Clinical Research Directory

Validation of the Healthcare Relationship Assessment Scale (ERA) in Health Sciences Students.

This study aims to design and psychometrically validate a practical and agile observational instrument-the Healthcare Relationship Assessment scale (ERA scale)-to evaluate communication skills and person-centered care among undergraduate health sciences students (Nursing, Physiotherapy, Pharmacy, and Psychology) during their external clinical placements. Adapted from the theoretical framework of the CICAA scale, the instrument is designed to reduce evaluation burden for clinical mentors while maintaining high measurement reliability and validity.

Generative AI Simulated Patients Versus Expert Demonstration Videos for Psychiatric Interview Training in Occupational Therapy Students

The goal of this study is to compare two methods for teaching psychiatric work-history interviewing to third-year occupational therapy students: practice with a generative AI simulated patient and an expert demonstration video. The main questions it aims to answer are: 1. Which teaching method leads to better interview performance in an objective structured clinical examination (OSCE) with a standardized patient? 2. How do the two methods affect students' interview self-efficacy? 3. How do students evaluate the two methods, and which learning sequence do they prefer? Students enrolled in a required vocational rehabilitation course were randomly assigned to one of two sequences. In the first teaching week, one sequence practiced interviewing a GPT-4o-based simulated patient (a 35-year-old person with schizophrenia), and the other watched and discussed an expert demonstration interview of the same case. Both groups completed a 9-minute standardized-patient OSCE on the same day. In the following week, the two sequences crossed over to the other method. Interview self-efficacy was measured before teaching, after the first method, and after the second method.

Enhancing Male Nursing Students' Competence in Maternity Care: A Quasi-Experimental Study in Egypt

The primary aim of this study is to evaluate the effect of structured clinical teaching scenarios on male nursing students' competence-including knowledge, self-confidence, and practical performance-in maternity care. In many countries, including Egypt, male nursing students face significant barriers during obstetric and gynecological clinical rotations due to cultural beliefs, patient preferences, and traditional gender perceptions. These limitations restrict opportunities for direct hands-on practice, which can negatively affect students' clinical confidence and procedural skills. To address these educational gaps, this quasi-experimental study utilizes a one-group pre-test/post-test design. A total of 150 male undergraduate nursing students enrolled in the maternity nursing clinical course at Delta University for Science and Technology, Egypt, will participate in structured scenario-based clinical teaching and simulation training. Clinical competence, practical skills, self-confidence, and learning satisfaction will be assessed before and immediately after the educational intervention using an Objective Structured Clinical Examination (OSCE), standardized performance checklists, and validated satisfaction and confidence scales.

Intelligent Simulated Patient System for Gastroenterology Education

This randomized controlled trial evaluated a large language model-based Intelligent Simulated Patient System (ISPS) for gastroenterology history-taking education. Ninety medical students were randomly assigned in a 1:1 ratio to 4 weeks of conventional clinical learning or ISPS-assisted training. The ISPS used teacher-defined structured case information to support simulated patient interactions and generated item-level formative feedback using predefined scoring rubrics. The implemented system did not use external electronic health record retrieval, retrieval-augmented generation, a vector database, or semantic-similarity threshold scoring. The primary outcomes were post-intervention medical history-taking performance and clinical diagnostic accuracy. History-taking performance was assessed in a standardized Objective Structured Clinical Examination by two senior physicians who were blinded to group allocation. Secondary outcomes included patient-centered communication competence and participants' acceptance of the ISPS.

Storyline-Based Gamified Blended Learning for ECG Interpretation in Nursing Students

The goal of this randomized controlled trial is to determine whether a Storyline-based gamified blended learning (SGBL) intervention improves electrocardiogram (ECG) interpretation competence and self-reported clinical decision-making among undergraduate nursing students. The main questions it aims to answer are: Does the SGBL intervention improve students' ECG interpretation competence compared with conventional face-to-face education? Does the SGBL intervention improve students' self-reported clinical decision-making compared with conventional face-to-face education? Researchers will compare the SGBL intervention with conventional face-to-face, lecture-based education covering the same educational content. Participants will: Attend six weekly face-to-face educational sessions, each lasting 90 minutes. Receive either the SGBL intervention or conventional face-to-face instruction. Complete assessments of ECG interpretation competence and self-reported clinical decision-making before the intervention and two weeks after completion of the educational program.

