Clinical Research Directory

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.

The Role of Simulation Fidelity in Early Surgical Skills Education

The aim of the study is to evaluate the effectiveness of teaching surgical suturing techniques using various materials (e.g., banana peel, orange peel, pork, chicken, and silicone pads). The study results will help identify the most effective teaching materials and methods, which will contribute to optimizing educational programs and improving the quality of training for future surgeons.

Comparison of Three Teaching Methods for Urinary Catheterization in Nursing Students

Research Questions 1. Do total learning motivation and sub-dimension scores (attention-relevance, confidence-satisfaction) differ significantly among nursing students using different instructional materials for urinary catheterization training? 2. Do students' perceptions of theoretical and skill competence differ significantly across the study groups? 3. Do the distributions of procedural steps reported as most difficult by students differ across the groups?

MAGICS - Multi-Agent Generative AI in Clinical Simulation for Clinical Deterioration Training

This study compares the effectiveness of a Generative AI-integrated blended simulation programme and high-fidelity simulation alone on nursing students' clinical reasoning and learning experience during deterioration training

Hybrid Simulation in Postpartum Hemorrhage Training for Nursing Students

Abstract Postpartum hemorrhage (PPH) is a leading cause of maternal mortality and morbidity worldwide, requiring nursing students to acquire both theoretical knowledge and clinical competence for safe and effective management. Hybrid simulation, integrating standardized patients with high-fidelity simulators, is an innovative educational approach that simultaneously enhances communication and psychomotor skills. This prospective randomized controlled study aims to evaluate the effects of a hybrid simulation-based postpartum hemorrhage management training on nursing students' learning satisfaction, self-confidence, and clinical readiness. The study was conducted with third-year nursing students at Eskisehir Osmangazi University Faculty of Health Sciences, Department of Nursing. Participants were randomly assigned to either an intervention group receiving hybrid simulation-based training using standardized patients and a birthing simulator, or a control group receiving routine education. Data were collected before and after the intervention using a Personal Information Form, the Student Satisfaction and Self-Confidence in Learning Scale, and the Nursing Clinical Readiness Scale to evaluate outcomes between the groups.

Simulation-Based Subcutaneous Injection Training in Midwifery Students

The goal of this clinical trial is to compare three simulation-based approaches for teaching subcutaneous injections to first-year midwifery students. A subcutaneous injection is an injection given into the tissue just under the skin. The main questions this study aims to answer are: Do the three teaching approaches lead to different levels of learning and injection skills? Do the approaches affect students' confidence in performing the skill? Do the approaches affect students' anxiety during injection practice? Researchers will compare three groups of midwifery students. One group will practice on the abdominal area of a patient-care mannequin. A second group will practice on an injection training pad placed on a peer's abdomen. A third group will practice on an injection training pad placed on their own abdomen. Participants will first receive the same classroom teaching and laboratory instruction on subcutaneous injection. One week later, they will practice the injection according to the group to which they were randomly assigned. No medication will be injected into a participant's body; the practice will use training equipment and saline solution. After the practice, researchers will assess participants' learning, injection skills, self-efficacy, and anxiety.

Effects of Virtual Reality Hand Hygiene Simulation on Nurses' Hand Hygiene

Healthcare-associated infections (HAIs) are an important patient safety concern, and hand hygiene is one of the most effective measures for preventing their transmission. However, hand hygiene compliance among healthcare professionals, including nurses, remains suboptimal. Innovative educational approaches may support the development of hand hygiene knowledge, behaviour, and compliance. Virtual reality (VR) simulation provides an immersive and interactive learning environment that allows learners to practice clinical situations and reinforce knowledge and skills. In nursing education, VR simulation may facilitate the transfer of theoretical knowledge into practice and provide opportunities for repeated learning experiences. This randomized controlled study evaluated the effectiveness of a VR-based hand hygiene simulation for nurses. Participants in both the experimental and control groups received standard hand hygiene training, while participants in the experimental group additionally received VR-based hand hygiene simulation. The study evaluated the effects of the intervention on nurses' hand hygiene knowledge, handwashing behaviour, and hand hygiene compliance.

Interprofessional Simulation Program for Clinical Resilience and Empathy: Project INSPIRE

The goal of this clinical trial is to develop and evaluate INSPIRE, an intervention for healthcare teams to improve care for individuals with substance use disorder (SUD) during their peri-delivery care. The main question it aims to answer is whether healthcare provider stigmas and behaviors change after receiving the training. The study will be implemented at the University of Utah.

