BACKGROUND Early detection and response to patient deterioration influence patient prognosis. Nursing education is therefore essential. The objective of this randomized controlled trial was to compare the respective educational value of simulation by gaming (SG) and a traditional teaching (TT) method to improve clinical reasoning (CR) skills necessary to detect patient deterioration. METHODS In a prospective multicenter study, and after consent, 2nd year nursing students were randomized into two groups: Simulation by gaming "SG": the student played individually with a serious game consisting of 2 cases followed by a common debriefing with an instructor;Traditional Teaching "TT": the student worked on the same cases in text paper format followed by a traditional teaching course with a PowerPoint presentation by an instructor. CR skill was measured by script concordance tests (80 SCTs, score 0-100) immediately after the session (primary outcome) and on month later. Other outcomes included students' satisfaction, motivation and professional impact. RESULTS One hundred forty-six students were randomized. Immediately after training, the SCTs scores were 59 ± 9 in SG group (n = 73) and 58 ± 8 in TT group (n = 73) (p = 0.43). One month later, the SCTs scores were 59 ± 10 in SG group (n = 65) and 58 ± 8 in TT group (n = 54) (p = 0.77). Global satisfaction and motivation were highly valued in both groups although significantly greater in the SG group (p < 0.05). The students declared that the training course would have a positive professional impact, with no difference between groups. CONCLUSIONS In this study assessing nursing student CR to detect patient deterioration, no significant educational difference (SCT), neither immediate nor 1 month later, was observed between training by SG and the TT course. However, satisfaction and motivation were found to be greater with the use of SG. TRIAL REGISTRATION ClinicalTrials.gov; NCT03428269. Registered 30 january 2018.

中文翻译：

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通过游戏模拟和传统教学方法提高检测患者病情所需的临床推理技能的比较价值：护理学生的一项随机研究。

背景技术对患者恶化的早期检测和响应影响患者的预后。因此，护理教育必不可少。这项随机对照试验的目的是比较游戏模拟（SG）和传统教学（TT）方法的各自教育价值，以提高检测患者病情恶化所需的临床推理（CR）技能。方法在一项前瞻性多中心研究中，并在获得患者同意后将2年级护理学生随机分为两组：通过游戏“ SG”进行模拟：该学生单独进行了一场严重的游戏，其中包括2例，然后与教练进行了常规汇报；传统教学“ TT”：学生以课文形式处理相同的案例，然后进行传统的教学课程，并由教师进行PowerPoint演示。会话结束后（主要结局）和一个月后立即通过脚本一致性测试（80个SCT，0-100分）测量CR技能。其他成果包括学生的满意度，动力和专业影响。结果146名学生被随机分组​​。训练后立即，SG组（n = 73）的SCT得分为59±9，而TT组（n = 73）的SCT得分为58±8（p = 0.43）。一个月后，SG组（n = 65）的SCT得分为59±10，TT组（n = 54）的SCT得分为58±8（p = 0.77）。总体满意度和动机在两个组中均得到高度重视，但在SG组中显着更高（p <0.05）。学生们宣布培训课程将对职业产生积极影响，各组之间没有差异。结论在本研究中，评估护理学生的CR以检测患者的病情恶化，在SG训练和TT课程之间，未观察到立即或1个月后的显着教育差异（SCT）。但是，发现使用SG可以提高满意度和积极性。试验注册ClinicalTrials.gov; NCT03428269。2018年1月30日注册。