Deliberate Repetitive Practice and Nursing Student Confidence in Peripheral Intravenous Catheter (PIVC) Insertion

This study examined whether a structured deliberate repetitive practice (DRP) simulation scenario was associated with changes in prelicensure nursing students' self-reported confidence and preparedness for peripheral intravenous catheter (PIVC) insertion. PIVC insertion is a foundational nursing skill, yet first-attempt failure rates are high and student confidence is often low. The DRP intervention consisted of standardized instruction, supervised repetitive practice on a patient simulator, and individualized feedback from a nurse educator. Pre- and post-intervention surveys measured students' confidence and preparedness using a researcher-developed three-item questionnaire. The study used a descriptive pre-post design at a single Midwestern university with prelicensure Bachelor of Science in Nursing students.

Augmented Reality Training for Pelvic Exams and Pap Smears in Medical Students

This randomized controlled trial evaluated whether augmented reality (AR)-based pre-simulation training improves the acquisition of speculum examination and Papanicolaou (Pap) smear sampling competencies among undergraduate medical students, compared with conventional text- and video-based preparation. Participants were randomly assigned to receive AR-based training or conventional training before completing a standardized simulated speculum examination and Pap smear session, assessed using a validated Direct Observation of Procedural Skills (DOPS) checklist by a blinded evaluator. The primary outcome was achievement of a minimum competency threshold at the time of the simulation.

The Effectiveness of Situation Awareness Approach on Nursing Competencies in Obstetric Practicum: A Multimodal Teaching

The declining birth rate and the complex and unpredictable nature of obstetric clinical situations have limited nursing students' opportunities to gain authentic clinical experience and increased the challenges and stress associated with obstetric practicum. Therefore, undergraduate nursing students preparing for obstetric clinical practice require adequate pre-clinical preparation to develop essential competencies in situation awareness, communication, clinical reasoning, and decision-making. However, traditional teaching approaches may not adequately replicate authentic obstetric situations or provide sufficient opportunities for students to integrate knowledge and respond appropriately to dynamic clinical conditions. This study aims to develop a Situation Awareness-Based Multimodal Instructional (SAMI) program for undergraduate nursing students. The program integrates situation awareness theory, multimodal learning, virtual simulation, and game-based learning, incorporating visual, auditory, tactile, movement, and spatial experiences to create immersive and context-based obstetric learning environments. The SAMI program is designed to prepare nursing students for clinical practice by enhancing their ability to recognize relevant clinical cues, understand patient conditions, anticipate potential changes, and make appropriate clinical judgments and decisions. First, the feasibility, usability, and learner experiences of the SAMI program will be examined. Approximately 28 undergraduate nursing students who initail their obstetric clinical practicum will be recruited. They are allocated into 4 groups and randomly be assigned experimental groups or control groups. The experimental group will received SAMI program teaching; while control group will receive usual teaching. Subsequently, to evaluate the effectiveness of the program, undergraduate nursing students across different educational institutions will be cruited during their obstetric practicum. The research outcomes will include situation awareness, obstetric communication, clinical reasoning, and confidence in clinical decision-making. Finally, this study will examine a model including educational background, obstetric practicum stress, situation awareness, and core competencies in maternal nursing care. We plan to recruite 300 nursing students to test the model. Ultimately, this study aims to establish an evidence-based, context-based, and multimodal pre-clinical preparation model that bridges the gap between classroom learning and obstetric clinical practice. The findings will provide empirical evidence on the effectiveness of the SAMI program in enhancing nursing students' clinical readiness and core competencies for obstetric practicum.

