Clinical Research Directory

"EFFECTS OF PEYTON'S MODEL"

Detailed Description This randomized controlled trial aims to compare the effectiveness of three educational approaches in improving nursing students' knowledge, clinical skill performance, and self-efficacy regarding sterile urine specimen collection from an indwelling urinary catheter. The study will be conducted during the Spring semester of the 2025-2026 academic year in the Nursing Skills Laboratory at Maltepe University. The study population will consist of first-year nursing students enrolled in the Fundamentals of Nursing course. Students aged 18 years or older who voluntarily agree to participate will be eligible. Students who have previously received training or have experience in collecting sterile urine specimens from an indwelling urinary catheter will be excluded from the study. Phase 1: Selection and Training of Peer Educators Peer educators will be selected from volunteer fourth-year nursing students who have previous mentoring experience with first-year students and a grade point average above 3.0. Before the intervention, peer educators will receive standardized training from the principal investigator using Peyton's Four-Step Teaching Approach. The training will focus on sterile urine specimen collection from an indwelling urinary catheter and will be based on a validated procedural checklist with excellent reliability. During the training, peer educators will complete all four stages of Peyton's model, including demonstration, deconstruction, comprehension, and performance with structured feedback to ensure standardized instruction throughout the study. Phase 2: Theoretical Education, Baseline Assessment, and Randomization All eligible first-year nursing students will receive a four-hour theoretical lecture delivered by the course instructor before practical training. The theoretical content will include urinary system anatomy and physiology, urinary elimination and assessment, urinary catheterization, sterile urine specimen collection from an indwelling urinary catheter, and prevention of catheter-associated urinary tract infections. Following the theoretical session, participants will complete baseline assessments consisting of a Demographic Information Form, a Knowledge Test, and the Student Self-Efficacy Scale. Participants will then be randomly assigned in a 1:1:1 ratio to one of three study groups: Peyton Four-Step Teaching delivered by the course instructor. Peyton Four-Step Teaching delivered by trained peer educators. Traditional demonstration-based instruction delivered by the course instructor (control group). Randomization will be performed by an independent researcher who is not involved in participant recruitment, intervention delivery, or outcome assessment. A computer-generated block randomization sequence (block size = 6) created using Randomizer.org will be used to ensure balanced allocation among groups. Allocation concealment will be maintained using sequentially numbered, opaque, sealed envelopes. The researcher responsible for outcome assessment will remain blinded to group allocation throughout the study. Phase 3: Practical Skills Training Following randomization, students will receive practical training according to their assigned group. The two intervention groups will be taught using Peyton's Four-Step Teaching Approach by either the course instructor or trained peer educators. This approach consists of demonstration, deconstruction with step-by-step explanation, comprehension through learner-guided instruction, and independent performance with structured feedback. The control group will receive conventional demonstration-based instruction in which the instructor demonstrates and explains the procedure before students independently perform the skill. All practical sessions will be conducted individually in the nursing skills laboratory using simulation manikins. Student performance during training will follow the same validated procedural checklist to ensure standardization across groups. Phase 4: Post-Intervention Assessment After completing the practical training, participants will complete the Knowledge Test, Student Self-Efficacy Scale, and a Student Satisfaction Questionnaire developed by the researchers. Clinical skill performance will be evaluated by a blinded assessor using the validated procedural checklist employed throughout the intervention. Statistical analyses will be performed by an independent researcher who is not involved in the intervention or assessment process. This study is designed to determine whether Peyton's Four-Step Teaching Approach, delivered either by faculty members or trained peer educators, provides superior educational outcomes compared with conventional demonstration-based instruction. Participation in the study is entirely voluntary. The assessments are conducted solely for research purposes and will not contribute to students' course grades, academic achievement, or formal performance evaluation.

