Strike 3 Out! Investigating Pre-Game Moods, Performance, and Mental Health of Softball Umpires.

Mood research in sports typically focuses on athletes, with sports officials being largely overlooked. In the current study, mood profiling was used to determine if softball umpires reported an identifiable and consistent mood profile and if mood was predictive of umpiring performance and/or reflective of positive mental health. Eleven male and five female participants aged 25-68 years (M = 48.5 ± 15.5 years) each completed the Brunel Mood Scale on multiple occasions prior to officiating games at the 2020 U18 National Softball Championships. A total of 185 mood profiles were analysed. Performance was assessed using Softball Australia's official umpire assessment tool. Overall, participants reported an iceberg mood profile, which tends to be associated with positive mental health and good performance. Umpiring performances (pass/fail) were correctly classified in 75.0% of cases from tension, depression, and confusion scores (p = 0.003). Participant sex explained 25.7% of the variance in mood scores (p < 0.001); age, 25.8% of the variance (p < 0.001); position on the diamond, 10.5% of the variance (p = 0.003); and accreditation level, 14.3% of the variance (p < 0.001). Australian softball umpires typically reported mood profiles associated with positive mental health, and none reported profiles associated with risk of mental ill-health.

A Greek Translation of the Brunel Mood Scale: Initial Validation among Exercise Participants and Inactive Adults.

The aim of the present study was to provide initial validity evidence of a Greek translation of the 24-item Brunel Mood Scale, referred to as the BRUMS-Greek, a measure of anger, confusion, depression, fatigue, tension, and vigour. Data were collected from 1417 Greek adult exercise participants and 369 physically inactive adults, totaling 1786 adults (male = 578, female = 1208) aged 18-64 years (M = 34.73 ± 11.81 years). Given the large univariate and multivariate non-normality, a confirmatory factor analyses treating responses as ordered categorical variables was conducted which supported the hypothesised six-correlated factor measurement model. The internal consistency reliability of the BRUMS-Greek subscales was supported via Cronbach alpha coefficients. The construct validity of the scales was supported (a) via correlations in the hypothesised direction with trait positive and negative affect, (b) with more positive and less negative moods reported immediately after participation in a single exercise class compared to pre-exercise mood, and (c) with exercise participants reporting more positive and less negative mood states compared to physically inactive adults. Women reported higher tension and lower vigour scores than men. Tension scores were higher and confusion scores lower among younger participants (≤35 years) than older participants (≥36 years). Participants with obesity reported higher negative mood scores than those who were underweight or normal weight. In sum, the BRUMS-Greek demonstrated acceptable psychometric characteristics, and is proposed to be a suitable measure for use with exercise participants, physically inactive adults, and other Greek populations to explore research questions related to mood.

Psychometric Characteristics of the Brazil Mood Scale among Youth and Elite Athletes Using Two Response Time Frames.

Regular assessment of the mood construct as an indicator of psychological wellbeing is used in Brazil to screen athletes for risk of mental health issues. The present study tested the psychometric characteristics of the Brazil Mood Scale (BRAMS) using both "right now" and "past week" response time frames and investigated between-group differences in mood based on athletes' sex, age, and social vulnerability. Participants were 898 athletes (511 male, 387 female, age range: 12-44 years) from eight sports. The factorial validity of the BRAMS was supported using both response time frames independently and in a multi-sample analysis. Subscale reliability was supported for both time frames. Fatigue, depression, and tension scores were higher using the "past week" time frame than the "right now" time frame. Males reported higher vigor scores than females, and younger participants (<18 years) reported lower scores for anger and depression than older participants (18+ years). No significant differences in mood (p > 0.05) were found between participants identified as socially vulnerable and those who were not socially vulnerable. Findings supported the psychometric integrity of the BRAMS and its use as a screening measure for psychological wellbeing among youth and elite athletes in Brazil.

Pre-Event Self-Efficacy and Sports Performance: A Systematic Review with Meta-Analysis.

