CV . Participants completed the Health Assessment Educational Modality Evaluation ( HAEME ) survey to assess self-efficacy and modality satisfaction . A performance checklist evaluated assessment skills . RESULTS Performance behaviors were significantly greater with HFS , but learners were significantly less satisfied with this modality . Significant differences in students ' self-efficacy were not found across the three modalities . CONCLUSIONS Significantly lower satisfaction with HFS may reflect learners ' perceived lack of realism . However , HFS may provide a low-stress opportunity for novice learners to practice skills . Results support the integration of distinct experiential learning modalities in an undergraduate nursing health assessment course This experimental study examined whether the use of clinical simulation in nursing education could help reduce medication errors .  Fifty-four student volunteers were r and omly assigned to an  experimental ( treatment ) group ( 24 students ) or a clinical control group ( 30 students ) . The treatment replaced some early-term clinical placement hours with a simulated clinical experience . The control group had all normally scheduled clinical hours . Treatment occurred prior to opportunities for medication administration In this article , the results of a mixed- methods study integrating the use of simulations in a nursing theory course in order to assess students ' perceptions of self-efficacy for nursing practice are presented . Nursing students in an intervention group were exposed to a combination of lecture and simulation , and then asked to rate their perceptions of self-efficacy , satisfaction and effectiveness of this combined teaching and learning strategy . Based on B and ura 's ( 1977 , 1986 ) theory of self-efficacy , this study provides data to suggest that students '  self-confidence for nursing practice may be increased through the use of simulation as a method of teaching and learning . Students also reported higher levels of satisfaction , effectiveness and consistency with their learning style when exposed to the combination of lecture and simulation than the control group , who were exposed to lecture as the only method of teaching and learning AIM To examine , in a simulated environment , the ability of final-year nursing students to assess , identify and respond to patients either deteriorating or at risk of deterioration . BACKGROUND The early identification and management of patient deterioration has a major impact on patient outcomes . ' Failure to rescue ' is of international concern , with significant concerns over nurses ' ability to detect deterioration , the reasons for which are unknown . DESIGN Mixed methods incorporating quantitative measures of performance ( knowledge , skill and situation awareness ) and , to be reported at a later date , a qualitative reflective review of decision processes . METHODS Fifty-one final-year , final-semester student nurses attended a simulation laboratory .  Students completed a knowledge question naire and two video-recorded simulated scenarios ( mannequin based ) to assess skill performance . The scenarios simulated deteriorating patients with hypovolaemic and septic shock .  Situation awareness was measured by r and omly stopping each scenario and asking a series of questions relating to the situation . RESULTS The mean knowledge score was 74 % ( range 46 - 100 % ) and the mean skill performance score across both scenarios was 60 % ( range 30 - 78 % ) . Skill performance improved significantly ( p < 0.01 ) by the second scenario . However , skill performance declined significantly in both scenarios as the patient 's condition deteriorated ( hypovolaemia scenario : p = 0.012 , septic scenario : p = 0.000 ) . The mean situation awareness score across both scenarios was 59 % ( range 38 - 82 % ) . Participants tended to identify physiological indicators of deterioration ( 77 % ) but had low comprehension scores ( 44 % ) . CONCLUSION Knowledge scores suggest , on average , a satisfactory academic preparation , but this study identified significant deficits in students ' ability to manage patient deterioration . RELEVANCE TO CLINICAL PRACTICE This study suggests that student nurses , at the point of qualification , may be inadequately prepared to identify and manage deteriorating patients in the clinical setting ABSTRACT The purpose of this study was to evaluate the effectiveness of HeartCodeTM BLS , a self‐directed , computer‐based course for obtaining basic life support ( BLS ) certification . For part 2 of the course , students learned and practice d their  cardiopulmonary resuscitation ( CPR ) psychomotor skills on a voice assisted manikin ( VAM ) . Students from 10 schools of nursing were r and omly assigned to two types of  CPR training : HeartCode BLS with VAM or the st and ard , instructor‐led ( IL ) course with manikins that were not voice assisted ; 264 students trained using HeartCode BLS and 339 had an IL course . When students passed their respective courses and were certified in BLS , their CPR skills were tested using the Laerdal PC SkillReportingtrade ; System . Students who trained using HeartCode BLS and practice d their CPR skills on VAMs were significantly more accurate in their ventilations , compressions , and single‐rescuer CPR than students who had the st and ard , IL course with regular manikins Health care improvement requires collaboration between academia and practice to bridge gaps in nurse education and achievement of quality outcomes . Quality and Safety Education for Nurses identified six domains , including patient-centered care , that should be addressed during prelicensure education . Simulation is a recommended strategy to teach safe clinical practice ; however , cost , space , and faculty re sources are barriers to its use . Computer-based social simulation is less re source intensive and effective in improving critical-thinking skills . A pilot study was conducted to compare required re sources and student learning outcomes for traditional versus computer-based simulation .  Fifty-three baccalaureate nursing students participated in the study ; 34 completed the computer-based simulation and 31 completed the traditional simulation .  Group patient-centered care competency scores improved similarly ( p < 0.001 ) , although fewer faculty hours were required to administer the computer-based intervention . Findings suggest computer-based simulation is an efficient and effective learning strategy to develop patient-centered care competencies AIM 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 . METHOD 
    Output:
    
The conclusion is that insufficient quality research exists to guide educators in making evidence -based decisions regarding simulation .