Gagné Instructional Model

Urinary catheterization is one of the essential clinical skills that undergraduate nursing students are expected to acquire during their early professional education. Competent performance of this procedure requires not only theoretical knowledge but also psychomotor competence and confidence. Identifying effective teaching strategies for urinary catheterization is therefore important for improving nursing education and promoting patient safety. Although peer-assisted learning has been widely implemented in nursing education, evidence comparing structured instructional models delivered by peer educators and faculty instructors remains limited. The purpose of this study is to evaluate the effects of peer-led training based on the Gagné Instructional Model on nursing students' urinary catheterization knowledge, skill performance, and self-efficacy. The effectiveness of peer-led Gagné-based training will be compared with faculty-led Gagné-based training and traditional demonstration-based instruction. This study is designed as a single-center, three-arm, parallel-group randomized controlled trial. The study population will consist of first-year undergraduate nursing students enrolled in the Fundamentals of Nursing course at Maltepe University Faculty of Nursing during the 2025-2026 academic year. Eligible students who are 18 years of age or older, have not previously received formal theoretical or practical education on urinary catheterization, have no prior urinary catheterization experience in clinical practice, and provide written informed consent will be invited to participate. Participants who have previously received urinary catheterization training or clinical experience, fail to attend the educational sessions, or do not complete the study assessments will be excluded. Sample size was calculated using G\*Power 3.1 for repeated-measures ANOVA (within-between interaction). Based on an effect size of 0.25, a significance level of 0.05, statistical power of 95%, three study groups, and two measurement time points, the minimum required sample size was calculated as 66 participants. To compensate for potential attrition, 81 participants (27 per group) will be recruited. Participants will be randomly assigned in a 1:1:1 ratio using computer-generated simple randomization to one of three study groups: (1) traditional demonstration-based instruction delivered by a faculty instructor, (2) peer-led training based on the Gagné Instructional Model, and (3) faculty-led training based on the Gagné Instructional Model. The educational content, teaching materials, training duration, simulation laboratory environment, and learning objectives will be identical across all groups. The only difference between groups will be the instructional approach and the individual delivering the training. Before the intervention, peer educators will receive standardized preparation regarding the Gagné Instructional Model to ensure consistency of instruction. Data collection will be conducted using a pretest-posttest design. Before the intervention, participants will complete a knowledge test, a self-efficacy scale, and an affective self-assessment form. Following completion of the educational intervention, the knowledge test and self-efficacy scale will be repeated, and urinary catheterization skill performance will be evaluated using a standardized skills checklist. Because participants and instructors cannot be blinded in educational intervention studies, assessor blinding will be implemented. Outcome assessors responsible for evaluating knowledge, self-efficacy, and urinary catheterization skill performance will remain unaware of participants' group allocation. Group assignments will also remain coded during statistical analyses to minimize assessment bias. The findings of this study are expected to provide evidence regarding the effectiveness of Gagné model-based peer education in undergraduate nursing education and contribute to the development of evidence-based instructional strategies for teaching psychomotor nursing skills.

Mobile Application-Supported Education in Nursing Students

This randomized controlled study evaluates the effectiveness of a mobile application-supported educational intervention on learning outcomes among first-year undergraduate nursing students. The study focuses on fundamental nursing skills related to oral, local, and parenteral medication administration. Students who met the eligibility criteria and agreed to participate were randomly assigned to an intervention group or a control group in a 1:1 ratio. All participants first received the standard theoretical instruction and laboratory-based skills training provided as part of the Fundamentals of Nursing course. Students assigned to the intervention group were then given password-protected access to a mobile application for 14 days. The application included instructional videos and educational content related to oral and local medication administration, subcutaneous and intramuscular injections, blood glucose measurement, blood sampling, and intravenous catheter insertion. The application had separate student and instructor interfaces. During the intervention period, the course instructor monitored students' participation and application completion percentages through the instructor interface. Students in the control group did not have access to the educational modules during this period. At the end of the two-week intervention, both groups completed a knowledge test and the Student Satisfaction and Self-Confidence in Learning Scale. On the same day, students underwent an Objective Structured Clinical Examination (OSCE) in the nursing skills laboratory. The OSCE was conducted by a second researcher who was blinded to group allocation. For students in the control group, only the OSCE assessment module was activated immediately before the examination; the educational modules remained inaccessible until the initial outcome assessments were completed. After completion of the randomized comparison and OSCE assessments, access to the mobile application was provided to all participants. Following an additional two-week access period, students' general attitudes toward mobile learning and e-learning were assessed. This final assessment was intended to describe participants' overall attitudes toward digital learning rather than to estimate a randomized between-group intervention effect. The primary outcomes are nursing knowledge and clinical skills performance. Secondary outcomes include student satisfaction, self-confidence in learning, attitudes toward e-learning, and mobile application usability. The findings are expected to provide evidence regarding the use of mobile learning technologies to support theoretical knowledge and clinical skills development in undergraduate nursing education.

Augmented Reality and 3D Model-Based Ventrogluteal Injection Training in Nursing Students (AR3D-VGI)