The relationship between self-efficacy and performance exclusively within the sports environment is yet to be quantified. Hence, we meta-analysed this relationship by following the PRISMA guidelines. Two previous meta-analyses, five relevant databases, and Google Scholar were searched. Forty-four articles published between 1983 and 2021 met the inclusion criteria, with 55 independent samples. Comprehensive meta-analysis software version 4 was used for all meta-analytic calculations using a random-effects model to calculate the mean effect size, and a mixed-effects model was used for moderation analyses. The mean pre-event self-efficacy and performance effect size was r = 0.31 (95% CI 0.22, 0.40). For moderation analyses, notable mean differences (p values ≥ 0.08) resulted for concordance [concordant (r = 0.37), nonconcordant (r = 0.22)], sports skill [closed (r = 0.37), open (r = 0.23)], and athlete level [elite (r = 0.40), sub-elite (r = 0.28)]. The true effect prediction interval ranged from negative (i.e., self-efficacy impairing performance) to positive (self-efficacy improving performance) for all moderator variables except self-referenced vs. other-referenced performance. In conclusion, the relationship between pre-event self-efficacy and performance is positive and moderate in magnitude, although with prediction intervals ranging from debilitating to facilitating performance. Researchers and practitioners should note that high athlete-rated self-efficacy might not always improve impending competitive sports performance.

Testing the Psychometric Properties of an Arabic Version of the Brunel Mood Scale among Physical Education Students.

In our study, we translated and tested the psychometric properties of an Arabic version of the Brunel Mood Scale (BRUMS), referred to as the Arabic Mood Scale (ARAMS), among physical education university students. A total of 681 participants completed the ARAMS in exploratory and confirmatory phases. Exploratory analyses were conducted on data from 253 students between the ages of 19 and 25 years (M = 21.14 ± 1.65 years) of whom 132 were women (52.2%) and 121 were men (47.8%). Confirmatory analyses were conducted on data from 428 students between the ages of 19 and 25 years (M = 20.93 ± 1.55 years) of whom 203 were women (52.6%) and 225 were men (47.4%). The measurement model of the ARAMS was initially evaluated using exploratory factor analysis (EFA) and was subsequently tested via confirmatory factor analysis (CFA). EFA identified a 24-item, 6-factor structure that aligned with the original BRUMS measurement model, and CFA demonstrated congruence between the two models. Internal consistency of the six subscales exceeded adequacy levels with good Cronbach's alpha and McDonald's Omega values respectively for anger (0.811; 0.812), confusion (0.830; 0.830), depression (0.858; 0.859), fatigue (0.823; 0.825), and tension (0.824; 0.825), and an acceptable value for vigor (0.749; 0.748). Findings support the factorial validity and internal consistency of the ARAMS, which appears to be a suitable measure for use in Arabic physical education contexts. Further validation studies are required before the ARAMS is used in other Arabic-language contexts.

Cross-Cultural Validation of the Malaysian Mood Scale and Tests of Between-Group Mood Differences.

Mood measures have been shown to have utility for monitoring risks to mental health and to predict performance among athletes. To facilitate use in a Malaysian context, we tested a Malay-language version of the 24-item Brunel Mood Scale (BRUMS), referred to as the Malaysian Mood Scale (MASMS). Following a thorough translation-back-translation process, the 24-item MASMS was administered to 4923 Malay-speaking respondents (2706 males, 2217 females; 2559 athletes, 2364 non-athletes), ranging in age from 17 to 75 years (M = 28.2 years, SD = 9.4 years). Confirmatory factor analysis supported the six-factor MASMS measurement model (CFI = 0.950, TLI = 0.940, RMSEA = 0.056 [CI 0.055, 0.058]). Convergent and divergent validity of the MASMS were supported via relationships with depression, anxiety, and stress measures. Significant differences in mood scores were found between athletes and non-athletes, males and females, and younger and older participants. Tables of normative data and profile sheets for specific groups were generated. We propose that the MASMS is a valid measure that can be used to monitor mental health status among athletes and non-athletes and that facilitates future mood-related research in Malaysia.

Mood profiles of amateur triathletes: Implications for mental health and performance.

Moods have been shown to be predictive of athletic performance and a reflection of mental health status. The aims of our study were (a) to compare pre-race mood scores of triathletes with population norms; (b) to compare pre-race mood scores of triathletes grouped by gender and age bands; (c) to explore whether six distinct mood profile clusters reported in the literature were evident among triathletes and their respective prevalence; (d) to determine if pre-race mood scores predicted triathlon performance; and (e) to interpret our findings in terms of the risk of mental health issues for triathletes. Participants were 592 age-group triathletes (also referred to as recreational or amateur triathletes) who completed the Brunel Mood Scale pre-race and recorded their time goal for the race. Mean mood scores deviated significantly from population norms, with Tension and Vigor scores at the 55th and 54th percentile, respectively, and Depression, Anger, Fatigue, and Confusion scores between the 42nd and 46th percentile. Females reported higher Tension scores than males (p < 0.001), and those in the 18-25 years and 26-35 years age bands reported higher Tension scores than those in the 46-55 years age band (p < 0.008). Using k-means cluster analysis, six distinct mood profiles were identified, the distribution of which approximated the general population, except for a low prevalence of very negative profiles. Mean scores for Depression and Anger were exceptionally low and only 1.5% of triathletes, compared to the normal prevalence of ~5%, reported an "inverse Everest" profile, which is associated with elevated risk of psychopathology. Mood scores did not predict triathlon performance, assessed by finish time as a percentage of time goal. Results showed an association between triathlon participation and psychological well-being. Findings will inform future investigations of mood responses among triathletes and provide a relevant point of reference for applied practitioners who work with triathletes.

