Development of neonatal Apgar scoring training program utilizing contactless hand tracking in immersive virtual reality.

BACKGROUND: The rapid and accurate assessment of neonatal asphyxia is critical to preventing potentially fatal outcomes. Therefore, nursing students must acquire the skills to assess newborn conditions immediately after birth and implement appropriate interventions. Virtual reality (VR) simulation education has emerged as a promising tool for nursing education, offering repetitive and customizable clinical training while ensuring patient safety and overcoming spatiotemporal limitations. AIM: This study investigated the effects of a contactless hand-tracking-based immersive VR neonatal Apgar scoring program, adapted from experiential learning theory. DESIGN: A non-randomized controlled trial with a pre-post-test, quasi-experimental design was conducted. SETTINGS: The study was conducted at two nursing schools from July to October 2023. PARTICIPANTS: Participants comprised nursing students holding bachelor's degrees in nursing, with three or four years of experience and successful completion of a neonatal nursing theory course. Additionally, individuals with at least six months of experience working in a neonatal ward or delivery room before enrolling in nursing school were eligible. METHODS: The participants were divided into three groups: the VR group (n = 27) received contactless hand-tracking-based immersive VR neonatal Apgar scoring training; the simulation group (n = 28) received face-to-face Apgar scoring simulation training; and the control group (n = 26) received instruction on the Apgar scoring criteria. Changes in scores among the VR, simulation, and control groups were statistically compared using ANOVA with SPSS-WIN 27.0. RESULTS: The VR group exhibited significant improvements in knowledge, learning satisfaction, self-confidence, immersion, and motivation compared to the simulation and control groups. Moreover, satisfaction was significantly higher in the VR group than in the simulation group. CONCLUSIONS: The hand-tracking-based immersive VR neonatal Apgar scoring program represents an innovative and effective educational tool, prioritizing the privacy and rights of mothers and infants. It can potentially replace traditional delivery-room clinical training, which is observation-based and limited.

Development and Effectiveness of a Rapid Cycle Deliberate Practice Neonatal Resuscitation Simulation Program: A Quasi-Experimental Study.

The Rapid Cycle Deliberate Practice (RCDP) simulation during neonatal resuscitation program (NRP) training provides in-event feedback for each simulation step, repeats the simulation from the beginning, and undergoes a continuous improvement process. It also offers after-event debriefing that involves follow-up discussion and reflection after completing simulations. These two methods differ in the timing and frequency of feedback application, and there may be differences in the effectiveness of neonatal resuscitation training. A quasi-experimental simulation study with a pre- and post-test design was used; the experimental group received RCDP simulation NRP training, based on the self-determination theory, while the control group received an after-event debriefing, following the NRP scenario. The experimental group displayed significantly improved clinical decision-making skills compared with the control group. When responding to emergencies involving high-risk newborns, we found that RCDP simulation during NRP training and better preparation for neonatal resuscitation among nursing students improved outcomes for newborns.

Video-Assisted Versus Traditional Problem-Based Learning: A Quasi-Experimental Study Among Pediatric Nursing Students.

BACKGROUND: The text-assisted problem-based, methods traditionally used to teach nursing students cannot adequately simulate holistic clinical situations and patient symptoms. Although video-assisted, problem-based learning methods combined with text have shown positive results in terms of improving comprehension and cognitive abilities, some studies have shown these methods to be inferior to text-assisted methods in terms of promoting deep critical thinking in medical students. PURPOSE: This study was designed to assess the benefits in nursing education of video-assisted, problem-based learning using online multimedia technologies compared with text-assisted, problem-based learning using traditional face-to-face classes. METHODS: A quasi-experimental, nonequivalent control group, preintervention-and-postintervention design was used. The experimental group ( n = 31) received video-assisted, problem-based learning materials with multimedia technologies (video scenarios, Google Docs worksheets, Google slides, Zoom cloud meetings, and e-learning management system) and weekly online lectures (100 minutes) for 4 weeks. The control group ( n = 35) received text-assisted, problem-based learning materials with traditional face-to-face classes and weekly lectures (100 minutes) for 4 weeks. The study data were analyzed using chi-square, Fisher's exact, and independent t tests as well as analysis of variance. RESULTS: At posttest, learning motivation ( t = 3.25, p = .002), academic self-efficacy ( t = 2.41, p = .019), and self-directed learning ( t = 3.08, p = .003) were significantly higher in the experimental group than in the control group. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Video-assisted, problem-based learning using multimedia technologies was shown to be effective in increasing learning motivation, academic self-efficacy, and self-directed learning in nursing students. These findings have implications for the development and planning of contactless classes in response to the coronavirus pandemic. Notably, no intergroup differences were found in terms of problem-solving skills. Future studies should include in-depth reviews and assessments of the difficulties faced in producing problem scenarios as well as the methods of instruction.

Simulation Training Needs of Nurses for Nursing High-Risk Premature Infants: A Cross-Sectional Study.

