Clinical Research Directory

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). Six 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'.

Different Reality Simulation Education Methods on Nursing Students

To compare the impact of simulation practices using a high-reality simulator, hybrid simulator and task-trainers on tracheal aspiration levels of nursing students' knowledge, skills, satisfaction, and self-confidence.

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.

Preventing Home Accidents With Simulation Based Training

Objective: This study will evaluate the effects of simulation-based nursing interventions on mothers of 2-4 year old children's ability to take safety precautions against home accidents, maintain parental supervision, and improve first aid knowledge and skills in home accidents. Materials and Methods: This randomized, controlled experimental study will be conducted in accordance with the CONSORT 2025 guideline. A total of 48 mothers 24 in the intervention group and 24 in the control group residing in the Karatay district of Konya province and meeting the inclusion criteria will be included in the study. Data will be collected using an "Introductory Information Form," the "Safety Precautions for Children Aged 0-6 Scale," the "Parents' Supervisory Behavior Profile Scale," and the "First Aid Self Efficacy Scale for Home Accidents." Mothers in the intervention group will receive a six week nursing intervention consisting of a guidebook, educational sessions, video presentations, image analysis, and simulations. The control group will not receive any interventions. Post intervention, educational materials will be shared with the control group. Research data will be analyzed using SPSS 29 statistical software. Parametric and nonparametric tests based on normal distribution, analysis of variance, effect size, confidence interval, and Intention to Treat analyzes will be used for between group and within time comparisons. Conclusion: The results of this study are expected to contribute to the development of evidence based educational practices to prevent home accidents, increase control skills, and strengthen first aid self efficacy in mothers.

Comparing 3D and 2D Views in Biportal Spine Surgery: A Pilot Simulation Study

This study aims to compare three-dimensional (3D) and two-dimensional (2D) visualization in biportal endoscopic spine surgery using a simulated environment. Surgeons will perform standardized tasks on a spine model while using either 3D or 2D endoscopic systems. The goal is to determine whether 3D technology can improve precision, efficiency, and movement control during surgery. The study uses a randomized, blinded, crossover design to ensure objective results and may help guide future training and technology use in spinal endoscopy.

The Role of Simulation-based Training in Resident Curriculum in Anaesthesia and Intensive Care

This observational study aims to describe the situation in Europe regarding simulation training during residency in Anaesthesia and Intensive Care. The main questions it aims to answer are: How many countries in Europe have obligatory simulation training during residency? How frequent is this training? What and how is trained during simulations? How is the situation regarding funding and participation in working hours in simulation training? What are the obstacles for the countries that do not have obligatory training? Participants will fill out an electronic survey.

AI-Powered Interview Simulation to Improve Employability and Reduce Anxiety in Nursing and Midwifery Students

This randomized controlled trial aims to evaluate the effectiveness of a ChatGPT-based job interview simulation on the employment perceptions and interview-related anxiety of senior nursing and midwifery students. Transitioning from education to professional practice in healthcare is a critical phase that directly influences employability and career readiness. Particularly for nursing and midwifery students, the ability to navigate job interviews with confidence plays a pivotal role in shaping their future career paths. As such, innovative and digital interventions are needed to better prepare students for this process. Grounded in Bandura's Social Cognitive Theory and the Technology Acceptance Model (TAM), the study explores how AI-driven simulations affect students' self-efficacy, perceived utility, and usability, and ultimately their career-related outlook. The intervention involves a structured, text-based job interview simulation powered by ChatGPT-4o, during which students respond to a series of nine professionally tailored questions. These questions are aligned with international competency frameworks such as those from ICN (2008) and ICM (2024), focusing on themes like professionalism, teamwork, evidence-based care, communication, and leadership. At the end of the simulation, the chatbot provides brief, constructive feedback to the participant. A total of 102 final-year students from Koç University and Istanbul University-Cerrahpaşa will be recruited using stratified randomization. Participants will be assigned to either an intervention group, which will complete the ChatGPT simulation, or a control group, which will not receive any interview intervention but will complete the same pre- and post-test questionnaires. Key outcome measures include the Perceived Future Employability Scale (PFE), the Interview Anxiety Scale (MASI-T), and a simulation experience form for the intervention group. Quantitative data will be analyzed using SPSS with appropriate parametric and non-parametric tests based on data distribution, and an intention-to-treat (ITT) approach will be adopted. To ensure the integrity of the experiment, blinding procedures, strict confidentiality, and group separation protocols will be applied. The simulation will be conducted individually on research-owned devices in private rooms, and no personal or textual data will be saved from the AI interactions. Ethical approval has been obtained from Koç University Social and Behavioral Ethics Committee. Participation is voluntary, informed consent will be collected, and all processes will comply with the Helsinki Declaration and Turkish Personal Data Protection Law. Ultimately, this study seeks to offer evidence on the pedagogical utility of AI-based simulation tools in preparing healthcare students for employment, while also contributing to the broader field of digital transformation in health education.

