Computerized clinical simulations: a strategy for staff development in critical care

BACKGROUND: Identifying the learning needs of employees and evaluating the results of staff development offerings are essential elements of the responsibilities of the staff development educator. High patient acuity, the shortage of critical care nurses, and rapidly changing technology within the critical care environment demand the provision of staff development offerings that are appropriate for the learning needs of critical care nurses and the evaluation of the effect of programs on critical care nursing practice. OBJECTIVE: The purposes of this descriptive, correlational study were to compare the ability of a knowledge test, a self-evaluation tool, and computerized clinical simulations to discriminate between nurses with varied levels of knowledge and experience, and to compare the learning needs identified from the three types of evaluative instruments. METHODS: Each subject (n = 142) completed the Basic Knowledge Assessment Tool for Critical Care, Cardiovascular Self-Evaluation Tool, and four computerized clinical simulations. RESULTS: Both the Basic Knowledge Assessment Tool and the Cardiovascular Self-Evaluation Tool discriminated between experienced/inexperienced and Advanced Cardiac Life Support-certified/noncertified critical care nurses. The computerized clinical simulations discriminated according to Advanced Cardiac Life Support certification, but not between experienced and inexperienced critical care nurses. The computerized clinical simulations identified more specific learning needs than did the Basic Knowledge Assessment Tool or Cardiovascular Self-Evaluation Tool. CONCLUSIONS: The evidence for discriminant validity, adequate internal consistency reliability, and ease of administration supports the continued use of these two tools as methods for critical care staff development needs assessment and evaluation. In addition, the study findings support the use of computerized clinical simulations as an adjunct to other needs assessment and evaluation methods in nursing staff development.