Table of Contents
Background:
Despite the growing popularity of patient simulators as educational tools in the medical field, there is still scant empirical support delimiting their efficacy. A study by Radhakrishnan, Roche, & Cunningham (2007) set out to answer some of these questions by using the Clinical Simulation Evaluation Tool (CSET) to measuring specific nursing clinical practice parameters among a group of students who had been trained with the Human Patient Simulator (HPS). Five main areas of performance were measured: basic assessment skills, safety, prioritization, problem-focused assessment, ensuing interventions, delegation and communication in a complex two-patient, and simulated assignment. It was found that ‘patient identification’ and ‘assessing vital signs’ -belonging to the groups ‘safety’ and ‘basic assessment skills’, respectively- were both significantly better in the group which received additional HPS training with their clinical training.
Psychometrics:
The psychometric properties of the Clinical Simulation Evaluation Tool (CSET) are discussed in Radhakrishnan, Roche & Cunningham (2007).
Author of Tool:
Kavita Radhakrishnan, Joan P. Roche, and Helene Cunningham
Key references:
Radhakrishnan, K., Roche, J. P., & Cunningham, H. (2007). Measuring clinical practice parameters with human patient simulation: A pilot study. International Journal of Nursing Education Scholarship, 4(1). Article 8.
Primary use / Purpose:
The Clinical Simulation Evaluation Tool (CSET) is an evaluation form which is used to score the performances of medical and nursing students on patient simulators such as the ‘Human Patient Simulator’ (HPS). These mannequin simulators are used in educational settings to better improve the skills of those training within a medical context.
Clinical Simulation Evaluation Tool (CSET)
Student:________________________Date: _______Evaluator:__________________ Clinical Faculty:_____________
| Objectives | Possible Points | Observed Patient A
CHF hypertension |
Observed Patient B
New Chest Pain |
Actual
Points
|
|
|
Safety |
|||||
| *Hand Hygiene: Performs proper hand hygiene before caring for each patient and as needed | *2 (1 each) | ___ Hand wash* | ___ Hand wash* | ||
| *Introduces Self: States name and role to patient, family member and/or helath care provider. | *2 (0.5 each) | ___ Introduces Self*
___ Identifies Role * |
___ Introduces Self*
___ Identifies Role* |
||
| *Verifies Patient Identification: Ask patient to state their name, DOB and verify on ID Band. OR verify patient name and Medical Record Number on ID band. Must look at ID band to receive points | *2 (0.5 each) | ___ Verify Patient Full Name*
___ Verify Patient DOB* OR ____Verify MR# * |
___ Verify Patient Full Name*
___ Verify Patient DOB* OR ____Verify MR#* |
||
| *VerifiesAllergy: Asks the patient about allergies AND verifies correct allergy band. | *4 (1 each) | _____Ask about allergies*
_____Verify allergy band* |
_____Ask about allergies*
_____Verify allergy band* |
||
| Communication: Explains to patient/and or family member what they are doing and/or why. | 4 (1 each) | ___ Explain Assessment
___ Explain Interventions |
___ Explain Assessment
___ Explain Interventions |
||
| Error: Identifies medical error/s and states correction for error. | 3 (1 each)
|
___ O2 off
|
___ Allergy Bracelet off
____Identify MD order route for Morphine wrong |
||
|
Assessments and Critical Thinking |
|||||
| Identifies the Priority Patient | 2 | __Priority Patient to assess first when going in room initially because Airway | |||
| ABC’s & LOC: Assesses Patient’s Airway (able to speak), Breathing (chest rising and falling), Circulation (check pulses) and Level of Conscious-ness (Should state out loud assessing these areas) | 4 (0.5 each)
