Clinical Simulation Evaluation Tool (CSET)

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:_____________

ObjectivesPossible PointsObserved 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 GradeCET Behavior Rating
46.5-50  (equivalent to 93-100)A4.0
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)B3.0
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)C2.0
36 or lower (equivalent to 72 or lower)C- or lower0 and scenario must be repeated