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.

Patient Safety and Medical Errors in Nursing Education: Learning by Doing and Experiencing With Simulated Patients

This research will be conducted with the aim of enabling first year nursing students to learn about patient safety and medical errors through simulated patient education. Students will participate in the theoretical and practical laboratory work of the Fundamentals of Nursing course during the spring semester of 2025-2026. The research will be implemented after the laboratory applications. This research will evaluate the impact of simulated patient education on the outcomes of first-year students' patient safety goals ('Correct identification of patients', 'Ensuring medication safety', 'Reducing the risk of healthcare-associated infections' and 'Reducing the risk of patient harm from falls'). The researchers have developed six scenarios related to patient safety and medical errors. The research will be conducted in a randomised controlled experimental design (n=62). First-year nursing students will be administered the Patient Safety Competency Self-Evaluation Scale (pre-test), the Medical Error Tendency Scale (pre-test), and a knowledge test (pre-test). Students will be randomised into experimental and control groups based on their knowledge test (pre-test) mean scores. After all students in the experimental and control groups have completed the educator-centred theoretical and laboratory applications, the study will proceed to the application phase. First, those in the experimental group will participate in scenario applications (first and second scenarios) to gain experience with simulated patients. The first scenario covers applications related to the objectives of 'correct identification of patients' and 'ensuring medication safety'. The second scenario covers applications related to the objectives of 'reducing the risks associated with falls' and 'reducing the risk of healthcare-associated infections'. One week after the simulation, the experimental group will undergo psychomotor skill assessment related to patient safety on a simulated patient, and the control group will undergo psychomotor skill assessment on a low-fidelity manikin using control ists (first skill assessment). Subsequently, all students will undergo the Patient Safety Competency Self-Evaluation Scale (post-test), the Medical Error Tendency Scale (post-test), and a knowledge test (post test). Eight weeks later, psychomotor skill assessments (second skill assessment) using control lists, the Patient Safety Competency Self-Evaluation Scale (follow up-test), the Medical Error Tendency Scale (follow-up test), and the knowledge test (follow-up test) will be administered again using the same method. The third and fourth scenarios will be used in the first psychomotor skill assessment exam that the experimental and control groups will take. The third scenario includes skills related to the objectives of 'verifying patient identity' and 'ensuring medication safety'. The fourth scenario includes skills related to the objectives of 'reducing the risk of healthcare-associated infections' and 'reducing the risks associated with falls'. The fifth and sixth scenarios will be used in the second psychomotor skills assessment exam for the experimental and control groups. The fifth scenario includes skills related to the objectives of 'verifying patient identity' and 'ensuring medication safety'. The sixth scenario includes skills related to the objectives of 'reducing the risk of healthcare-associated infections' and 'reducing the risks associated with falls'.

Clinical Performance and Multitasking in Anesthesia : a Simulation-based Study

Cognitive failure under multitasking conditions has been demonstrated in various settings, including healthcare. However, in anesthesiology, the impact of multitasking on clinical performance has not yet been fully characterized. The objective of our study is to evaluate the impact of multitasking on anesthesiologists' clinical performance in a simulated setting.

Simulation-Based Learning on Clinical Reasoning, Knowledge Retention, and Transfer in Undergraduate Medical Education

This randomized controlled trial evaluates whether a digital, video-based clinical-reasoning simulation improves clinical-reasoning performance compared with conventional lecture-based teaching across multiple clinical disciplines, including orthopedics and ophthalmology. Within each discipline, participants are randomly allocated 1:1 to an intervention group or a control group. The intervention group learns the assigned topic through an interactive, web-based simulation built on real patient video cases with structured clinical-reasoning steps. The control group receives the same learning objectives and content through a standard didactic lecture, over a comparable duration. After the learning session, all participants complete the same set of standardized clinical scenarios, scored with a predefined rubric. The primary outcome is the post-intervention clinical-reasoning score. Secondary outcomes include diagnostic accuracy, confidence, and satisfaction. The trial uses a shared protocol across discipline-specific cohorts to allow consistent, pre-specified comparison of simulation-based versus lecture-based instruction.

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.