Risks to mental health of higher degree by research (HDR) students during a global pandemic.

The COVID-19 pandemic has affected university students globally. Our study investigated mental health indicators among higher degree by research (HDR) students at a regional university in Queensland, Australia. A total of 231 HDR students (female = 137, male = 94) completed the Brunel Mood Scale to assess the constructs of Tension, Depression, Anger, Vigor, Fatigue, and Confusion. A subset of 11 students participated in three focus groups to explore their experiences. Results showed that reported mood among HDR students was generally more negative than population norms, although more positive than moods reported previously during the pandemic. A total of 52 participants (22.5%) reported mood profiles that indicated elevated risk of mental ill-health. Mood profiles varied significantly by gender, age, study mode (full-time/part-time), location (on-campus/online), and citizenship (domestic/international). Quantitative data were supported by focus group findings, which identified mental health and wellbeing as key themes of concern to HDR students. Our findings indicate that support mechanisms to safeguard the mental health and wellbeing of HDR students should be a priority for universities.

Revisiting the Self-Confidence and Sport Performance Relationship: A Systematic Review with Meta-Analysis.

Self-confidence is a common research topic, and most applied textbooks include interventions designed to enhance athlete confidence. Our purpose was to quantify the self-confidence and sport performance literature using meta-analytic techniques. We also examined potential risk of bias indicators, and the moderation effects of study quality, sport characteristics, timing of confidence measurement, and individual differences among participants. Following a review of two past meta-analyses, a systematic search of APA PsycArticles, ERIC, Psychology and Behavioral Sciences Collection, PsychINFO, and SPORTDiscus within the EBSCOhost platform, and some hand searching, 41 articles published between 1986 and 2020 met the inclusion criteria. Collectively, the included studies investigated 3711 athletes from 15 countries across 24 sports. The overall random effects estimate of the relationship (expressed as r) between self-confidence and performance was 0.25 (95% CI 0.19, 0.30), with little evidence of publication bias. The summed total risk of the individual study bias score did not moderate the confidence-performance relationship, whereas significant moderator effects emerged for individual sports (0.29) compared with team sports (0.14), objective (0.29) compared to subjective (0.14) performance measures, and 100% male (0.35) compared to 100% female (0.07) samples. In conclusion, the confidence-performance relationship is small in magnitude, nearly free of bias, and moderated by sport type, performance objectivity, and athlete sex.

Validation of a Lithuanian-Language Version of the Brunel Mood Scale: The BRUMS-LTU.

Mood can be considered as a diffuse and global emotional state, with both valence and arousal characteristics, that is not directed towards a specific object. Investigation of moods in specific language and cultural contexts relies on the availability of appropriately validated measures. The current study involved the translation and validation of the Brunel Mood Scale (BRUMS) from English into Lithuanian. The 24-item, 6-factor scale, referred to as the BRUMS-LTU, was administered to 746 participants who were fluent in Lithuanian (nmen = 199 (26.7%), nwomen = 547 (73.3%); age range = 17-78 years, M = 41.8 years, SD = 11.4 years). Confirmatory factor analysis showed an adequate fit of the hypothesized measurement model to the data (CFI = 0.954, TLI = 0 .944, RMSEA = 0 .060 [CI 0.056, 0.064], SRMR = 0.070) and multi-sample analysis supported configural, metric, scalar, and residual invariance across genders. Concurrent measures (i.e., Perceived Stress Scale, Big Five Personality Test) correlated with subscale scores in line with theoretical predictions, supporting both convergent and divergent validity. Internal consistency coefficients of the six subscales were satisfactory. Mood scores varied significantly by gender, with men generally reporting more positive moods than women. Findings support the adequacy of the psychometric properties of the BRUMS-LTU. Thus, the scale can be recommended for use in further psychological studies of mood in Lithuania and may also be useful for applied practitioners.