|
__ Airway
__ Breathing (check) __ Circulation (check) __ LOC |
__ Airway
__ Breathing (check) __ Circulation (check) __ LOC |
||
| Vital Signs /O2 Sat/Pain: Assesses initial and previous VS/O2 Sat (don’t need to actually do, can check monitor) and Pain 0-10 (PQRSTU). Identifies pt’s normal and/or abnormal as a scenario evolves. | 4 (0.5 each)
|
__ Temp, BP, HR, RR ↑
__ O2 sat __ Pain 0-10 (PQRSTU) __ Identifies changes |
__ Temp, BP, HR, RR
__ O2 sat __ Pain 0-10 (PQRSTU) __ Identifies changes |
||
| Focus Assessment: Assesses systems appropriately based on patient presentation, signs and symptoms. | 5 (0.5 each) | ___ LS Crackles
___ Pedal Edema ___ Dyspnea (ask about shortness of breath) |
Chest Pain Assessment
____When it started? ____Location? ____Radiation? _____Quality? ____Pain Scale 0-10 ____Elevated ST segment____Oxy Sat lower |
||
|
Problem Identification and Critical Thinking |
|||||
| Identify Problem/s: Identifies actual and/or possible medical and/or nursing problems (Can identify while thinking out loud or by actions) | 2 (0.5 each)
|
___ Potential fluid overload 600 in 200 out (in report)
___ Anxiety related to shortness of breath ___ ________________ |
___ Actual MI
___ Allergy to shellfish – problem with order for Cardiac Cath with dye ___ _______________ |
||
| Interventions, Evaluation & Critical Thinking | |||||
| Priority Interventions: Initiates appropriate priority interventions in a timely manner for each patient.
|
8.5
(0.5 each) |
___ Raise the HOB
___ Apply O2 ___ Reassure & support ___ Reassess VS as needed
|
___ Raise HOB ___ Apply O2
____Get EKG ___ Give NTG ___ Assess VS before each NTG dose ___ Call MD After Call MD do or say what would do: ___Increase Oxygen (First unless delegating) ____Morphine (*with correct dose calculated- critical to pass) (Second) ___ ASA ____Hang NS 40 mL ____Delegate blood work ____Cancel stress test ____ Reassess VS as needed |
||
| Delegates appropriate possible tasks to others. | 2.5
(0.5 each) |
___ Check O2 sat as follow-up
___ Provide care |
___ EKG ___ Blood work
____Cancel Stress Test |
||
| Communicates with HCP in timely manner: Gives appropriate info using SBARR guidelines (see sheet near phone to call HCP if needed). | 2 (0.5 each)
|
___ Situation ___ Background
___ Assessment/ Recommendations ___ Read Back |
|||
|
Other Critical Thinking and Processing Components |
|||||
| Thinking Process: Discusses out loud during/after scenario possible problems, pathophysiology, and/or rationale for assessment and interventions. | 1 (0.5 each) | _____Thinks out loud during scenario
1 _____________ 10 rarely all times |
_____Thinks out loud during scenario
1 _____________ 10 rarely all times |
||
| Reflection: Identifies strengths and areas for improvement when viewing video with objectives and discussion with faculty and peers. | 2 (0.5 each) | ___Strengths
___Areas of Improvement |
___Strengths
___Areas of Improvement |
||
| Final Actual Total Points: _____
Equivalent Letter Grade: _____ Remediation and Redo Recommended: Yes No Comments (write in colums to right): |
50 possible total points | ||||
Grading Scale
| Actual Points (out of possible 50) | Equivalent Letter Grade | CET Behavior Rating |
| 46.5-50 (equivalent to 93-100) | A | 4.0 |
| 45-46 (equivalent to 90-92) | A- | 3.7 |
| 43.5-44.5 (equivalent to 87-89) | B+ | 3.3 |
| 41.5-43 (equivalent to 83-86) | B | 3.0 |
| 40-41 (equivalent to 80-82) | B- | 2.7 |
| 38.5-39.5 (equivalent to 77-79) | C+ | 2.3 |
| 36.5-38 (equivalent to 73-76) | C | 2.0 |
| 36 or lower (equivalent to 72 or lower) | C- or lower | 0 and scenario must be repeated |