Despite a concerted effort to improve patient safety within the acute care setting, patient injuries, unexpected deaths, and unplanned admissions to ICUs continue to occur. Rapid response teams (RRTs) have been developed to reduce the number of failure-to-rescue incidents in hospitalized patients by responding to a patient's deteriorating condition before an adverse event occurs. Nurses are instrumental in reducing the number of failure-to-rescue incidents through early recognition of clinical instability, prompt interventions, and activation of the RRT. The purpose of this study was to examine the effect of the Simulated Training for Enhancing Patient Safety (STEPS) as an intervention to improve nurses' RRT knowledge and clinical judgment.




A 19-item pre-post test within-subject design was used to determine the impact of the STEPS intervention on nurses' RRT knowledge and clinical judgment. The study also examined individual perception of the simulation experience (educational practice, simulation design, and satisfaction and self-confidence in learning) after the STEPS intervention. Participants were registered nurses employed in a progressive care unit at a Midwestern medical center.




Eleven participants completed the pretest, the immediate posttest, and the posttest 3 months after the STEPS intervention. The 3-month posttest scores for the 11 participants showed 8 increased their scores, 2 decreased their scores, and 1 stayed the same. There was no significant statistical difference over time. Nurses agreed or strongly agreed that their simulation experience was a satisfying learning experience. Human patient simulation is an effective teaching method for nurses. Nurses were highly satisfied with their simulated learning experience and valued fidelity, collaboration, and constructive feedback. Further study is needed to measure learning outcomes in nursing for human patient simulation activities.