Standardized Patients in Arterial Pressure Monitoring Training

This study aims to evaluate and compare the effects of using standardized patients versus static manikins in nursing education for arterial blood pressure monitoring and stabilization training. The primary objective is to investigate the impact of these two different simulation methods on students' cognitive load, clinical skills, and self-efficacy levels. Arterial pressure monitoring is a critical, invasive intervention commonly performed in intensive care units and operating rooms, requiring a high degree of precision. While traditional technical skill assessments usually focus solely on procedural success scores or completion speed, this study utilizes the framework of Cognitive Load Theory to examine the mental toll (intrinsic, extrinsic, and germane load) and psychological readiness (self-efficacy) experienced by nursing students during the procedure. The study will be conducted as a randomized controlled experimental trial with 3rd-year nursing students who have successfully completed their Medical-Surgical Nursing course. Participants will be randomly assigned to either the experimental group or the control group: The Experimental Group will receive theoretical and practical training, followed by performing the arterial pressure monitoring line stabilization on a "Standardized Patient" (an experienced healthcare professional acting a scenario with a moving limb to mimic real clinical chaos without any actual invasive intervention). The Control Group will receive the same training but will perform the stabilization procedure on a traditional static medical manikin. Data will be collected using a Descriptive Information and Performance Recording Form (to measure procedural time and error rates), the Cognitive Load Scale, and the Self-Efficacy Scale for Clinical Skills. Measurements will be taken at baseline (pre-test) and immediately after the intervention (post-test). The findings of this study are expected to provide evidence-based guidance for developing "mind-friendly" nursing curricula and safer, more realistic simulation protocols that enhance student self-efficacy while ensuring patient safety before entering actual clinical environments.

Simulation Training for Adolescent Leukemia Care in Nursing Students

This study aims to evaluate the effects of scenario-based simulation training for adolescent leukemia care on nursing students' perceived stress, knowledge level, and learning satisfaction. Nursing students often encounter challenges when managing complex clinical situations involving pediatric oncology patients. Simulation-based education may help students develop clinical skills and confidence in a safe learning environment. The study investigates whether participation in an adolescent leukemia simulation scenario improves students' knowledge related to extravasation management, affects their perceived stress levels, and enhances their learning satisfaction. In addition, students' experiences and perceptions regarding the simulation training will be explored through qualitative interviews.

Parenteral Injection Training Module

Injection practices are a legal obligation of healthcare professionals, but they are also ethically responsible, and the safe maintenance of these practices is extremely important for both patient and employee safety. Due to reasons such as the lack of knowledge and skills of healthcare professionals regarding safe injection, lack of experience, in-service training and periodic training for newly recruited personnel, situations that threaten patient and employee safety occur. Mistakes made in situations requiring technical skills related to injection practices lead to local complications such as ecchymosis, hematoma, pain, abscess, lipodystrophy, infection, and can result in life-threatening situations. In addition, lack of technical skills causes sharp-edge injuries in the world and in excess of their number, and causes blood-borne diseases for many healthcare professionals. In order to prevent these complications and injuries, the education of healthcare professionals requires an education system based on theory and clinical practice, supporting students' cognitive, sensory and psychomotor skills. In the education process, the aim should be to provide clinical skills as well as theoretical knowledge and to develop the acquired skills. Because clinical education allows students to integrate theoretical knowledge with practice in healthcare settings and learn by experience. Gaining competence in parenteral interventions in the clinic is a gradual process and is one of the most important issues in both undergraduate education and postgraduate in-service training. Although clinical practice training is one of the basic practices for learning and acquiring clinical skills in traditional medical and nursing education curricula, it is seen that it is insufficient and it is recommended to benefit from developments in the field of educational technologies in order for practice training to increase patient and student safety. Considering the increasing emphasis on the right of patients to receive care from well-educated health professionals and the right of employees to be safe in risky practices, it is thought that developing a tool that will provide students with the opportunity to practice repeatedly in parenteral injection practice training will be an effective tool in solving all the problems mentioned above. For this purpose, the parenteral practice (intravenous, intramuscular, subcutaneous) skill training module, which is targeted to be developed in the project, aims to improve students' injection skills, provide safe injection practices and ensure their own safety.

