背景:基于模拟的护理教育中沉浸式技术的采用显着增长,提供资源限制的解决方案,并实现对临床环境的安全访问。尽管有其优势,关于沉浸式技术的有效性,仍然有各种各样的报道。验证沉浸式技术在护理教育中的有效性对于未来的教育计划至关重要。
目的:本系统综述旨在确定针对本科护生的沉浸式技术教育的内容,并评估与传统教学方法相比,沉浸式技术的有效性。
方法:使用四个数据库进行文献检索:PubMed,护理和相关健康文献累积指数(CINAHL),Embase,和WebofScience,最新搜索于2023年1月19日完成。纳入标准如下:参与者是本科护理学生;研究以韩语或英语发表;设计包括随机对照试验(RCT)或非随机研究;干预涉及虚拟现实(VR),增强现实(AR)混合现实(MR),或扩展现实(XR)。使用Cochrane偏倚风险工具(RoB2)的第2版和非随机研究偏倚风险评估工具(RoBANS)进行质量评估。纳入研究的主要结果根据新世界柯克帕特里克模型(NWKM)进行分类,范围从1级(反应)到4级(结果)。采用RevMan5.4软件进行Meta分析。由于meta分析结果的异质性,进行了亚组分析.建议的分级,评估,发展,采用了评估(GRADE)方法来评估确定性并综合相关文献的结果。
结果:共纳入23项研究,参与者人数从33到289不等。19项研究采用VR模拟各种护理场景,包括灾难训练,复苏,健康评估,和家庭保健。四项研究利用了AR技术。15项研究涉及虚拟患者的场景。基于NWKM,主要结果变量被归类为1级(可用性和满意度),二级(知识,动机,信心,性能,态度,和自我效能感),和3级(临床推理)。在选定的研究中没有发现4级结果。荟萃分析的亚组分析结果表明,基于沉浸式技术的护理教育比传统教育更有效(标准均差(SMD)=0.59,95%置信区间(CI)=0.28-0.90,P<.001,I2=49%)。此外,实验组和对照组之间的置信度存在显着差异(SMD=0.70,95%CI=0.05-1.35,P=0.03,I2=82%),和自我效能感(SMD=0.86,95%CI=0.42-1.30;P<.001,I2=63%)。
结论:这些发现支持沉浸式技术教育对护理本科生的有效性,尽管方法和干预措施存在异质性。我们建议应进行长期队列研究,以评估基于沉浸式技术的护理教育对NWKM4级的影响。
背景:
BACKGROUND: The adoption of immersive technology in simulation-based nursing education has grown significantly, offering a solution to resource limitations and enabling safe access to clinical environments. Despite its advantages, there are still diverse reports regarding the effectiveness of immersive technology. It is crucial to verify the effectiveness of immersive technology in nursing education to inform future educational programs.
OBJECTIVE: This systematic review aimed to identify the contents of immersive technology-based education for undergraduate nursing students and evaluate the effectiveness of immersive technology compared to traditional teaching methods.
METHODS: A literature search was performed using 4 databases: PubMed, CINAHL, Embase, and Web of Science; the latest search was completed on January 19, 2023. The inclusion criteria were as follows: participants were undergraduate nursing students; studies were published in Korean or English; designs included randomized controlled trials (RCTs) or nonrandomized studies; and interventions involved virtual reality (VR), augmented reality (AR), mixed reality, or extended reality. Quality assessment was conducted using Cochrane Risk-of-Bias Tool version 2 for RCTs and the Risk-of-Bias Assessment Tool for Nonrandomized Studies. The main outcomes of the included studies were classified according to the New World Kirkpatrick Model (NWKM), ranging from level 1 (reaction) to level 4 (results). Meta-analysis was conducted using RevMan 5.4 software, and subgroup analysis was conducted due to heterogeneity of the results of the meta-analysis. The Grading of Recommendations, Assessment, Development, and Evaluation approach was adopted for assessing certainty and synthesizing results of the relevant literature.
RESULTS: A total of 23 studies were included, with participant numbers ranging from 33 to 289. Of these, 19 (82.6%) studies adopted VR to simulate various nursing scenarios, including disaster training, resuscitation, health assessments, and home health care; 4 (17.4%) studies used AR technologies; and 15 (65.2%) studies involved virtual patients in their scenarios. Based on the NWKM, the main outcome variables were classified as level 1 (usability and satisfaction), level 2 (knowledge, motivation, confidence, performance, attitude, and self-efficacy), and level 3 (clinical reasoning); level 4 outcomes were not found in the selected studies. Results of the subgroup analysis showed that immersive technology-based nursing education is more effective than traditional education in knowledge attainment (standard mean difference [SMD]=0.59, 95% CI 0.28-0.90, P<.001, I2=49%). Additionally, there were significant difference differences between the experimental and control group in confidence (SMD=0.70, 95% CI 0.05-1.35, P=.03, I2=82%) and self-efficacy (SMD=0.86, 95% CI 0.42-1.30, P<.001, I2=63%).
CONCLUSIONS: These findings support the effectiveness of immersive technology-based education for undergraduate nursing students, despite heterogeneity in methods and interventions. We suggest that long-term cohort studies be conducted to evaluate the effects of immersive technology-based nursing education on NWKM level 4.