Gamification-Based Virtual Reality in Subcutaneous Injection Skill Teaching
NCT Number: NCT06494462
Status: ACTIVE_NOT_RECRUITING
Study Type: INTERVENTIONAL
Phases: NA
Conditions: Training Group
Interventions: OTHER: virtual reality training
Sponsor: Aydin Adnan Menderes University
Sex: ALL
Age: ADULT
Enrollment: 96
Study Design: Allocation: RANDOMIZED|Intervention Model: PARALLEL|Masking: NONE|Primary Purpose: OTHER
Start Date: 2024-01-07
Completion Date: 2026-01-01
Locations: Adnan Menderes University Nursing Faculty, Aydın, Turkey

Summary:
This randomized controlled experimental study aimed to determine the effect of gamification-based virtual reality applications and video demonstration methods on nursing students' skill learning and confidence levels in subcutaneous injection skill training.

The population of the study consisted of 96 first-year nursing students enrolled in the Fundamentals of Nursing course at a university's Faculty of Nursing during the spring semester of the 2024-2025 academic year. The students will be randomized into three groups, each containing 32 students: two experimental groups and one control group. First, the topic of subcutaneous injection application will be theoretically explained to all students for 90 minutes. After completing the theoretical explanation, the skill of subcutaneous injection application will be taught in a laboratory setting using the Gamification-Based Virtual Reality Application + Demonstration method for students in Experimental Group 1, the Video Demonstration + Demonstration method for students in Experimental Group 2, and only the Demonstration method for students in the Control Group. After the theoretical explanation and laboratory practices according to their groups, the subcutaneous injection skill levels of the students in all three groups will first be assessed in the laboratory setting using the Objective Structured Clinical Examination (OSCE) and later evaluated in the clinical setting using the Subcutaneous Injection Skill Checklist. The confidence levels of the students will be determined through self-reporting using the "Confidence Scale" after all clinical practices are completed.

The research data will be collected between April and June 2025. Descriptive (number, percentage, mean, standard deviation, minimum-maximum) and comparative statistics (Chi-Square Test, Mann Whitney U Test, Wilcoxon Test) will be used in the analysis of the data. The level of statistically significance will be considered at p\<0.05.

Primary Outcome Measures: Skill Evaluation, First, the evaluation will be conducted using the Objective Structured Clinical Examination (OSCE).The OSCE score will be determined according to the procedure steps specified in the SC Injection Skill Checklist. The form consisting of 27 items in which each application step is scored shows the skill level as points. In the evaluation, each step that the student performs correctly will be calculated as 2 points, each incomplete step will be calculated as 1 point, and each step that the student does not perform or performs incorrectly will be calculated as 0 points. The lowest score that can be obtained from the form is 0 and the highest score is 54.

In the second stage, all students will be evaluated in Clinics of the University Hospital. Skill assessments will be performed using the Subcutaneous Injection Skill Checklist.The average score obtained as a result of the two assessments will determine the student's skill level., twice, first evaluation will take place up to 10 weeks after the begining of the study (end of laboratory training) and second evaluation will take place up to 12 weeks the begining of the study (after 7 or 15 days the laboratory training) in hospital
Secondary Outcome Measures: Confidence, The confidence levels of students in all three groups will be evaluated using the " Self Confidence Scale". The scale consists of 33 items collected under two factors as internal self-confidence and external self-confidence. In the self-report and 5-point Likert-type scale, 17 items collected under the internal self-confidence factor are mostly related to individuals' self-confidence towards themselves, while the external self-confidence dimension consisting of 16 items is related to individuals' self-confidence towards their external environment and social life. The highest score that can be obtained from the scale is 165 and the lowest score is 33. A high score obtained from the scale indicates a high level of self-confidence. The total score obtained from the scale divided by the number of items determines the level of self-confidence. Accordingly, \<2.5 indicates low self-confidence, 2.5-3.5 indicates medium self-confidence, and 3.5 and above indicates high self-confidence., once, up to 20 weeks (when the research is finished)