Emergency Structured Clinical Examination Training bOX

This study assessed whether a training toolbox called ECOX could help medical students prepare for their objective structured clinical examination (OSCE) during an emergency medicine clerkship. The hypothesis was that adding ECOX to usual training would improve examination performance and reduce examination-related anxiety. Eight 10-week clerkship rotations at Angers University Hospital, France, were randomly assigned to usual training alone or usual training plus ECOX, with four rotations in each group. All students in a rotation received the same assignment. ECOX provided a timer and reference assessment grids for practising seven-minute encounters with real patients who agreed to participate. Students could use the toolbox throughout their clerkship. Both groups completed the same three-station examination at the end of the clerkship. Examiners were unaware of group allocation. Anxiety was assessed at the beginning of the clerkship and immediately before the final examination.

Virtual Reality Training in Nasogastric Catheter Application for Nursing Students

Nasogastric catheter insertion is a complex psychomotor nursing skill in which incorrect placement can cause serious harm, including pulmonary aspiration, pneumothorax and death. Nurses are professionally responsible for the procedure from their first day in clinical practice, so competence must be acquired before graduation. The final-year students eligible for this trial had an unusual educational history. They took the Fundamentals of Nursing course, in which nasogastric catheter application is first taught, in the spring semester of 2019-2020. Face-to-face teaching was suspended in March 2020 because of the COVID-19 pandemic and the course was completed online, so the cohort received no hands-on laboratory training in that course. Clinical practice was further disrupted by the Kahramanmaras earthquakes of February 2023. Opportunities for repeated individual practice of this skill therefore remained limited throughout their education. This single-centre, pretest-posttest randomised controlled trial compared immersive virtual reality training with traditional simulator-based practice in nasogastric catheter application. Eighty-five final-year nursing students at Eskisehir Osmangazi University were randomised to a virtual reality group or a traditional method group, and 78 completed the study. Both groups received the same theoretical and demonstration training; they then practised the procedure either in an immersive virtual reality application or on a medium-fidelity simulator, up to three times each. The outcomes assessed were psychomotor skill performance, performance on safety-critical procedural steps, knowledge, self-confidence, anxiety and motivation. Data collection took place between 14 March and 20 May 2024.

Virtual Reality Training in Nasogastric Tube Application for Nurses

This randomized controlled trial evaluated the effectiveness of immersive virtual reality (VR) technology in teaching nurses nasogastric tube application skills. The study included nurses working in internal medicine, surgical, and intensive care units at a university hospital in Türkiye between July and September 2025. Sixty-five nurses were allocated to a virtual reality group or a conventional training group. Both groups received the same theoretical instruction and demonstration on a medium-fidelity simulator. Afterward, nurses in the virtual reality group practiced the nasogastric tube insertion and removal procedure in an immersive virtual reality application, while nurses in the conventional training group practiced the same procedure on a medium-fidelity simulator. We carried out final assessments at least two weeks after the practice session. We compared procedural skill, performance of safety-critical procedural steps, knowledge, self-confidence, anxiety, and motivation toward the instructional material between the two groups. The study included 62 nurses.

Remote Guidance for eFAST Training Using a Head-Mounted Device

This study looks at the best way to remotely teach and guide doctors-in-training to perform a bedside ultrasound exam called eFAST (extended Focused Assessment with Sonography for Trauma), which is used to quickly check injured patients for internal bleeding or air around the lungs. The study takes place in a simulation setting, with no real patients. Resident physicians who have completed the basic ultrasound courses each watch the same short instructional video and then perform three eFAST examinations on the same healthy volunteer. Participants are randomly assigned to one of three groups: (1) the instructional video only, with no live help; (2) the video plus real-time audio guidance from a remote expert who can see the live ultrasound image; or (3) the video plus guidance through a head-mounted device that also lets the expert see the participant's own point of view. Afterwards, experts who were not involved in a given exam review the recorded ultrasound images, without knowing which group the participant was in, and rate the image quality and skill. The study also measures how long the exams take, the participants' workload, and the comfort and usability of the system. The goal is to learn whether real-time remote guidance, and in particular guidance through a head-mounted device, helps trainees produce better and faster eFAST examinations than an instructional video alone.