The aim of this study was to evaluate the impact of a skills training program-conducted using augmented reality (AR) and 3D model technologies-on first-year nursing students' knowledge, skills, anxiety, and satisfaction, as well as the retention of learning, regarding the correct identification of the injection site and the application of the correct technique for intramuscular (IM) injections in the deltoid (VG) region. The hypotheses of the study are as follows: H1: There is a difference in knowledge scores regarding the administration of intramuscular injections into the ventrogluteal region between the AR group and the control group. H2: There is a difference in skill scores regarding the administration of intramuscular injections into the ventrogluteal region between the AR and control groups. H3: There is a difference in state anxiety scores regarding the administration of intramuscular injections into the ventrogluteal region between the AR and control groups. H4: There is a difference in satisfaction scores regarding training methods for intramuscular injection into the ventrogluteal region between the AR and the control group. H5: There is a difference in knowledge scores regarding intramuscular injection into the ventrogluteal region between the 3D Model group and the control group. H6: There is a difference in skill scores regarding intramuscular injection into the ventrogluteal region between the 3D Model group and the control group. H7: There is a difference in state anxiety scores regarding intramuscular injection into the ventrogluteal region between the 3D Model group and the control group. H8: There is a difference in satisfaction scores regarding training methods for intramuscular injection into the ventrogluteal region between the 3D Model group and the control group. H9: There is a difference in retention scores regarding knowledge of intramuscular injection into the ventrogluteal region between the AR and control groups. H10: There is a difference in retention scores regarding knowledge of intramuscular injection into the ventrogluteal region between the 3D Model and control groups. H11: There is a difference in skill retention scores regarding the application of intramuscular injection into the ventrogluteal region between the AR and the control group. H12: There is a difference in skill retention scores regarding the application of intramuscular injection into the ventrogluteal region between the 3D Model and the control group. After providing theoretical training to the entire group, the researcher will randomly assign participants and have them practice using the AR, a 3D hip model, and a traditional model. After four weeks, the researcher will assess retention.

VR Goggles-Supported Virtual Reality Model in Midwifery Basic Clinical Skills Training

This randomized controlled trial aims to evaluate the effectiveness of a virtual reality (VR)-based training model supported by VR goggles in improving basic clinical skills among midwifery students. Traditional skills training in midwifery education can be limited by time, instructor availability, and opportunities for repeated practice. VR technology offers an immersive, standardized, and repeatable learning environment that may enhance skill development and learner engagement. In this study, midwifery students will be randomly assigned to either the VR training group or the traditional training group. Participants in the VR group will practice selected basic clinical skills using a VR goggle-supported simulation model, while the control group will receive standard skills laboratory training. Both groups will be evaluated through objective structured clinical examinations (OSCEs), self-confidence scales, and skill performance checklists. The study aims to determine whether VR-enhanced training improves clinical skill acquisition, performance accuracy, and learner confidence compared with traditional methods. Findings from this research may help inform modern, technology-supported approaches to midwifery education.

The Effect of Benner's Jigsaw Teaching Technique Based on the Novice to Expert Model and Scenario-Based Peripheral Intravenous Catheterization Instruction on Skill Acquisition of Nursing Students: An Experimental Study.

This randomized controlled experimental study aims to evaluate the effectiveness of a training program based on the Jigsaw teaching technique and scenario-based learning in improving the peripheral intravenous catheterization skill levels of first-year nursing students. Participants will be randomly assigned to either the intervention group, receiving Jigsaw-based collaborative learning combined with clinical scenarios, or the control group receiving traditional skills training. The primary outcome is the improvement in students' clinical skill performance as measured by a standardized skill assessment checklist. The study seeks to determine whether innovative, active learning methods can enhance fundamental nursing skills training

The Effect of Video-Based Virtual Reality Education on Self-Confidence and Motivation in Nursing Students

This study is a randomized controlled, parallel patterned, single-blind experimental study conducted to investigate the effects of video-based virtual reality (VR) training on self-confidence and motivation levels of nursing students regarding peripheral venous catheterization (PVC) skills. The intervention group will receive video-based training via VR headsets, while the control group will be presented with the same content via traditional face-to-face narration and demonstration. Self-confidence and motivation levels before and after the training will be assessed with valid scales. The study is expected to contribute to the development of innovative technology-supported teaching strategies in nursing education.

Enhancing Nursing Skills With SimCapture Technology

The action research aims to enhance clinical nursing skills of nursing students through the implementation of the SimCapture cloud management system. Research has found that traditional teaching methods are insufficient in cultivating students' clinical skills, and students' learning characteristics and technological developments have also placed new demands on teaching. Although the research team previously attempted blended learning and simulation-based teaching, students' technical grades have shown a declining trend. To address this issue, the researchers plan to implement the SimCapture system and, based on observational learning theory, design teaching activities to enhance students' learning motivation and self-efficacy, ultimately improving their clinical skills.

Video vs Model Training for Leopold Maneuver Skills

This randomized controlled study aims to compare the effectiveness of video-based and model-based training methods in improving Leopold maneuver skills among second-year midwifery students. The study will be conducted at the Faculty of Health Sciences, Kahramanmaraş Sütçü Imam University. Eligible students will be randomly assigned into three groups: video-supported training, model-supported training, and control. All participants will first receive a 2-hour theoretical training session. Then, the video group will watch an instructional video, the model group will perform hands-on practice using anatomical models, and the control group will receive no additional intervention. Skill acquisition will be evaluated through practical assessments conducted a few days and two months after training. At the end of the study, compensatory training will be provided to all groups to ensure educational equity. Data collection tools include a psychomotor skills assessment form, a student satisfaction scale, and the Spielberger State Anxiety Inventory. Statistical analyses will be performed using SPSS software.