A web-based simulation for Rescuing A Patient In Deteriorating Situations (RAPIDS)

A web-based simulation known as e-RAPIDS was developed to enhance nurses’:

1. awareness on the importance of early recognition;
2. skill performances in assessing, managing and reporting of deteriorating patients;
3. knowledge of physiological signs of deterioration.

1. animation video (Click to watch) to illustrates the important of early recognition and explains the physiological signs of early deterioration.
2. multimedia instructional material that covers the tasks within the ABCDE and ISBAR mnemonics.
3. virtual patient simulation consists of five simulation scenarios associated with common deteriorating condition.

The effectiveness of the virtual patient simulation as a refresher training program was evaluated by comparing it with mannequin-based simulation. Although the study did not demonstrate the superiority of virtual simulation over mannequin-based, both modalities were shown to be effective learning strategies for improving clinical performance in assessing and managing clinical deterioration.¹⁴ Randomized controlled trial studies conducted on both registered and enrolled nurses in an acute tertiary hospital also supported the effectiveness of e-RAPIDS in enhancing their clinical performance and knowledge on clinical deterioration.^15-18

A before-and-after study and a qualitative evaluation study provided evidences on the effectiveness of e-RAPIDS in improving nursing practice with deteriorating ward patient^19,20

Please read the following articles for a detailed description and evaluation of the eRAPIDS.

1. Liaw SY, Chan SW, Chen FG, Hooi SC, Siau C. Comparison of virtual patient simulation with mannequin-based simulation for improving clinical performances in assessing and managing clinical deterioration: a randomized controlled trial. Journal of Medical Internet Research. 2014;16(9). [medline:25230684]

2. Liaw SY, Wong LF, Chan SW, Ho JTY, Zubaidah SZ, Ang SBL, Goh PS, Ang ENK. Designing and evaluating an interactive multimedia web-based simulation for developing hospital nurses’ competencies in acute nursing care: randomized controlled trial. Journal of Medical Internet Research. 2015;17(1):e5. doi: 10.2196/jmir.3853

3. Liaw SY, Wong LF, Ang SBL, Ho JTY, Siau C, Ang ENK. Strengthening the afferent limb of rapid response systems: an educational intervention using web-based learning for early recognition and responding to deteriorating patients. BMJ Qual Saf. 2016;25960:448-56.[doi: 10.1136/bmjqs-2015-004073]

4. Lin PY, Chua WL, Mok WQ, Liaw SY. Using a case-based animation on physiological compensatory mechanism to remediate nurses' misconceptions about changes in patient vital signs. Journal of Clinical Nursing. 2016;25(3-4):566-8.[doi: 10.1111/jocn.13082]

5. Liaw SY, Chng DYJ, Wong LF, Ho JTY, Mordiffi SZ, Cooper S, Chua WL, Ang ENK. The impact of a web-based educational program on the recognition and management of deteriorating patients. Journal of Clinical Nursing. 2017;26(23-24):4848-56.[doi: 10.1111/jocn.13955]

6. Liaw SY, Wong LF, Lim EYP, Ang SBL, Mujumdar S, , HO JTY, Mordiffi SZ, Ang ENK. Effectiveness of a web-based simulation in improving nurses' workplace practice with deteriorating ward patients: a per- and postintervention study. Journal of Medical Internet Research. 2016;18(2):e37.[doi: 10.2196/jmir.5294]

7. Liaw SY, Lim EYP, Wong LF, Ho JTY, Mordiffi SZ, Ang SBL, Chua WL, Ang ENK. The effect of a web-based educational program on nursing practice in recognising and reposing to deteriorating ward patients: A qualitative evaluation study. Collegian. 2017;24(5):455-61.[doi: 10.1016/j.colegn.2016.09.008]