First Aid, Hemorrhage, Nursing Education, Self Efficacy, Virtual Reality
Conditions
Brief summary
The goal of this clinical trial is to learn if a 360-degree interactive virtual reality (VR) video simulation works to improve first aid knowledge, knowledge retention, and self-efficacy in stopping severe bleeding among first-year undergraduate nursing students. The main questions the study aims to answer are: * Does experiencing the interactive VR video simulation increase students' knowledge of bleeding first aid? * Does the VR video simulation increase students' long-term retention of first aid knowledge? * Does the VR video simulation improve students' self-efficacy in bleeding first aid? Researchers compared four groups using a Solomon four-group design to evaluate the effectiveness of the VR simulation, while also testing whether taking a pre-test affected the final outcomes. Participants: * Completed an introductory survey and possibly a baseline test measuring first aid knowledge and self-efficacy. * Attended a 1-hour standard classroom lecture about first aid for bleeding. * (Intervention groups only) Completed a 5-minute interactive 360-degree video simulation of a severe bleeding emergency using an Oculus Quest 2 VR headset, which required answering 7 clinical decision-making questions. * Completed follow-up tests 4 weeks and 8 weeks after the training to measure their bleeding first aid knowledge and self-efficacy.
Interventions
OTHER360-degree VR video simulation
A 5-minute interactive 360-degree video simulation of a severe bleeding emergency using an Oculus Quest 2 VR headset, which requires answering 7 clinical decision-making questions
Sponsors
Manisa Celal Bayar University
Aliye Üster Foundation
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
DOUBLE (Subject, Investigator)
Intervention model description
This study utilizes a Solomon four-group design to isolate the educational effects of the interactive 360-degree VR video simulation while systematically controlling for pre-test sensitization. Participants are randomly assigned to one of four parallel groups with different pre-testing and intervention conditions: Intervention Group 1 (Pre-tested): Receives the pre-test, standard classroom instruction (lecture), the 360-degree VR video simulation, the post-test (at 4 weeks), and the retention test (at 8 weeks) Intervention Group 2 (Unpre-tested): Receives standard classroom instruction, the 360-degree VR video simulation, the post-test, and the retention test without undergoing a pre-test Control Group 1 (Pre-tested): Receives the pre-test, standard classroom instruction, the post-test, and the retention test Control Group 2 (Unpre-tested): Receives standard classroom instruction, the post-test, and the retention test without undergoing a pre-test
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
* Being a volunteer participant * Being a first-year nursing student enrolled at Ege University Faculty of Nursing during the 2021-2022 academic year. * Having successfully completed the "First Aid Module" (First Aid Course) within the current curriculum
Exclusion criteria
* Having any pre-existing health or visual conditions that prevent the safe use of virtual reality (VR) equipment (such as active epilepsy, severe uncorrected visual impairment, or pre-existing psychiatric disorders). * Requesting to withdraw from the study or refusing to participate at any stage of the research
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Bleeding First Aid Knowledge | Baseline (Pre-test), 4 weeks post-intervention (Post-test), and 8 weeks post-intervention (Retention test) | Assessed using the "First Aid for Bleeding Knowledge Test" developed and validated by the researchers. This is a 20-item multiple-choice test designed to measure cognitive learning. Correct answers are scored as 1 and incorrect answers as 0. The total score ranges from 0 to 20, with higher scores indicating higher levels of bleeding first aid knowledge. |
| Bleeding First Aid Self-Efficacy | Baseline (Pre-test) and 4 weeks post-intervention (Post-test) | Assessed using the "First Aid for Bleeding Self-Efficacy Scale" developed and validated by the researchers. This is a 19-item, five-point Likert-type scale (ranging from 1=completely insufficient to 5=completely sufficient) that measures students' perceived competence in managing bleeding situations. The total score ranges from 19 to 95, with higher scores reflecting greater clinical self-efficacy. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Perception of Simulation Design | Immediately after the virtual reality simulation session | Assessed using the 20-item Simulation Design Scale (adapted into Turkish by Unver et al., 2017) only for the intervention groups. The scale evaluates five key elements of simulation design: objectives/information, student support, problem-solving, guided reflection/feedback, and fidelity. Items are rated on a five-point Likert scale (1=strongly disagree to 5=strongly agree). The overall score ranges from 20 to 100, where higher scores reflect a stronger presence of effective simulation design components. |
| Student Satisfaction and Self-Confidence in Learning | Immediately after the virtual reality simulation session | Assessed using the 12-item Student Satisfaction and Self-Confidence in Learning Scale (adapted into Turkish by Unver et al., 2017). It includes two subscales: satisfaction with current learning (5 items) and self-confidence in learning (7 items). Items are rated on a five-point Likert scale (1=strongly disagree to 5=strongly agree). The total score ranges from 12 to 60, with higher scores indicating greater learning satisfaction and self-confidence. |
| Video Engagement and Immersion | Immediately after the virtual reality simulation session | Assessed using the 15-item Video Engagement Scale (adapted into Turkish by Deryakulu et al., 2019) to measure the student's emotional and cognitive immersion. It consists of five subscales (attention, going into a narrative world, identity, empathy, and emotion) rated on a seven-point Likert scale (1=strongly disagree to 7=strongly agree). The total score ranges from 15 to 105, with higher scores indicating stronger engagement with the VR environment. |
| Occurrence of Cybersickness / Simulation Side Effects | During and up to 15 minutes immediately following the virtual reality experience | Assessed using a structured Researcher Observation Form to track any simulator-related physical discomfort (such as dizziness, nausea, headache, or neck pain) experienced by participants during or immediately after the VR headset experience. Side effects are recorded categorically as present/absent and graded by severity (none, mild, moderate). |
Countries
Turkey (Türkiye)
Outcome results
None listed