Effectiveness of simulation-based peripheral intravenous catheterization training for nursing students and hospital nurses: A systematic review and meta-analysis

Effect of standardized patient simulation with BCG vaccination on nursing students' skills, knowledge and satisfaction, and self-confidence: A randomized controlled study

AIM

To examine the effect of standardised patient simulation training on nursing students' skills and knowledge in administering the Bacillus Calmette-Guérin vaccine, as well as their satisfaction and self-confidence.

BACKGROUND

The Bacillus Calmette-Guérin vaccine is administered by nurses to prevent tuberculosis. However, there have been reports of complications arising from inadequate knowledge and skills related to Bacillus Calmette-Guérin vaccine administration.

DESIGN

A randomised controlled experimental design.

METHOD

This experimental study was conducted between October 2022 and January 2023 at a university, Medical Training and Simulation Centre. The fourth-year nursing students enrolled in their intern term were asked to participate in this experimental study. Participants were allocated to the intervention group (n=45) and the control group (n=45). The control group received only theoretical training and then BCG application on the model. The socio-demographic survey was conducted to collect demographic data. The Bacillus Calmette-Guérin Vaccine Knowledge Form, Bacillus Calmette-Guérin Vaccine Administration Checklist, and the student satisfaction and self-confidence scale in learning were used. The intervention group received simulation training using a standardized patient. All students' knowledge and skills were measured before and 3 months after the theoretical training.

RESULTS

Simulation training using standardized patients significantly increased nursing students' Bacillus Calmette-Guérin vaccine knowledge (intervention group=21.57±5.12; control group=15.33±5.61), skills (intervention group=20.88±4.29; control group=10.22±4.56), confidence and satisfaction (intervention group=4.61±0.30; control group=4.17±0.3) compared with the control group (p < 0.05).

CONCLUSION

Training with standardized patient techniques provides students the opportunity to practice realistically in a safe environment, enabling repetitive practice, which enhances self-confidence and satisfaction.

Are virtual reality intravenous injection training programs effective for nurses and nursing students? A systematic review

OBJECTIVE

This study examines the characteristics and effects of virtual reality (VR) intravenous injection training programs for nurses and nursing students, using Kirkpatrick's four-level model of educational evaluation. Kirkpatrick's framework is based on the premise that learning from training programs can be classified into four levels: reaction, learning, behavior, and results.

DESIGN

A systematic review.

DATA SOURCES

Literature searches were conducted of eight electronic databases (PubMed, CINAHL, Cochrane, EMBASE, DBpia, KISS, RISS, KoreaMed) to identify original research articles from each database's inception to March 2023.

REVIEW METHODS

For the 13 selected articles, quality appraisal was performed using the RoB 2 and ROBINS-I tools for randomized controlled trials (RCTs) and non-RCTs, respectively.

RESULTS

Virtual intravenous simulators and desktop and immersive VR technologies were utilized in intravenous injection training. These VR technologies were applied either alone or in conjunction with simulators, focusing on junior nursing students without intravenous injection experience. We found a positive effect on nursing students' intravenous injection performance (Level 2: learning evaluation) in approximately half the studies. However, results were inconsistent due to measurement tools' diversity. In all studies, the degree of evaluation for Levels 1 (reaction evaluation), 3 (behavior evaluation), and 4 (results evaluation) of the Kirkpatrick Model was low.

CONCLUSIONS

Desktop or immersive VR with low-fidelity or high-fidelity simulators should be provided to senior nursing students and new nurses for intravenous injection training. Additionally, standardized tools should be developed to accurately measure training effects. Finally, the Kirkpatrick Model's four levels should be evaluated to demonstrate the training programs' value.

Reviewing the current state of virtual reality integration in medical education - a scoping review

BACKGROUND

In medical education, new technologies like Virtual Reality (VR) are increasingly integrated to enhance digital learning. Originally used to train surgical procedures, now use cases also cover emergency scenarios and non-technical skills like clinical decision-making. This scoping review aims to provide an overview of VR in medical education, including requirements, advantages, disadvantages, as well as evaluation methods and respective study results to establish a foundation for future VR integration into medical curricula.

METHODS

This review follows the updated JBI methodology for scoping reviews and adheres to the respective PRISMA extension. We included reviews in English or German language from 2012 to March 2022 that examine the use of VR in education for medical and nursing students, registered nurses, and qualified physicians. Data extraction focused on medical specialties, subjects, curricula, technical/didactic requirements, evaluation methods and study outcomes as well as advantages and disadvantages of VR.

RESULTS

A total of 763 records were identified. After eligibility assessment, 69 studies were included. Nearly half of them were published between 2021 and 2022, predominantly from high-income countries. Most reviews focused on surgical training in laparoscopic and minimally invasive procedures (43.5%) and included studies with qualified physicians as participants (43.5%). Technical, didactic and organisational requirements were highlighted and evaluations covering performance time and quality, skills acquisition and validity, often showed positive outcomes. Accessibility, repeatability, cost-effectiveness, and improved skill development were reported as advantages, while financial challenges, technical limitations, lack of scientific evidence, and potential user discomfort were cited as disadvantages.

DISCUSSION

Despite a high potential of VR in medical education, there are mandatory requirements for its integration into medical curricula addressing challenges related to finances, technical limitations, and didactic aspects. The reported lack of standardised and validated guidelines for evaluating VR training must be overcome to enable high-quality evidence for VR usage in medical education. Interdisciplinary teams of software developers, AI experts, designers, medical didactics experts and end users are required to design useful VR courses. Technical issues and compromised realism can be mitigated by further technological advancements.