Sport psychology and performance meta-analyses: A systematic review of the literature.

Sport psychology as an academic pursuit is nearly two centuries old. An enduring goal since inception has been to understand how psychological techniques can improve athletic performance. Although much evidence exists in the form of meta-analytic reviews related to sport psychology and performance, a systematic review of these meta-analyses is absent from the literature. We aimed to synthesize the extant literature to gain insights into the overall impact of sport psychology on athletic performance. Guided by the PRISMA statement for systematic reviews, we reviewed relevant articles identified via the EBSCOhost interface. Thirty meta-analyses published between 1983 and 2021 met the inclusion criteria, covering 16 distinct sport psychology constructs. Overall, sport psychology interventions/variables hypothesized to enhance performance (e.g., cohesion, confidence, mindfulness) were shown to have a moderate beneficial effect (d = 0.51), whereas variables hypothesized to be detrimental to performance (e.g., cognitive anxiety, depression, ego climate) had a small negative effect (d = -0.21). The quality rating of meta-analyses did not significantly moderate the magnitude of observed effects, nor did the research design (i.e., intervention vs. correlation) of the primary studies included in the meta-analyses. Our review strengthens the evidence base for sport psychology techniques and may be of great practical value to practitioners. We provide recommendations for future research in the area.

Physical activity and mental well-being under COVID-19 lockdown: a cross-sectional multination study.

BACKGROUND: COVID-19 lockdowns have reduced opportunities for physical activity (PA) and encouraged more sedentary lifestyles. A concomitant of sedentariness is compromised mental health. We investigated the effects of COVID-19 lockdown on PA, sedentary behavior, and mental health across four Western nations (USA, UK, France, and Australia). METHODS: An online survey was administered in the second quarter of 2020 (N = 2541). We measured planned and unplanned dimensions of PA using the Brunel Lifestyle Physical Activity Questionnaire and mental health using the 12-item General Health Questionnaire. Steps per day were recorded only from participants who used an electronic device for this purpose, and sedentary behavior was reported in hours per day (sitting and screen time). RESULTS: In the USA and Australia samples, there was a significant decline in planned PA from pre- to during lockdown. Among young adults, Australians exhibited the lowest planned PA scores, while in middle-aged groups, the UK recorded the highest. Young adults exhibited the largest reduction in unplanned PA. Across nations, there was a reduction of ~ 2000 steps per day. Large increases in sedentary behavior emerged during lockdown, which were most acute in young adults. Lockdown was associated with a decline in mental health that was more pronounced in women. CONCLUSIONS: The findings illustrate the deleterious effects of lockdown on PA, sedentary behavior, and mental health across four Western nations. Australian young and lower middle-aged adults appeared to fare particularly badly in terms of planned PA. The reduction in steps per day is equivalent to the non-expenditure of ~ 100 kcal. Declines in mental health show how harmful lockdowns can be for women in particular.

Influence of sex, age, and education on mood profile clusters.

In the area of mood profiling, six distinct profiles are reported in the literature, termed the iceberg, inverse iceberg, inverse Everest, shark fin, surface, and submerged profiles. We investigated if the prevalence of the six mood profiles varied by sex, age, and education among a large heterogeneous sample. The Brunel Mood Scale (BRUMS) was completed via the In The Mood website by 15,692 participants. A seeded k-means cluster analysis was used to confirm the six profiles, and discriminant function analysis was used to validate cluster classifications. Significant variations in the prevalence of mood profiles by sex, age, and education status were confirmed. For example, females more frequently reported negative mood profiles than males, and older and more highly educated participants had a higher prevalence of the iceberg profile than their younger and lesser educated counterparts. Findings suggest that refinement of the existing tables of normative data for the BRUMS should be considered.

Mood Responses Associated With COVID-19 Restrictions.

The COVID-19 pandemic resulted in more than half the world's population being placed in lockdown to stem the spread of the virus. The severe restrictions imposed in many nations had the potential to significantly influence the physical and psychological well-being of those affected. The aim of the current study was to investigate mood responses during the period of restrictions from March to June, 2020. Mood responses of 1,062 participants (386 male, 676 female) were collected using the Brunel Mood Scale, hosted on the In The Mood website www.moodprofiling.com. The mean pattern of mood responses reflected an inverse iceberg profile, characterized by significantly elevated scores for tension, depression, anger, fatigue, and confusion, and below average scores for vigor; a profile associated with increased risk of mental health issues. Females reported more negative mood scores than males. Participants in the ≤25 age group reported the most negative profiles whereas those in the ≥56 age group reported the least negative profiles. Mood differences related to education status were also evident. Finally, mood scores fluctuated over time, with profiles being most negative during April and June. Overall, results confirmed significant mood disturbance during the period of COVID-19 restrictions, representing increased risk of psychopathology.