Caregiver Training Regarding Percutaneous Endoscopic Gastrostomy Feeding and Care

Background: Percutaneous endoscopic gastrostomy (PEG) is used for patients who cannot be fed orally, have a reduced swallowing reflex, or require long-term feeding. PEG care and feeding, which is performed with nursing support in healthcare institutions, becomes the responsibility of the caregiver after discharge. During this process, a lack of information and insufficient mastery of PEG feeding can create stress for caregivers. This situation jeopardizes patient safety. Therefore, healthcare professionals should manage patient-centered care from the moment the PEG indication is established until discharge. In this regard, consistent guidance and healthcare education are needed for caregivers. Aim and hypotheses: This study aims to examine the effects of hands-on PEG feeding and PEG care training, enriched with audiovisual materials (video), on caregivers' knowledge level, skills, and stress levels related to the PEG feeding and care process. H1: The training provided for caregivers increases their knowledge level regarding PEG feeding and care. H2: The training provided for caregivers increases their skill level regarding PEG feeding and care. H3: The training provided for caregivers reduces their stress levels related to PEG feeding and care. Design: This study was designed as a randomized controlled trial with experimental and control groups. Method: The study population will consist of caregivers of patients receiving inpatient care at a state hospital and undergoing PEG placement for the first time. The sample size was calculated using the G-Power 3.1 program, resulting in a sample size of 54 (n1=27, n2=27), including the dropout rate. Participants will be randomly assigned to groups. The intervention group will receive hands-on training related to PEG feding and care using a low-fidelity model. In addition, caregivers will be provided with video training on PEG feeding and care that they can watch for review when needed. The control group will receive standard institutional training provided by the nutrition nurse of the institution where the study is conducted. Data will be collected face-to-face using a "Personal Information Form", "State Anxiety Inventory", "Skills Checklist", and "PEG Care Konowledge Form". Three measurements will be taken in the study. Test 0: Before the training (Personal Information Form, State Anxiety Inventory), Test 1: After the training (with the PEG Care Knowledge Form and the State Anxiety Inventory). Additionally, the researcher will evaluate the caregiver's feeding and care practices using the Skills Checklist. Test 2: Two weeks after from the Test 1 (State Anxiety Inventory and PEG Care Konowledge Form), also the researcher will also evaluate the caregiver's practices a second time using the Skills Checklist. Data will be analyzed using the SPSS Statistics 27 software package.

High-Fidelity Simulation-Based Breech Birth Education in Midwifery Students

The purpose of this randomized controlled clinical trial is to evaluate whether high-fidelity simulation-based breech birth management education improves knowledge, clinical skill performance, and satisfaction among midwifery students. The main questions this study aims to answer are: Does high-fidelity simulation-based breech birth education improve midwifery students' knowledge levels compared with low-fidelity mannequin-based practice? Does high-fidelity simulation-based breech birth education improve midwifery students' clinical skill performance compared with low-fidelity mannequin-based practice? Researchers will compare midwifery students receiving high-fidelity simulation-based breech birth education with students receiving low-fidelity mannequin-based practice to determine whether the high-fidelity simulation method is more effective in improving breech birth management knowledge and skills. Participants will: Complete a pre-test assessing breech birth knowledge before the educational intervention. Receive theoretical education on breech birth management. Be randomly assigned to either the high-fidelity simulation group or the low-fidelity mannequin-based practice group. Complete a post-test assessing breech birth knowledge after the intervention. Be evaluated for breech birth management skills using a structured skill assessment form. Complete a simulation satisfaction scale after the simulation-based education.

Using Simulation-based Team Training to Improve Psychological Safety and Relational Coordination as Well as Conducting a Process Evaluation

Simulation-based team training is increasingly used in hospitals to support teamwork and communication, particularly in situations that are complex or time-critical. While such training is known to improve observable team behaviours, less is known about how it is implemented in everyday clinical work and how it influences relational aspects of teamwork, such as psychological safety and relational coordination. This study explores the implementation and perceived impact of a simulation-based training programme focused on infectious disease management in a hospital department. Psychological safety refers to whether staff feel safe to speak up, ask questions, and express concerns, while relational coordination concerns how well different professional groups communicate, share goals, and align their work. Using a qualitative process and outcome evaluation, the study examines how the simulation activities were introduced, adapted, and experienced by different staff groups, and how participants perceived their influence on collaboration and professional behaviour. Data are collected through interviews with clinical staff and managers, questionnaires measuring psychological safety and relational coordination before and after the intervention, and systematic registration of simulation activities (including who participated, what was trained, and when and where simulations took place). By combining process evaluation with an exploration of perceived outcomes, the study aims to provide insight into how simulation-based team training functions as a behavioural intervention in complex clinical settings, and how it may support psychologically safe and well-coordinated teamwork in everyday practice.