Cognitive and physiological evaluation of virtual reality training in nursing

Virtual reality (VR) has increasingly been used in several disciplines, including nursing, a profession in high demand that is now facing a shortage. This study investigated the effectiveness and efficacy of VR hybrid training over traditional training (TR) methods. Sixteen college students were recruited and randomly assigned to get 100% TR or 50% TR and 50% VR (VR50). Participants attended a three-day program with a registered nurse, consisting of lectures and practical lab sessions. Participants' performance, training time, cognitive development, physical development, mental workload, user experience, Students' Satisfaction and Self-Confidence, and team learning were evaluated. The results showed that the VR50 performed as well as, and sometimes even better than the TR group (p-value = 0.043). VR50 group significantly had higher cognitive development and found VR easy to use and attractive (p-value < 0.05). VR-integrated training makes nurses' training more affordable and accessible while providing instant and relevant feedback.

Practitioner Summary: This study assessed employment-integrated virtual training in nursing, particularly peri-care, by comparing the performance, cognitive, physical, and mental workload of traditional and integrated VR training groups. The findings of this study provide significant support for incorporating VR training into educational settings.

Paediatric nurses' experiences of success and failure in first-time peripheral intravenous catheter insertion: A qualitative study

PURPOSE

To explore in-depth the thoughts, anxiety factors, and experiences of paediatric nurses regarding the success and failure of first-time peripheral intravenous catheter insertion.

DESIGN AND METHODS

The study employed a qualitative research method using the phenomenology design. Face-to-face semi-structured in-depth interviews were conducted with nurses (N = 12) working in the paediatric service and neonatal intensive care unit of a teaching and research hospital. The transcripts were analysed using a phenomenological approach and an inductive process.

RESULTS

Four themes were identified: Peripheral Intravenous Catheter Insertion, Experience of Success on the First Attempt, Experience of Failure on the First Attempt, and Proposed Solutions. Nurses felt a sense of happiness when they successfully inserted a peripheral intravenous catheter on their first attempt in paediatric patients. Conversely, they experienced emotions such as sadness, worry, stress, and anxiety when they failed and had to make repeated attempts.

CONCLUSION

Unsuccessful peripheral intravenous catheter insertions cause distress and anxiety for nurses, patients, and parents alike. Therefore, nurses' experiences of peripheral intravenous catheter insertions in healthcare settings should not be ignored and require improvement.

IMPLICATIONS FOR CLINICAL PRACTICE

Unsuccessful peripheral intravenous catheter insertions affect children, parents, and nurses negatively, thus reducing the success rate of repeated peripheral intravenous catheter insertions. Therefore, it is advisable for nurses conducting paediatric peripheral intravenous catheterisations to undergo periodic training. A specialised intervention team should be established for cases of initial failure, and a mentoring system between seasoned and new nurses is recommended.

Simulation-based learning in nursing curriculum- time to prepare quality nurses: A systematic review and meta-analysis

Background

Simulation-based learning (SBL) emerged as an imperative pedagogical approach adaptable to situations involving widely varying clinical content without exposing patients to the risks inherent in trainee learning. The purpose of the present review was to assess the outcome of SBL on the domains of learning i.e cognitive, affective, and psychomotor.

Methods

We searched PubMed, Embase, Cochrane library, Clinical Trial database, and other sources to evaluate the effectiveness of SBL versus traditional teaching methods among nursing students till March 2021. Two authors individually extracted the data and identified the risk of bias and analyzed the data.

Results

The selected studies with a total of 364 nursing students were included for analysis. Overall, it was found that learning via simulation has beneficial effects. In combined subgroup analysis, use of simulation showed significant effects on students' understanding (SMD = 1.31, 95% CI [0.80, 1.82], P < 0.00001), Self-confidence (SMD = 1.93, 95% CI [1.01,2.84], P < 0.0001), (SMD = 1.83, 95% CI [0.91,2.74], P < 0.0001), Learning satisfaction [E:17.94, C-17.60] and Skill (SMD = 1.62, 95% CI [0.62,2.62], P = 0.002) and psychological care (SMD = 1.60, 95%CI [0.61,2.58], P = 0.001). Heterogeneity ranging from I2 = 54%-86% was found during the analysis.

Conclusion

The findings of the present study considered simulation as an effective teaching method to enhance cognitive, affective, and psychomotor skills.

Exploring training needs of newly graduated medical doctors to inform the undergraduate simulation-based curriculum: a national Delphi consensus study

PURPOSE

Mastering technical procedures is a key component in succeeding as a newly graduated medical doctor and is of critical importance to ensure patient safety. The efficacy of simulation-based education has been demonstrated but medical schools have different requirements for undergraduate curricula. We aimed to identify and prioritize the technical procedures needed by newly graduated medical doctors.

METHODS

We conducted a national needs assessment survey using the Delphi technique to gather consensus from key opinion leaders in the field. In the first round, a brainstorm was conducted to identify all potential technical procedures. In the second round, respondents rated the need for simulation-based training of each procedure using the Copenhagen Academy for Medical Education and Simulation Needs Assessment Formula (CAMES-NAF). The third round was a final elimination and prioritization of the procedures.

RESULTS

In total, 107 experts from 21 specialties answered the first round: 123 unique technical procedures were suggested. Response rates were 58% and 64% in the second and the third round, respectively. In the third round, 104 procedures were eliminated based on the consensus criterion, and the remaining 19 procedures were included and prioritized. The top five procedures were: (i) insert peripheral intravenous catheter, (ii) put on personal protection equipment, (iii) perform basic airway maneuvers, (iv) perform basic life support, and (v) perform radial artery puncture.

CONCLUSION

Based on the Delphi process a final list of 19 technical procedures reached expert consensus to be included in the undergraduate curriculum for simulation-based education.