Mood Profiling in Singapore: Cross-Cultural Validation and Potential Applications of Mood Profile Clusters.

Mood profiling is a popular method of quantifying and classifying feeling states. Previous research has identified several novel mood profiles in predominantly Western English-speaking populations (Parsons-Smith et al., 2017), and replicated the findings in the domain of sport and exercise (Quartiroli et al., 2018; Terry and Parsons-Smith, 2019). The aim of the current study was to investigate if six hypothesized clusters of mood responses were evident in a population of English-speaking sport and non-sport participants in Singapore. A seeded k-means cluster analysis was applied to the mood responses of 1,444 participants (991 male, 440 female, 13 unspecified; aged 18-65 years) who completed the Brunel Mood Scale (BRUMS; Terry et al., 1999, 2003a). The six hypothesized mood profiles (i.e., iceberg, inverse Everest, inverse iceberg, shark fin, submerged, and surface profiles) were identified clearly. Chi-squared analyses showed unequal distribution of the profiles by gender, age group, ethnicity, education level, and sport participation. Findings support the cross-cultural generalizability of the six mood profiles in English-speaking sport and non-sport samples in Singapore and contribute to investigation into the antecedents, correlates, and consequences of each mood profile.

Effects of music in exercise and sport: A meta-analytic review.

Regular physical activity has multifarious benefits for physical and mental health, and music has been found to exert positive effects on physical activity. Summative literature reviews and conceptual models have hypothesized potential benefits and salient mechanisms associated with music listening in exercise and sport contexts, although no large-scale objective summary of the literature has been conducted. A multilevel meta-analysis of 139 studies was used to quantify the effects of music listening in exercise and sport domains. In total, 598 effect sizes from four categories of potential benefits (i.e., psychological responses, physiological responses, psychophysical responses, and performance outcomes) were calculated based on 3,599 participants. Music was associated with significant beneficial effects on affective valence (g = 0.48, CI [0.39, 0.56]), physical performance (g = 0.31, CI [0.25, 0.36]), perceived exertion (g = 0.22, CI [0.14, 0.30]), and oxygen consumption (g = 0.15, CI [0.02, 0.27]). No significant benefit of music was found for heart rate (g = 0.07, CI [-0.03, 0.16]). Performance effects were moderated by study domain (exercise > sport) and music tempo (fast > slow-to-medium). Overall, results supported the use of music listening across a range of physical activities to promote more positive affective valence, enhance physical performance (i.e., ergogenic effect), reduce perceived exertion, and improve physiological efficiency. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Cross-Cultural Validation of Mood Profile Clusters in a Sport and Exercise Context.

Mood profiling has a long history in the field of sport and exercise. Several novel mood profile clusters were identified and described in the literature recently (Parsons-Smith et al., 2017). In the present study, we investigated whether the same clusters were evident in an Italian-language, sport and exercise context. The Italian Mood Scale (ITAMS; Quartiroli et al., 2017) was administered to 950 Italian-speaking sport participants (659 females, 284 males, 7 unspecified; age range = 16-63 year, M = 25.03, SD = 7.62) and seeded k-means clustering methodology applied to the responses. Six distinct mood profiles were identified, termed the iceberg, inverse iceberg, inverse Everest, shark fin, surface, and submerged profiles, which closely resembled those reported among English-speaking participants (Parsons-Smith et al., 2017). Significant differences were found in the distribution of specific mood profiles across gender and age groups. Findings supported the cross-cultural generalizability of the six mood profiles and offer new research avenues into their antecedents, correlates and behavioral consequences in Italian-language contexts.

The Heat Is On: Effects of Synchronous Music on Psychophysiological Parameters and Running Performance in Hot and Humid Conditions.