The Effect of Scenario-Based Simulation Training for Nutritional Counseling During Pregnancy on Nursing Students' Anxiety Levels, Self-Efficacy Perceptions, and Clinical Skill Performance

The Effect of Scenario-Based Simulation Training for Nutritional Counseling During Pregnancy on Nursing Students' Anxiety Levels, Self-Efficacy Perceptions, and Clinical Skill Performance: A Randomized Controlled Trial Research Hypotheses H1: Scenario-based simulation training significantly reduces anxiety levels among nursing students. H2: Scenario-based simulation training significantly increases nursing students' perceived self-efficacy. H3: Scenario-based simulation training significantly improves nursing students' clinical skill performance. H0₁: Scenario-based simulation training has no statistically significant effect on nursing students' anxiety levels. H0₂: Scenario-based simulation training has no statistically significant effect on nursing students' perceived self-efficacy. H0₃: Scenario-based simulation training has no statistically significant effect on nursing students' clinical skill performance.

Effects of Team-Based Simulation on Nursing Students' Soft Skills

Objective: This study aims to investigate the effects of "team-based simulation" on the development of communication skills, self-awareness levels, and teamwork competencies among first-year nursing students. Hypotheses: H1: Team-based simulation training significantly increases the self-awareness levels of nursing students compared to individual-based training. H2: Team-based simulation practices lead to a statistically significant improvement in students' attitudes toward teamwork, specifically regarding mutual support and team structure. H3: Students who participate in team-based simulations demonstrate higher levels of satisfaction with learning and self-confidence compared to those in individual-based settings. Study Description: The research was conducted with 112 first-year nursing students using a randomized controlled and "cross-over" design. Participants were divided into two groups, experiencing both team-based and individual-based simulation applications in different sequences. Data were collected at four different time points-pre-test, intra-post-simulation, and one-month follow-up-using various scales. The study determined that team-based simulation lays the groundwork for the development of students' self-awareness, enhances teamwork skills, and increases satisfaction levels. To ensure the sustainability of these gains, it is recommended that such interactive and repetitive simulation methods be systematically integrated into nursing education curricula.

POV Video and Mental Practice Training for Neonatal LMA Insertion

This prospective, randomized, single-blind simulation study aims to evaluate and compare the educational efficacy of a hybrid instructional modality-combining point-of-view (POV) video training and structured mental practice (MP)-against standard instructor-led live demonstration for neonatal laryngeal mask airway (LMA) insertion training among novice healthcare professionals. Learning neonatal airway management skills presents unique educational and cognitive challenges, especially for non-physician providers who are frequently required to perform these high-stakes interventions during the Neonatal Resuscitation Program (NRP) curricula. A total of 52 eligible healthcare professionals (including physicians, midwives, nurses, paramedics, and emergency medical technicians) with no prior neonatal LMA insertion experience will be prospectively enrolled and randomly allocated into two equal parallel groups (n=26 per group). Group A (Control) will receive a standard, step-by-step 5-minute live instructor demonstration on a high-fidelity term neonatal simulator. Group B (Intervention) will view a 3-minute standardized POV video captured from a first-person perspective via a head-mounted action camera worn by an expert instructor, immediately followed by a 1-minute structured mental rehearsal, with no live demonstration provided. Following the respective educational interventions, all participants will individually perform the neonatal LMA insertion on the simulator in a separate room. A trained evaluator, who remains strictly blinded to the group assignments, will record the performance outcomes. The primary outcome measures are the objective total OSCE score (evaluated via a 22-item standardized checklist) and the physical procedural completion time in seconds. Secondary outcomes include first-attempt success rates, critical error rates, instances of excessive force application, airway trauma or procedural failure, and subjective cognitive workload dimensions assessed via the NASA Task Load Index (NASA-TLX) questionnaire. The findings will provide insights into scalable, cost-effective, and cognitively optimized learning models for integration into neonatal resuscitation training frameworks.

