Game-Based 3D Simulation for Vital Signs Training in Nursing Education

NCT ID: NCT07009275

Last Updated: 2025-06-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

73 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-01-25

Study Completion Date

2023-09-10

Brief Summary

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This study aims to improve nursing students' skills in measuring vital signs using a 3D animation-based game simulation. Measuring vital signs is a key responsibility for nurses and requires both knowledge and hands-on practice. To help students learn without risking patient safety, we developed an educational game that uses 3D animation technology.

A total of 73 nursing students participated in this randomized controlled study. One group used the 3D game simulation, while the other group received traditional teaching. We compared students' test scores, their satisfaction with the learning method, and their confidence in what they learned.

Detailed Description

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The nursing profession is a discipline that requires competence in both cognitive and psychomotor skills in order to protect and improve the health of individuals and provide appropriate care in cases of illness \[1\]. In this context, the effective acquisition of psychomotor skills is considered to be one of the fundamental objectives of nursing education \[2\]. During the education process, students are expected to acquire many skills of varying degrees of difficulty and complexity and become proficient in their application \[3\]. Among these skills, the accurate assessment, measurement and monitoring of vital signs is one of the important responsibilities of nurses \[4\].

Any change in vital signs is an early indicator of changes in the patient's overall condition \[5, 6\]. Therefore, accurate and timely monitoring of vital signs and their effective use in the clinical decision-making process are of great importance for patient safety \[7\]. However, the relevant literature indicates that vital signs are not regularly and accurately monitored by nurses, and that the quality of monitoring is poor or not reported \[8, 9\]. So, these omissions in monitoring vital signs lead to an increase in preventable intensive care admissions and mortality rates \[10\].

Monitoring vital signs, which is critical for effective patient management in clinics, is often left to nursing students with basic knowledge \[11\]. However, due to the non-invasive nature of vital signs applications, students often perform these applications with minimal or no supervision from a clinical nurse educators or nurses \[12\]. A review of the literature reveals significant deficiencies in students' knowledge and application of vital signs \[11-13\]. It is critical that students perform the clinical skills they have acquired correctly and appropriately in order to improve patient safety and quality of care \[14, 15\]. Considering the importance of monitoring vital signs in a timely and accurate manner for the early identification of clinical deterioration, nursing students must be competent in vital signs assessment \[12\]. Therefore, it is necessary to use more effective and current learning methods in teaching vital signs.

At this point, the integration of innovative technologies into nursing education enables students to gain experience by repeating these applications without harming the patient and learning from their mistakes \[16\]. One of these technologies is a virtual game simulation obtained by transferring a real-life situation to the computer platform and gamifying it, which has just begun to be used in nursing education \[15\]. Recently, virtual gaming simulations have been increasingly used in nursing education to reduce some of the resource challenges of face-to-face simulation \[17\]. The objective of a virtual gaming simulation is to provide students with the opportunity to apply the concepts they have learned in a realistic scenario \[18\]. This practice enables students to actively participate in their own learning by its very nature \[19\]. The utilisation of virtual gaming simulations affords students the opportunity to receive prompt feedback, oversee their performance and conduct objective assessments \[20\]. Students are afforded the opportunity to repeat the game until they are satisfied with their performance \[21\]. Therefore, virtual game simulations contribute to the increase of students' academic achievement and skill performance \[20\]. At the same time, virtual gaming simulation as a teaching strategy enables students to participate in a realistic clinical scenario, reducing their anxiety and supporting their self-confidence \[15, 22\]. Because simulation offers students the opportunity to develop their nursing knowledge, clinical and psychomotor skills and clinical decision making levels in a simulated safe environment and over a long period of time before encountering real patients \[17\].

When reviewing the literature on nursing education, no research findings were found regarding the use of game-based virtual reality simulation applications for measurement skills related to vital signs. In this study, a game-based simulation application developed using 3D animation technology was designed to fill this gap and to enable nursing students to acquire vital signs measurement skills. We aimed to evaluate the effects of this application on students' academic achievement, satisfaction and self-confidence in learning. In this way, the aim is to provide an effective and technology-based teaching strategy that will increase patient safety in nursing education.