Opportunities fomr clinical training in the newborn nursery and neonatal intensive care units (NICU) are becoming insufficient and limited to observation-oriented training. Premature infants admitted to the NICU require specialized and highly sophisticated care. Therefore, this descriptive cross-sectional study aimed to understand nurses' educational needs for establishing a high-risk premature infant nursing simulation training program. It used a descriptive cross-sectional design. We conducted a survey involving 99 newborn nursery and NICU nurses; data were analyzed using descriptive statistics, a paired t-test, an Importance-Performance Analysis (IPA), a Borich needs analysis, and the locus for focus to confirm educational priorities. The scores indicating the importance of nursing high-risk premature infants were higher than those of performance. Results indicated that the highest educational need was in the "treatment and procedure" domain. After deriving the priority of educational needs using the Borich needs analysis and the locus for focus, "maintenance of various tubes" showed the highest priority. By identifying the training priorities for high-risk premature infants nursing using various analytical frameworks, an extended reality simulation program met nurses' high-risk premature infant nursing educational needs. Training for high-risk premature infants treatment and procedures-maintaining various tubes-is highly demanded by nurses and should be prioritized.

The effects of neonatal resuscitation gamification program using immersive virtual reality: A quasi-experimental study.

BACKGROUND: Clinical practice in neonatal intensive care units for nursing college students has been restricted due to the COVID-19 pandemic outbreak; thus, the gamification program has emerged as an alternative learning method. Consequently, there is a need to examine the effectiveness of such alternative learning methods to enhance the response to high-risk newborn emergencies. OBJECTIVES: To examine the effects (neonatal resuscitation nursing knowledge, problem-solving and clinical reasoning ability, self-confidence in practical performance, degree of anxiety, and learning motivation) of a neonatal resuscitation gamification program using immersive virtual reality based on Keller's ARCS model. DESIGN: A non-randomized controlled simulation study with a pretest-posttest design. SETTING: Lab and lecture rooms of two universities in South Korea, from June to November 2021. PARTICIPANTS: Prelicensure nursing students. METHODS: The virtual reality group (n = 29) underwent a neonatal resuscitation gamification program using virtual reality based on Keller's ARCS model. The simulation group (n = 28) received high-fidelity neonatal resuscitation simulations and online neonatal resuscitation program lectures. The control group (n = 26) only received online neonatal resuscitation program lectures. Changes in scores among these groups were compared using analysis of variance and analysis of covariance with SPSS for Windows version 27.0. RESULTS: Post intervention, neonatal resuscitation knowledge [F(2) = 3.83, p = .004] and learning motivation [F(2) = 1.79, p = .025] were significantly higher in the virtual reality and simulation groups than in the control group, whereas problem-solving ability [F(2) = 2.07, p = .038] and self-confidence [F(2) = 6.53, p < .001] were significantly higher in the virtual reality group than in the simulation and control groups. Anxiety [F(2) = 16.14, p < .001] was significantly lower in the simulation group than in the virtual reality and control groups. CONCLUSIONS: The neonatal resuscitation gamification program using immersive virtual reality was found to be effective in increasing neonatal resuscitation knowledge, problem-solving ability, self-confidence, and learning motivation of the nursing students who participated in the trial application process.

Impact of the COVID-19 Pandemic on Neonatal Nursing Practicum and Extended Reality Simulation Training Needs: A Descriptive and Cross-Sectional Study.

This study investigated the neonatal intensive care unit (NICU) clinical practicum status during the COVID-19 pandemic and the need for extended reality (XR)-based training for neonatal care. A structured questionnaire was distributed to 132 prelicensing nursing students. Data were analyzed using importance-performance analysis and Borich needs analysis. Students wanted to use XR to learn about treating high-risk preterm infants. COVID-19 limited clinical training in NICUs, and most students preferred training in XR programs to improve their nursing competency for neonates. There is a large demand for nursing skills concerning high-risk newborns and hands-off training.

Efficacy Testing of a Multi-Access Metaverse-Based Early Onset Schizophrenia Nursing Simulation Program: A Quasi-Experimental Study.

This study investigated the effects of a multi-access, metaverse-based early onset schizophrenia nursing simulation program based on Raskin and Rogers' person-centered therapy. The program's effectiveness was tested using a nonequivalent control group pre-test/post-test design. A quasi-experimental simulation study with both pre- and post-test designs was adopted. The experimental group (n = 29) used the simulation program, whereas the control group (n = 29) received only an online lecture on schizophrenia nursing. Changes in scores among experimental and control groups were compared using independent t-tests and analyses of covariance with PASW SPSS-WIN 27.0. Post-intervention, the knowledge regarding patients with early onset schizophrenia, critical thinking ability, and the ability to facilitate communication increased significantly in the experimental group compared with the control group. The nursing simulation program for children with early onset schizophrenia using a metaverse improved nursing students' knowledge, critical thinking ability, and ability to facilitate communication. This training method should be adapted without spatiotemporal constraints by partially supplementing clinical and simulation-based practice. In clinical nursing training, metaverse technical limitations should be identified, and training topics should be selected. Employing EduTech in a metaverse environment can provide clinical education to nurses in psychiatric wards and improve therapeutic communication with their psychiatric patients.