Running in high heat and humidity increases psychophysiological strain, which typically impairs running performance. Listening to synchronous music has been shown to provide psychophysiological benefits, which may enhance running performance. The present randomized, crossover study examined effects of listening to synchronous music on psychophysiological parameters and running performance in hot and humid conditions. Twelve male runners (21.7 ± 2.2 y; 166.17 ± 7.18 cm; 60.32 ± 9.52 kg; 59.29 ± 5.95 ml kg-1 min-1) completed two running trials in simulated conditions (31°C and 70% humidity) with and without synchronous music. Participants ran on a treadmill inside a climatic chamber for 60 min at 60% V˙ O2max and continued to run to exhaustion at 80% V˙ O2max. Time-to-exhaustion under the synchronous music condition was 66.59% longer (mean = 376.5 s vs. 226.0 s, p = 0.02, d = 0.63) compared to the no music condition. Ratings of perceived exertion were significantly lower for the synchronous music condition at each time point (15, 30, 45, and 60 min) of the steady state portion of the running trials. Small differences in heart rate were detected between conditions. No significant between-condition differences were found in urine specific gravity, percentage of body weight loss, thermal comfort, and blood lactate. Findings suggest that listening to synchronous music is beneficial to running performance and perceived exertion in hot and humid conditions.

Effects of Relaxing and Arousing Music during Imagery Training on Dart-Throwing Performance, Physiological Arousal Indices, and Competitive State Anxiety.

Music that is carefully selected to match the requirements of activities and the characteristics of individuals has been shown to produce significant impacts on performance enhancement (Priest et al., 2004). There is also evidence that music can enhance imagery (Grocke and Wigram, 2007), although few studies have investigated the effects of music on imagery in the context of sport skills. In the present study, the effects of relaxing and arousing music during imagery on dart-throwing performance, physiological arousal indices, and competitive state anxiety, were investigated among 63 novice dart throwers. Participants had moderate-to-high imagery ability and were randomly assigned to unfamiliar relaxing music (URM), unfamiliar arousing music (UAM), or no music (NM) groups. Performance was assessed by 40 dart throws at a concentric circles dartboard before and after 12 imagery sessions over 4 weeks. Measures of galvanic skin response (GSR), peripheral temperature (PT), and heart rate (HR) were taken during imagery sessions 1 and 12, and the Competitive State Anxiety Inventory-2 Revised (CSAI-2R) was administered prior to the pre- and post-intervention performance task. Dart-throwing gain scores were significantly higher for URM than for UAM and NM, with no significant difference between UAM and NM (URM = 37.24 ± 5.66, UAM = 17.57 ± 5.30, and NM = 13.19 ± 6.14, F2,62 = 5.03, p = 0.01, η2 = 0.14). GSR, PT, and HR reflected lower arousal for URM than for UAM or NM. Significant decreases in somatic anxiety were evident for URM and UAM but not NM. Significant decreases in cognitive anxiety were evident for URM and NM but not UAM. Significant increases in self-confidence were evident for URM but not UAM or NM. Performance improved in all three conditions but URM was associated with the largest performance gain, the lowest physiological indices of arousal, and the most positive CSAI-2R profiles. Listening to relaxing music during imagery may have benefits for performance in other fine motor skills.

Face-to-face instruction combined with online resources improves retention of clinical skills among undergraduate nursing students.

BACKGROUND: There is growing evidence that online resources used to develop clinical skills among students in the healthcare professions can produce equivalent learning outcomes to traditional face-to-face training methods. Whether clinical competence is retained equally well for online and face-to-face training methods is not yet established. OBJECTIVES: The objective of the study was to compare retention of competence in using an IV infusion pump among nursing students trained in its use using three different protocols. DESIGN: A quasi-experimental design was used. SETTING: The study was conducted in the School of Nursing and Midwifery at a regional university in Queensland, Australia. PARTICIPANTS: Participants were 102 first year nursing students (female=89, male=13) enrolled in a medications course, ranging in age from 18 to 44years. METHODS: Three groups of participants were trained in the use of an IV infusion pump and competence was assessed following a 26-week period of no access to the pump. Group 1 participants (ONL; n=34) were trained online using an Intravenous Pump Emulator (IVPE); Group 2 participants (ONC; n=38) were trained on campus using an actual IV pump in a traditional face-to-face setting; Group 3 participants (ONL+ONC; n=30) were trained both on campus using the actual IV pump and online using the IVPE. RESULTS: As hypothesised, no significant differences in learning outcomes, measured by assessment scores out of 80 points, were found between the ONL (M=68.7±5.9) and ONC (M=65.5±11.5; p>0.05) groups. The ONL+ONC group recorded the highest mean assessment score (M=70.0±5.0) and completed the assessment task significantly faster (p<0.001) than the other two groups. CONCLUSIONS: This study suggests that nursing students retained clinical competence in preparing and administrating IV infusions better when face-to-face and online learning were combined.