Conditions

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Nursing Education Vital Signs Animation Academic Acheivement Satisfaction

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

A randomized controlled experimental design
Primary Study Purpose

OTHER

Blinding Strategy

SINGLE

Investigators

Study Groups

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Intervention group

The intervention group consisted of students using the game-based simulation application developed using 3D animation technology.

Group Type EXPERIMENTAL

The game-based simulation application developed using 3D animation technology

Intervention Type OTHER

The intervention group consisted of students using the game-based simulation application developed using 3D animation technology, while the control group consisted of students using traditional learning methods.

Control group

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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The game-based simulation application developed using 3D animation technology

The intervention group consisted of students using the game-based simulation application developed using 3D animation technology, while the control group consisted of students using traditional learning methods.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Being enrolled as a student in the Faculty of Nursing,
* Voluntarily agreeing to participate in the study,
* Not having previously received theoretical and practical training on vital signs,
* Not being an international student,
* Not having transferred to the Faculty of Nursing from other health sciences programs with different educational or assessment practices.

Exclusion Criteria

* Not being enrolled in the Faculty of Nursing,
* Refusing to participate or withdrawing consent,
* Having prior theoretical or practical education related to vital signs,
* Being an international student,
* Having transferred from other health sciences programs that use different clinical or educational evaluation systems.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Sakarya University of Applied Sciences

UNKNOWN

Sponsor Role collaborator

Kocaeli University

OTHER

Sponsor Role lead

Responsible Party

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Funda Erol

Dr.

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Kocaeli University

İzmit, Kocaeli, Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

References

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Yılmaz D, Çınar G. The effect of simulator use in blood pressure measurement training on nursing students' psychomotor skills. Sağlık ve Toplum Dergisi. 2020;20(1):104-10

Reference Type BACKGROUND

Bayram SB, Caliskan N. The use of virtual reality simulations in nursing education, and patient safety. Contemporary Topics in Patient Safety-Volume 1: IntechOpen; 2020

Reference Type BACKGROUND

Luctkar-Flude M, Tyerman J, Tregunno D, Bell C, Lalonde M, McParland T, et al. Designing a virtual simulation game as presimulation preparation for a respiratory distress simulation for senior nursing students: Usability, feasibility, and perceived impact on learning. Clinical Simulation in Nursing. 2021;52:35-42

Reference Type BACKGROUND

Bayram ŞB, Çalışkan N. Using a game-based virtual reality application in psychomotor skills acquisition: An experience sharing Journal of Human Sciences. 2019;16(1):155-63

Reference Type BACKGROUND

Verkuyl M, Hughes M. Virtual gaming simulation in nursing education: A mixed-methods study. Clinical Simulation in Nursing. 2019;29:9-14

Reference Type BACKGROUND

Atthill S, Witmer D, Luctkar-Flude M, Tyerman J. Exploring the impact of a virtual asynchronous debriefing method after a virtual simulation game to support clinical decision-making. Clinical Simulation in Nursing. 2021;50:10-8

Reference Type BACKGROUND

Şahin G, Başak T. Game-based learning in nursing education. Gümüşhane University Journal of Health Sciences. 2019;8(3):308-14

Reference Type BACKGROUND

Mohammed QH. Knowledge and practices of nursing college student's regarding blood pressure measurement in Hospitals at Kirkuk City. Kufa Journal for Nursing Sciences. 2016;6(2):177-84

Reference Type BACKGROUND

Özsaban A, Turan N, Beki Ç, Aşti T. The relationship between nurses' attitudes toward vital signs monitoring and emotional ıntelligence levels. Genel Tıp Dergisi. 2022;32(6):652-7

Reference Type BACKGROUND

Kısacık ÖG, Gündoğan AÖ, Yılmaz E. Attitudes of Nurses and Nursing Students Towards Vital Signs: A Comparatıve Study. Journal of Nursing Effect. 2024;17(4):575-90

Reference Type BACKGROUND

Gülnar E, Yılmaz ED, Özveren H. Hemşirelerin yaşam bulgularina ilişkin tutum ve uygulamalarinin belirlenmesi. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi. 2020;22(3):377-85

Reference Type BACKGROUND

Öztürk D, Göçmen Baykara Z. The effect of peer education on the teaching of nursing skills. Journal of Education and Research in Nursing. 2019;16(4):295-300

Reference Type BACKGROUND

Foronda CL, Fernandez-Burgos M, Nadeau C, Kelley CN, Henry MN. Virtual Simulation in Nursing Education: A Systematic Review Spanning 1996 to 2018. Simul Healthc. 2020 Feb;15(1):46-54. doi: 10.1097/SIH.0000000000000411.

