Student Cue Recognition in Pediatric Deterioration Signal Detection Trials: A Secondary Analysis
Leslie T Zimpelman1, Alison Carmona2
1Harris College of Nursing & Health Sciences, Texas Christian University, Fort Worth, TX, USA l.t.zimpelman@tcu.edu.
Research and Theory for Nursing Practice
|November 12, 2025
Summary
Nursing students effectively identified key respiratory cues in pediatric patients but sometimes misinterpreted other vital signs. External factors, like prior knowledge, influenced their clinical decision-making during patient assessments.
Area of Science:
- Pediatric Nursing
- Clinical Skill Development
- Patient Monitoring
Background:
- Pediatric patients exhibit unique physiological responses, making early detection of deterioration challenging for nursing students.
- Nursing education must equip students with the skills to accurately interpret subtle pediatric patient cues.
- Signal detection trials offer a simulated environment to assess student competency in recognizing patient status changes.
Purpose of the Study:
- To identify specific clinical cues nursing students notice in pediatric patients.
- To understand how students interpret and respond to these cues during simulated scenarios.
- To explore the influence of external factors on student decision-making in pediatric patient assessment.
Main Methods:
- Qualitative secondary analysis of semi-structured interviews with senior nursing students (n=14).
- Focus on cue recognition during simulated signal detection trials.
- Content analysis to identify emergent themes in student responses and decision-making processes.
Main Results:
- Students frequently noticed vital signs and assessment findings, with respiratory rate, oxygen saturation, and work of breathing being key indicators.
- While respiratory signals were often correctly identified, other patient status changes were sometimes misinterpreted.
- External factors such as prior knowledge, time constraints, and scenario specifics influenced students' interpretations and responses.
Conclusions:
- Senior nursing students can identify critical respiratory cues in pediatric patients but require further training to interpret a broader range of deterioration indicators accurately.
- Clinical decision-making by nursing students is significantly impacted by contextual and external factors beyond direct patient data.
- Educational strategies should address both cue recognition accuracy and the mitigation of external influences on clinical judgment in pediatric nursing.