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.

Stress Evaluation and Management Using High Fidelity Simulation in Medical Education

The goal of this interventional study is to collect clinical and neurophysiological information to determine whether high-fidelity simulation can serve as a stress-inducing stimulus in a population of healthy residents (Emergency medicine, Anesthesia and Intensive care medicine, Paediatrics), both male and female, aged between 25 and 40 years. The main questions it aims to answer are: 1. Define in which phase of the simulation the highest level of stress is observed. 2. Determine the level of stress reached after performing a second high-fidelity simulation after a period of time. 3. Identify whether specific brain areas are activated during high-fidelity simulation. Participants will form teams, consisting of three medical trainees from the same specialty training program, that will undergo two high-fidelity simulations based on a clinical scenario relevant to their residency. * During the simulation, automatic pupillometry will be performed on all team members at the four time points. * Additionally, a two-lead ECG will be recorded for all team members at baseline and end of the debriefing * One team member will undergo EEG monitoring throughout the entire simulation. The EEG recordings will be sampled at baseline, during the simulation and end of the debriefing.

The EFFECT of SIMULATION-BASED TRAINING on POSTPARTUM HAEMORRHAGE MANAGEMENT SKILLS

This study was planned to determine the effect of simulation-based training using two different reality levels-visually enhanced mental simulation (VEMS) and hybrid simulation-on postpartum haemorrhage (PPH) management skills in nursing students.

Comparison of the Effectiveness of High Fidelity Simulation and Low Fidelity Simulation in Active External Bleeding Control Management of Caregivers of Elderly Individuals

The elderly population is increasing worldwide. Due to the increase in the elderly population, emergencies related to ageing are also encountered more frequently. One of these emergencies is trauma in the elderly. Traumas are frequently seen in elderly individuals due to physiological deficiencies related to aging as well as environmental factors. External bleeding caused by trauma is also encountered. If first aid to stop active external bleeding is not administered in a timely and correct manner, death due to bleeding can occur. Nowadays, elderly individuals live either with their families, alone, or in institutions. In the event of external bleeding, either the individual themselves, caregiving family members, or staff at the institution should be able to perform first aid to stop the bleeding. Elderly individuals may not be able to perform first aid due to cognitive and neurological deficiencies. The ability of caregivers to provide first aid can be life-saving. If caregivers of elderly individuals are trained in first aid for external bleeding, they can quickly and correctly administer first aid to stop the bleeding. First aid training often consists of didactic education and demonstrations. A training strategy that ensures knowledge retention and skill acquisition is simulation training. This study aims to evaluate and compare the effectiveness of high-fidelity simulation and low-fidelity (Visually Enhanced Mental Simulation - VEMS) simulation in the skills of caregivers for elderly individuals in managing active external bleeding control. The population of the study will consist of non-health professional caregivers of elderly individuals living in Antakya district of Hatay province. The sample size, calculated using the G Power program, has been determined to include 30 caregivers of elderly individuals. The study consists of four main work packages. In the first stage, the simulation environment will be prepared, and in the second stage, a preliminary application of the project will be conducted. In the third stage, the implementation of the research and the completion of checklists will be ensured. For this, volunteer caregivers of elderly individuals will be identified. After theoretical training is given to the participants, they will be assigned to intervention group 1 (VEMS) and intervention group 2 (high-fidelity simulation) using simple randomization. Following a pre-assessment with low-fidelity simulation, participants will undergo simulation training according to their intervention groups. Subsequently, a final assessment will be conducted using the same lowfidelity simulation. In the final stage, data analysis and interpretation of the findings will be carried out. The collected data will be analyzed statistically, and the significance level will be accepted as p\<0.05. With this study, insight will be provided into the effectiveness of VEMS and high-fidelity simulation in first aid training for active external bleeding for caregivers of elderly individuals. On the other hand, it is planned that the project results will be published in at least one article in journals indexed in the SSCI Expanded.