Effectiveness of neonatal emergency nursing education through simulation training: Flipped learning based on Tanner's Clinical Judgement Model.

AIM: To examine the effects of neonatal simulation-based practice by applying flipped learning based on Tanner's clinical judgement model to pre-simulation briefing for nursing students. DESIGN: A quasi-experimental non-equivalent control group pre- and postintervention design. METHODS: Using Tanner's clinical judgment model, flipped learning was developed and applied to the pre-simulation briefing curriculum prior to the neonatal nursing simulation exercise. Flipped learning was compared with a general pre-simulation briefing with 65 South Korean students. From September 7, 2019, to October 25, 2019. RESULTS: The experimental group's critical thinking, self-confidence and clinical judgement ability increased, but knowledge, satisfaction and anxiety did not differ from that of the control group. Pre-simulation briefing design focuses on improving students' environmental comfort and reducing anxiety rather than developing complex reasoning skills and clinical judgement abilities. Applying flipped learning based on Tanner's clinical judgement model to pre-simulation briefing increased critical thinking, self-confidence and clinical judgement ability.

Effects of Self-efficacy and Self-control on Internet Addiction in Middle School Students: A Social Cognitive Theory-Driven Focus on the Mediating Influence of Social Support.

PURPOSE: The aim of this study was to investigate internet addiction among middle school students and to examine the mediating effects of social support in the relationships of self-efficacy and self-control with internet addiction. METHODS: The participants in the study were 119 middle school students in J city. The measurements included a self-efficacy scale, a self-control scale, a social support scale, and the Internet Addiction Scale for Youth. Data were analyzed using the independent t-test or Mann-Whitney U test, one-way analysis of variance, the Scheffé test, Pearson correlation coefficients, and multiple-regression using SPSS version 22.0. Mediation effects were analyzed by the Sobel test and Baron and Kenny's hierarchical analysis technique. RESULTS: Significant correlations were found among self-efficacy, self-control, and internet addiction. Social support had partial mediating effects in the relationship between self-efficacy and internet addiction, as well as in the relationship between self-control and internet addition. CONCLUSION: In order to prevent internet addiction, the promotion of interactions among peers, which is a component of social support, is particularly important. It is also necessary to promote face-to-face activities that can strengthen relationships. The findings suggest that intensifying social support may help reduce the level of internet addiction in middle school students.

[Effects of Team-based Problem-based Learning Combined with Smart Education: A Focus on High-risk Newborn Care]. / 스마트 교육을 활용한 팀 기반 ë¬¸ì œ 중심 학습의 효과: ê³ ìœ„í—˜ ì‹ ìƒì•„ 간호를 중심으로.

PURPOSE: This study was conducted to examine the effects of team-based problem-based learning combined with smart education among nursing students. METHODS: A quasi-experimental non-equivalent control group, pre-posttest design was used. The experimental group (n=36) received problem-based learning combined with smart education and lectures 7 times over the course of 7 weeks (100 minutes weekly). Control group (n=34) only received instructor-centered lectures 7 times over the course of 7 weeks (100 minutes weekly). Data were analyzed using the x 2 test, the Fisher exact test, and the independent t-test with SPSS for Windows version 21.0. RESULTS: After the intervention, the experimental group reported increased learning motivation (t=2.70, p=.009), problem-solving ability (t=2.25, p=.028), academic self-efficacy (t=4.76, p<.001), self-learning ability (t=2.78, p<.001), and leadership (t=2.78, p=.007) relative to the control group. CONCLUSION: Team-based problem-based learning combined with smart education and lectures was found to be an effective approach for increasing the learning motivation, problem-solving ability, academic self-efficacy, self-learning ability, and leadership of nursing students.

Effects of a prevention program for internet addiction among middle school students in South Korea.

OBJECTIVES: This study explored the effects of a self-regulatory efficacy improvement program on self-control, self-efficacy, internet addiction, and time spent on the internet among middle school students in South Korea. The program was led by school nurses, and it is integrated self-efficacy and self-regulation promotion strategies based on Bandura's social cognitive theory. DESIGN AND SAMPLE: A quasi-experimental, nonequivalent, control group, pre-posttest design was used. The participants were 79 middle school students. MEASURES: Measurements included the Self-Control Scale, Self-Efficacy Scale, Internet Addiction Proneness Scale, and an assessment of internet addiction. RESULTS: Self-control and self-efficacy significantly increased and internet addiction and time spent on the internet significantly decreased in the intervention group compared with the control group. CONCLUSION: A program led by school nurses that integrated and applied self-efficacy and self-regulation intervention strategies proved effective for prevention of students' internet addiction.