VR Simulation-Based Implanted Port Catheter Training in Nursing Students

Implanted port catheter care is a critical clinical skill in oncology nursing, requiring accurate knowledge, aseptic technique, safe procedural practice, and early recognition of potential complications. This parallel group randomized controlled study aims to evaluate the effectiveness of virtual reality simulation-based implanted port catheter training in undergraduate nursing students. Eligible second-year nursing students will be randomly assigned to either an intervention group or a control group. All students will receive a two-hour traditional implanted port catheter training session in the classroom setting. In addition to traditional training, students in the intervention group will receive virtual reality simulation-based training consisting of two scenarios: safe implanted port catheter access and extravasation/complication management. The control group will receive only traditional training.

Gamification Versus E-Learning for Electrocardiogram Education

This randomized controlled study aims to compare the effectiveness of a gamification educational method and an e-learning educational method for electrocardiogram (ECG) education. Nursing students and novice nurses are randomly assigned to either a gamified learning group or an e-learning group. The study evaluates whether the gamification approach improves ECG knowledge, learning confidence, and learning satisfaction compared with conventional e-learning instruction.

Mixed Reality vs. Traditional Arthroscopic Simulation

This randomized controlled trial evaluates and compares the educational effectiveness of two arthroscopic training platforms: a traditional physical bench-model simulator and an immersive Mixed Reality (MR) simulator. Medical students and residents undergo a baseline assessment on a physical knee simulator and are then randomized into either the Traditional Simulator Group (TSG) or the Mixed Reality Simulator Group (MRSG). Participants complete a three-session training protocol focusing on basic psychomotor skills. Trainees are then evaluated on an anatomical knee task to measure true clinical skill transfer. Performance is video-recorded and scored by independent, blinded physicians using the validated Arthroscopic Surgical Skill Evaluation Tool (ASSET).

The Effect of AI-Assisted Nursing Process Training on Nursing Process Competence, Perception and Attitudes Towards Artificial Intelligence in Nurses: A Randomized Controlled Study

This study aims to determine how applied artificial intelligence (AI) training affects nurses' ability to manage the nursing process and their perceptions and attitudes toward AI technology * The nursing process is a scientific, six-stage approach used by nurses to identify patient needs and provide holistic care The research is a randomized controlled trial involving 78 nurses at Yalova Education and Research Hospital . Participants will be split into two groups: Both groups will receive standard theoretical training on the nursing process . The intervention group will receive additional specialized training on using AI tools (such as ChatGPT and Deepseek) to help create nursing care plans through practical case studies . Nurses' skills and views will be measured using specific scales before the training and one month after the intervention to evaluate the training's effectiveness * This study is expected to provide valuable insights into how AI can support clinical decision-making and help healthcare providers adapt to new technologies * The research has been approved by the Yalova University Ethics Committee (Protocol 2026/183) and will be conducted between May and December 2026

Virtual Reality Infection Control Training for Healthcare Workers During the Hajj Season

The goal of this clinical trial is to evaluate the effectiveness of immersive virtual reality (VR) training on improving infection control preparedness among healthcare workers during the Hajj pilgrimage in Saudi Arabia. The main questions this study aims to answer are: Does VR training improve healthcare workers' knowledge, confidence, and preparedness for infection control compared to traditional training? Are there differences in outcomes between the VR training and traditional lecture-based education?

