Comparing Mixed Reality, Video-Based, and Instructor-Led Training for Nasogastric Tube Insertion in Nursing Students

NCT ID: NCT07293663

Last Updated: 2025-12-19

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

RECRUITING

Clinical Phase

NA

Total Enrollment

160 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-02-12

Study Completion Date

2027-04-30

Brief Summary

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This study explores how nursing students learn to insert a nasogastric tube (NGT), a common but potentially risky clinical procedure. The goal is to compare three different teaching methods:

Mixed Reality (MR) glasses with virtual instructions Video-based learning Traditional instructor-led training

The study investigates which method leads to better learning outcomes, how usable the technologies are, and how students experience MR in their learning.

Participants will be first-year nursing students with no prior experience in NGT insertion. They will be randomly assigned to one of the three training methods, complete the procedure, and answer questionnaires about their performance and experience. Six months later, they will repeat the procedure to assess long-term learning.

Detailed Description

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This randomized controlled trial investigates the effectiveness of three teaching methods Mixed Reality (MR), Video-Based Learning (VBL), and Instructor-Led Training in teaching nasogastric tube (NGT) insertion to first-year nursing students. The study aims to compare learning outcomes, usability, and user experience across these methods, and to assess long-term retention of clinical skills.

NGT insertion is a routine but high-risk procedure in nursing. Incorrect placement can lead to serious complications such as aspiration, nasal trauma, or increased mortality. Effective training is essential to ensure safe and competent practice.

Participants will be randomized into three parallel groups with identical instructional content based on a standardized NGT insertion protocol:

Mixed Reality (MR) Group (N=60) Students use Meta Quest 3 mixed reality glasses running a stepwise instructional application developed with CTRL Studio.

The MR application provides interactive, virtual guidance for each step of the NGT insertion procedure.

Prior to practice, students receive technical familiarization, including hands-on use of the MR device and navigation of the virtual interface.

The virtual content is identical to the other groups and can be replayed during practice.

Video-Assisted Group (N=60) Students watch a video of the NGT insertion procedure recorded from the operator's point of view using a head-mounted, voice-controlled smart camera.

The video content is identical to the MR and instructor-led sessions and can be replayed during practice. No additional verbal guidance is provided during practice.

Instructor-Led Group (Control) (N=60) Students receive classroom-based instruction including theoretical slides and a live demonstration of the NGT insertion procedure.

Students practice individually on a manikin under teacher supervision. The teacher answers questions but does not provide step-by-step coaching.

All students complete a pre-test on NGT theory and a demographic questionnaire. Each student performs the NGT insertion individually on a manikin during the practice phase.

After practice, students complete:

NASA-TLX workload assessment and NGT theory post-test (all groups) System Usability Scale (SUS) and User Experience Questionnaire (UEQ) (MR and video groups only) MR group also submits a written reflection on device usability.

Finally, students repeat the NGT insertion in a separate room without guidance. Performance is assessed by a blinded research assistant using a standardized NGT checklist.

The study follows the Medical Research Council (MRC) Framework for developing and evaluating complex interventions. The intervention materials are evidence-based and piloted with teachers and students before implementation. The sample size is calculated to ensure statistical power, and data will be analyzed using SPSS software. ANOVA and t-tests will be used to compare group outcomes, and qualitative data from student reflections will be analyzed using content analysis.

This study contributes to the development of evidence-based teaching strategies in nursing education. It explores how immersive technologies like MR can enhance skill acquisition, motivation, and satisfaction. The findings will inform future curriculum design and support the integration of digital tools in clinical training.

Ethical approval has been obtained, and all participants will provide informed consent. Data will be anonymized and securely stored. The study is conducted in collaboration with the University of Turku and Turku University of Applied Sciences.

Conditions

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Education, Nursing Students Clinical Competence Teaching Innovation Nasogasrtic Tube Insertion User Experience Teaching Method

Keywords

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Nasogastric Tube Insertion Nursing Education Mixed Reality Video-Based Learning Instructor-Led Training Meta Quest 3 Nursing Clinical Skills Randomized Controlled Trial Nursing Students Extended Reality in Healthcare

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Participants are randomized into three parallel groups, each receiving a different instructional method for nasogastric tube (NGT) insertion training. All groups follow the same standardized protocol and instructional content. The MR group uses Meta Quest 3 mixed reality glasses with a stepwise virtual application developed in CTRL Studio. The video group watches a head-mounted smart camera recording of the procedure. The instructor-led group receives classroom-based instruction and a live demonstration. Each student performs the procedure individually on a manikin, and outcomes are assessed post-intervention and at six-month follow-up.
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
Only the outcomes assessor is blinded to group allocation. Students, instructors, and researchers are aware of the assigned intervention. The assessor evaluates NGT insertion performance without knowledge of which instructional method the student received.