Developing Disability Awareness, Attitude, and Empathy in Nursing Students

Abstract Individuals with disabilities frequently face barriers to accessing healthcare services due to physical, social, economic, and policy-related factors. As essential members of the healthcare workforce, nurses play a critical role in addressing these inequities. Previous studies focusing on disability awareness, attitudes, and empathy highlight the need for high-quality research employing mixed-method, simulation-based interventions aimed at enhancing awareness and empathy, fostering positive attitudes, and supporting learning outcomes. However, the existing literature lacks studies that simultaneously compare different simulation methods and comprehensively evaluate awareness, attitudes, and empathy using a multidimensional approach. This study aims to examine the effectiveness of simulation-based interventions-standardized patient encounters and virtual reality training-in improving nursing students' awareness, strengthening positive attitudes, and increasing sensitivity in the delivery of healthcare services to individuals with disabilities. The findings are expected to support the integration and expansion of disability-focused simulation practices in nursing curricula and contribute to the development of evidence-based nursing education programs. Keywords: nursing students; disability; attitude; simulation; virtual reality

Ultrasound Simulation Case-based Workshop Implementation and Impact Assessment

This study is a prospective cohort study implementing a point-of-care ultrasound (POCUS) simulation case-based workshop in emergency (EM) physicians at different training levels as an educational and competency-based assessment tool. The investigators incorporate elements of Miller's pyramid (second and third levels of "knows how" and "shows how") and the latter part of Kern's six step model framework for curriculum development (intervention implementation and student assessment, program evaluation, and feedback). The investigators will compare pre-/post-workshop knowledge and post-OSCE (Objective Structured Clinical Exam) technical skills scores. The investigators will also collect demographic data on baseline POCUS scans completed, training level, interest in ultrasound fellowship, monthly performed clinical POCUS scans, etc. The standardized simulation cases for EM POCUS training can then be generalized for use at any program globally to improve clinical training and patient care.

High-Fidelity Simulation and Longitudinal Outcomes in Novice Nurses (HFS-NOVA)

This study examined whether high-fidelity simulation (HFS) training - a realistic, hands-on learning method using advanced patient mannequins - can improve both technical skills and psychological well-being in newly graduated nurses. Seventy novice nurses at a tertiary medical centre in Taiwan participated in a structured HFS session focused on airway crisis management. Six outcomes were measured at three time points: before training (T1), immediately after training (T2), and three months later (T3). These outcomes included: airway management knowledge, clinical performance, learning attitude, self-efficacy (confidence in clinical abilities), nursing learning resilience (ability to cope with professional challenges), and psychological well-being.

Simulation-Based Cardiac Point-of-Care Ultrasound Program to Improve Clinical Outcomes in Acute Heart Failure Patients

The aim of this study is to co-design a cardiac POCUS simulation training intervention and implementation strategy for EM clinicians and evaluate the effectiveness of the cardiac point-of-care ultrasound (POCUS) simulation-based training (CPST) and CPG implementation. By performing this study, the investigators hope to improve diagnostic processes and time-to-diuretic dosing for acute heart failure (AHF) patients.

Hybrid Episiotomy Training and Student Outcomes

The goal of this clinical trial is to evaluate the effects of a hybrid episiotomy repair training model on self-efficacy, anxiety, and cognitive load in third-year midwifery students. The main questions it aims to answer are: Does standardized sponge-based training improve students' episiotomy skills self-efficacy and cognitive load? Is there a difference between chicken tissue-based training and virtual reality-based training in terms of self-efficacy, anxiety, and cognitive load outcomes? Researchers will compare chicken tissue-based training and virtual reality-based training to determine whether there are differences in educational outcomes between these two advanced simulation methods. Participants will: * complete baseline assessments of anxiety, self-efficacy, and cognitive load, * receive standardized episiotomy repair training using a sponge model, * be randomly assigned to either chicken tissue-based hands-on training or virtual reality-based video training, * complete post-training assessments following each training phase.