Reliable and valid instruments are needed to assess patient safety competencies, specifically nursing students’ ability to appropriately respond to simulated rescue events.


This was an instrument development study conducted with 152 senior nursing students in 2 phases.


Student groups performed poorly during the simulation scenario, with mean scores on the Heart Failure Simulation Competency Evaluation Tool ranging from 46% to 56%. Interrater reliability increased to .839 after item revision during Phase 2 of the study.


This simulation competency assessment package is ready to be tested with more diverse student groups and novice nurses in the practice setting.


KeyWords: failure to rescue; instrument development; patient safety; simulation; nursing students