Reference Type BACKGROUND
PMID: 32028447 (View on PubMed)

Ordu Y, Caliskan N. The effect of virtual game simulation on students' perception of nursing diagnosis and clinical practice: Post-test only randomized controlled trial. Nurse Educ Pract. 2023 Oct;72:103792. doi: 10.1016/j.nepr.2023.103792. Epub 2023 Sep 26.

Reference Type BACKGROUND
PMID: 37769493 (View on PubMed)

Carrero-Planells A, Pol-Castaneda S, Alamillos-Guardiola MC, Prieto-Alomar A, Tomas-Sanchez M, Moreno-Mulet C. Students and teachers' satisfaction and perspectives on high-fidelity simulation for learning fundamental nursing procedures: A mixed-method study. Nurse Educ Today. 2021 Sep;104:104981. doi: 10.1016/j.nedt.2021.104981. Epub 2021 May 25.

Reference Type BACKGROUND
PMID: 34062333 (View on PubMed)

Alshehry AS, Cruz JP, Bashtawi MA, Almutairi KO, Tumala RB. Nursing Students' Knowledge, Competence and Attitudes towards Vital Signs Monitoring during Clinical Practice. J Clin Nurs. 2021 Mar;30(5-6):664-675. doi: 10.1111/jocn.15586. Epub 2020 Dec 16.

Reference Type BACKGROUND
PMID: 33259648 (View on PubMed)

Connor N, McArthur D, Camargo Plazas P. Reflections on vital sign measurement in nursing practice. Nurs Philos. 2021 Jan;22(1):e12326. doi: 10.1111/nup.12326. Epub 2020 Oct 1.

Reference Type BACKGROUND
PMID: 33001547 (View on PubMed)

Gillan PC, Delaney LJ, Tutticci N, Johnston S. Factors influencing nursing students' ability to recognise and respond to simulated patient deterioration: A scoping review. Nurse Educ Pract. 2022 Jul;62:103350. doi: 10.1016/j.nepr.2022.103350. Epub 2022 Apr 20.

Reference Type BACKGROUND
PMID: 35468343 (View on PubMed)

Kellett J, Sebat F. Make vital signs great again - A call for action. Eur J Intern Med. 2017 Nov;45:13-19. doi: 10.1016/j.ejim.2017.09.018. Epub 2017 Sep 20.

Reference Type BACKGROUND
PMID: 28941841 (View on PubMed)

Mok W, Wang W, Cooper S, Ang EN, Liaw SY. Attitudes towards vital signs monitoring in the detection of clinical deterioration: scale development and survey of ward nurses. Int J Qual Health Care. 2015 Jun;27(3):207-13. doi: 10.1093/intqhc/mzv019. Epub 2015 Apr 16.

Reference Type BACKGROUND
PMID: 25888564 (View on PubMed)

Kamio T, Kajiwara A, Iizuka Y, Shiotsuka J, Sanui M. Frequency of vital sign measurement among intubated patients in the general ward and nurses' attitudes toward vital sign measurement. J Multidiscip Healthc. 2018 Oct 15;11:575-581. doi: 10.2147/JMDH.S179033. eCollection 2018.

Reference Type BACKGROUND
PMID: 30410344 (View on PubMed)

Eyikara E, Baykara ZG. Effect of simulation on the ability of first year nursing students to learn vital signs. Nurse Educ Today. 2018 Jan;60:101-106. doi: 10.1016/j.nedt.2017.09.023. Epub 2017 Oct 13.

Reference Type BACKGROUND
PMID: 29078202 (View on PubMed)

Tanrikulu F, Gundogdu H, Erol F, Dikmen Y. A comparison of 3D game-based simulation versus traditional methods in vital signs education. BMC Med Educ. 2025 Oct 2;25(1):1344. doi: 10.1186/s12909-025-07980-4.

Reference Type DERIVED
PMID: 41039559 (View on PubMed)

Other Identifiers

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E-26428519-044-65435

Identifier Type: -

Identifier Source: org_study_id

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