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.

Virtual Reality Birth Simulator

The investigators compared an in-house developed virtual reality simulator for normal vaginal deliveries with a legacy mannequin-based simulation in a cluster randomised study involving Year 4 medical students undergoing their Ob/Gyn clerkship with aims to compare pre- and post-simulation knowledge questionnaire score. As part of a cross-over component, the investigators will also compare feedback scores for each modality and the preferred modality. Ethical approval and waiver of consent has been obtained from the National University of Singapore Institutional Review Board, Reference Number 2020-606.

Enhancing Pediatric Acute Care Through Adaptive E-Learning and In-Person Skills Practice in Tanzania

The goal of this clinical trial is to evaluate whether the integration of in-person skills practice (ISP) with an adaptive e-learning platform can improve refresher learning progress (RLP) among healthcare providers in pediatric care settings in Tanzania. The main questions it aims to answer are: Can healthcare providers who participate in ISP sessions facilitated by clinical champions achieve greater improvements in refresher learning progress (RLP)? Will providers in the intervention group demonstrate improved metacognition and practical skill performance compared to those in the control group? Researchers will compare healthcare providers using the ISP digital platform (Rhapsode Capable™) to providers using paper-based ISP to see if the digital platform results in significantly higher RLP and fewer skill-based errors. Participants will: Complete adaptive e-learning modules focused on pediatric care topics (e.g., newborn resuscitation, severe malnutrition). Participate in ISP sessions where clinical champions provide feedback and assess performance.

Integrated Learning Support System Based on Immersive Simulated Training for Nursing Students

This study aims to evaluate the effectiveness of an Integrated Learning Support System (ILSS) in preparing undergraduate nursing students for immersive simulated training in managing drug-induced nephrotoxicity. The study hypothesizes that the ILSS, which accommodates different learning styles, will be more effective in reducing stress and anxiety compared to the standard learning model (SLM). The research will involve a parallel randomized controlled trial with 96 students from two Brazilian institutions. The students will be divided into control and experimental groups, with the latter using the ILSS in addition to SLM during preparation. The study will assess outcomes such as knowledge acquisition, skill development, and stress reduction using various instruments, including the Lasater Clinical Judgment Rubric and DASS-21. The study's findings aim to validate the ILSS as a tool to enhance learning outcomes and reduce stress and anxiety, thereby promoting better professional development and patient safety in nursing practice.

The Effect of Simulation Method on Self-Confidence and Stress Levels in Nursing Students

The aim of this study was to determine the impact of training provided through simulation method on self-confidence and stress levels in nursing students during patient intervention.

PROgressive struCturEd Simulation-based Surgical Training Program (PROCESS) - Open Vascular Surgery

A triple-arm, randomized, simple-blinded clinical trial will be conducted. A control sequence and an intervention sequence of three subgroups with different exposure levels to the simulation program are proposed. Group 1: open abdominal aortic repair (AAOR), Group 2: vascular anastomosis (VA) and AAOR, and Group 3: specific micro-surgical skills, VA and AAOR. Surgical residents of general, vascular, or cardiovascular surgery programs will be included. Sample size calculation resulted in 45 participants, 15 in each group. Simple blinding will involve external evaluators. Randomization will occur as a simple randomization.