Study Groups

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Mixed Reality Group

Participants in this arm receive nasogastric tube (NGT) insertion training using Meta Quest 3 mixed reality glasses. The instructional application, developed with CTRL Studio, provides stepwise virtual guidance. Students receive technical familiarization before practice. The instructional content is standardized and identical to other groups. This arm evaluates the effectiveness and usability of MR-based training.

Group Type EXPERIMENTAL

Mixed Reality NGT Training

Intervention Type DEVICE

Participants use Meta Quest 3 mixed reality glasses with a stepwise instructional application developed in CTRL Studio. The application provides interactive virtual guidance for nasogastric tube (NGT) insertion. Students receive technical familiarization before practice. Content is standardized and identical to other groups.

Video-Based Learning Group

Participants in this arm receive NGT insertion training by watching a video recorded from the operator's point of view using a head-mounted, voice-controlled smart camera. The video is identical to the MR and instructor-led groups and can be replayed during practice. No verbal guidance is provided during the procedure. This arm evaluates the effectiveness and usability of video-based training.

Group Type EXPERIMENTAL

Video-Based NGT Training

Intervention Type DEVICE

Participants watch a video of the NGT insertion procedure recorded from the operator's point of view using a head-mounted, voice-controlled smart camera. The video is identical to the MR and instructor-led groups and can be replayed during practice. No verbal guidance is provided during the procedure.

Instructor-Led Training Group (Control)

Participants in this arm receive classroom-based instruction including theoretical slides and a live demonstration of the NGT insertion procedure. Students practice individually on a manikin under teacher supervision. The teacher answers questions but does not provide step-by-step coaching. This arm serves as the control condition and represents traditional teaching methods.

Group Type EXPERIMENTAL

Instructor-Led NGT Training

Intervention Type BEHAVIORAL

Participants receive classroom-based instruction including theoretical slides and a live demonstration of the NGT insertion procedure. Students practice individually on a manikin under teacher supervision. The teacher answers questions but does not provide step-by-step coaching.

Interventions

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Mixed Reality NGT Training

Participants use Meta Quest 3 mixed reality glasses with a stepwise instructional application developed in CTRL Studio. The application provides interactive virtual guidance for nasogastric tube (NGT) insertion. Students receive technical familiarization before practice. Content is standardized and identical to other groups.

Intervention Type DEVICE

Video-Based NGT Training

Participants watch a video of the NGT insertion procedure recorded from the operator's point of view using a head-mounted, voice-controlled smart camera. The video is identical to the MR and instructor-led groups and can be replayed during practice. No verbal guidance is provided during the procedure.

Intervention Type DEVICE

Instructor-Led NGT Training

Participants receive classroom-based instruction including theoretical slides and a live demonstration of the NGT insertion procedure. Students practice individually on a manikin under teacher supervision. The teacher answers questions but does not provide step-by-step coaching.

Intervention Type BEHAVIORAL

Other Intervention Names

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Meta Quest 3 MR Training Video-Based Skill Training Traditional Teaching Classroom-Based Instruction Teacher-Guided Training

Eligibility Criteria

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Inclusion Criteria

* First-year nursing student
* Performing nasogastric tube (NGT) insertion for the first time
* No prior theoretical education or pre-material on NGT insertion procedure

Exclusion Criteria

* Previous nursing education (e.g., practical nurse qualification)
* Diagnosis of epilepsy
* Presence of a pacemaker
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Turku University of Applied Sciences

UNKNOWN

Sponsor Role collaborator

University of Turku

OTHER

Sponsor Role lead

Responsible Party

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Marika Leppänen

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Marika Leppänen, Doctoral Researcher

Role: PRINCIPAL_INVESTIGATOR

University of Turku, Department of Nursing Science

Heli Virtanen, Professor

Role: STUDY_CHAIR

University of Turku, Department of Nursing Science

Minna Kyttälä, Professor

Role: STUDY_CHAIR

University of Turku, Department of Education

Teijo Lehtonen, Doctor of Science (Technology)

Role: STUDY_CHAIR

University of Turku, Department of Computing

Locations

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Turku University of Applied Sciences

Turku, , Finland

Site Status RECRUITING

Countries

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Finland

Central Contacts

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Marika Leppänen, Doctoral Researcher

Role: CONTACT

Phone: +358505331989

Email: [email protected]

Facility Contacts

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Marika Leppänen, Doctoral Researcher

Role: primary

Mirka Toivonen, PhD

Role: backup

Provided Documents

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Document Type: Study Protocol

View Document

Other Identifiers

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TY/1218/06.01.01/2024

Identifier Type: OTHER

Identifier Source: secondary_id

TY1218-RCT

Identifier Type: -

Identifier Source: org_study_id