Blockchain-Enabled E-Portfolios for Competency Tracking in Undergraduate Nursing Education: A Randomized Controlled Trial

This study evaluates whether a blockchain-enabled electronic portfolio can improve competency tracking and lifelong learning in undergraduate nursing education. Conventional electronic portfolios are often fragmented across courses and clinical rotations, difficult to verify across institutions, and limited in supporting learner ownership of records. To address these challenges, this study compares a blockchain-enabled e-portfolio system with a conventional Moodle-based e-portfolio during a medical-surgical clinical rotation. Third-year undergraduate nursing students at Jouf University, Saudi Arabia, were randomly assigned to use either the blockchain-enabled e-portfolio intervention or the conventional e-portfolio control. The intervention was designed to support cryptographically verifiable competency records, structured reflective evidence, and personalized competency feedback through dashboard analytics. The main outcomes include clinical competence assessed by an Objective Structured Clinical Examination (OSCE), lifelong learning orientation, portfolio quality, and trust in the credibility and portability of competency records. After the quantitative phase, focus group interviews were conducted with students in the intervention group to explore their experiences with the system and the mechanisms through which it may influence learning. The study aims to determine whether blockchain-enabled e-portfolios offer educational advantages over conventional portfolio systems in competency-based nursing education and to identify implementation factors that may support or hinder adoption.

Video-Supported Flipped Learning for Episiotomy Training in Midwifery Students

This study aims to evaluate the effect of a video-supported flipped learning model on anxiety and skill levels of midwifery students in episiotomy education. Episiotomy is an important clinical skill in midwifery education, and the method used to teach this skill may influence students' anxiety and performance. This randomized controlled educational study will be conducted with midwifery students who are enrolled in the episiotomy course. Participants will be randomly assigned to either an intervention group or a control group. Students in the intervention group will receive episiotomy education using a video-supported flipped learning model, in which theoretical content is provided through instructional videos prior to in-class activities. The control group will receive traditional classroom-based education. Students' anxiety levels and episiotomy skill performance will be assessed using validated measurement tools before and after the educational intervention. The findings of this study are expected to contribute to evidence-based teaching strategies in midwifery education and support the use of innovative learning models to improve student outcomes.

Using Real-Time Lung Visuals to Reduce Mental Strain and Improve Diagnosis Speed

The goal of this clinical simulation study is to learn if a "Digital Twin" graphical lung display reduce the mental workload of clinicians. The study also evaluates if this helps physicians diagnose and manage ventilator-related crises more effectively than standard ventilator screens. The main questions it aims to answer are: Does the Digital Twin display lower the cognitive stress (mental workload) experienced by clinicians during a crisis? Does the Digital Twin display reduce the time it takes for clinicians to identify specific respiratory complications? Does the use of real-time physiological visualization improve the accuracy of clinical decision-making? Researchers will compare the performance of clinicians using a standard ventilator display (the "Black Box" condition) to their performance when provided with an additional synchronized 3D lung and advanced waveform display (the "Digital Twin" condition). Participants will: Complete four randomized mechanical ventilation crisis scenarios using a high-fidelity lung simulator (ASL 5000). Manage scenarios involving high airway resistance, low lung compliance, auto-PEEP, and patient-ventilator asynchrony. Undergo a 14-day "washout" period between sessions to ensure no memory bias between the control and intervention groups. Complete a NASA-TLX survey after each scenario to measure their perceived mental, physical, and temporal demand.

Development of a Clinical Skills Teaching Video Database in Occupational Therapy

This study aims to develop a video and audio database for teaching and learning clinical skills in occupational therapy. The database will include recordings of clinical teaching sessions, skill demonstrations, student practice, and interactions between occupational therapists, trainees, and patients or family members. Participants may include occupational therapists involved in clinical teaching, occupational therapy interns or postgraduate trainees, and adult patients or family members who receive occupational therapy services. Participation involves voluntary video or audio recording of clinical teaching or therapy-related activities after informed consent is obtained. This study does not involve any experimental treatment, intervention, or comparison of outcomes. The collected materials will be securely stored, anonymized, and organized for future educational use and research on clinical skills teaching and assessment in occupational therapy.