The Effect of Virtual Reality in Teaching Nasogastric Tube Application Skills to Nurses
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Enrollment
- 65
- Locations
- 2
- Primary Endpoint
- Nasogastric Catheter Application Skill Score
Study Overview
Brief Summary
This randomized controlled trial evaluated the effectiveness of immersive virtual reality (VR) technology in teaching nurses nasogastric tube application skills. The study included nurses working in internal medicine, surgical, and intensive care units at a university hospital in Türkiye between July and September 2025.
Sixty-five nurses were allocated to a virtual reality group or a conventional training group. Both groups received the same theoretical instruction and demonstration on a medium-fidelity simulator. Afterward, nurses in the virtual reality group practiced the nasogastric tube insertion and removal procedure in an immersive virtual reality application, while nurses in the conventional training group practiced the same procedure on a medium-fidelity simulator.
We carried out final assessments at least two weeks after the practice session. We compared procedural skill, performance of safety-critical procedural steps, knowledge, self-confidence, anxiety, and motivation toward the instructional material between the two groups. The study included 62 nurses.
Detailed Description
BACKGROUND
Nasogastric tube application is widely used in inpatient wards and intensive care units for nutritional support, medication administration, assessment of gastric contents, gastric lavage, gastric emptying, and decompression. Although often regarded as a simple procedure, incorrect placement can cause pneumothorax, pneumonia, infection, vocal cord paralysis, and tube obstruction, and deaths associated with these complications have been reported. Under the Turkish Nursing Regulation, nasogastric tube application and the associated care and monitoring are among the duties of the nurse.
The literature indicates considerable variation in field practice among nurses performing this procedure. Virtual reality provides an immersive environment in which clinical procedures can be practiced repeatedly without risk to patients, allowing learners to progress at their own pace. Although several studies have examined virtual reality training in nursing students, few have addressed its effectiveness among practicing nurses. This trial was designed to address that gap.
DESIGN AND SETTING
Single-center, two-arm, parallel-group, pretest-posttest randomized controlled trial with 1:1 allocation, conducted at Eskisehir Osmangazi University Health Practice and Research Hospital, Türkiye, between July and September 2025. Group allocation is reported according to the CONSORT statement. The study was registered retrospectively: the first participant was enrolled on 7 July 2025, and registration was completed thereafter, but the interventions and the posttest measurements were performed after registration.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Other
- Masking
- Single (Outcomes Assessor)
Masking Description
The two raters who scored the skill checklist at the pretest and posttest assessments were not members of the research team and were not informed of participants' group allocation. The statistician who analysed the data was a different person from the statistician who performed the allocation and was also masked; groups were coded as 1 and 2 before data entry. Participants and the researcher delivering the intervention could not be masked because of the nature of the intervention.
Eligibility Criteria
- Ages
- 18 Years to 65 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •Working as a nurse in an internal medicine, surgical or intensive care unit of the hospital where the study was conducted
- •Volunteering to participate in the study
- •Aged 18 years or over
Exclusion Criteria
- •- Working in outpatient clinics, physical therapy, psychiatry or paediatric clinics
Arms & Interventions
Virtual Reality Group
Participants received the theoretical instruction and demonstration common to both arms, followed by an individual free practice session in which they performed the nasogastric tube insertion and removal procedure in an immersive virtual reality application under researcher supervision. Up to three sessions were permitted; all participants attended one session, experiencing all 85 procedural steps, with a practice time of 7 to 10 minutes.
Intervention: Immersive Virtual Reality Training (Behavioral)
Conventional Training Group
Participants received the theoretical instruction and demonstration common to both arms, followed by an individual free practice session in which they performed the nasogastric tube insertion and removal procedure on a medium-fidelity simulator under researcher supervision. Up to three sessions were permitted; all participants attended one session, experiencing all 85 procedural steps, with a practice time of 5 to 10 minutes.
Intervention: Conventional Simulator Practice (Behavioral)
Outcomes
Primary Outcomes
Nasogastric Catheter Application Skill Score
Time Frame: 7 day
The change in the mean score of the nasogastric catheter application skill checklist (pre-test and post-test comparison) will be evaluated with the application on the model in the first week after the training.
Change in Nasogastric Catheter Application Skill Score
Time Frame: Baseline (pretest) and at least two weeks after the free practice session (posttest)
Psychomotor performance in nasogastric tube insertion and removal, assessed with the Nasogastric Catheter Application Checklist. The checklist contains 85 steps (53 insertion, 32 removal). Each step scores 2 if performed completely, 1 if performed partially and 0 if not performed. The total score ranges from 0 to 170. Higher scores indicate better procedural skill.
Secondary Outcomes
- Change in Critical Procedural Step Score(Baseline (pretest) and at least two weeks after the free practice session (posttest))
- Change in Nasogastric Catheter Application Knowledge Test Score(Baseline (pretest) and at least two weeks after the free practice session (posttest))
- Change in Self-Confidence Score(Baseline (pretest) and at least two weeks after the free practice session (posttest))
- Change in Anxiety Score(Baseline (pretest) and at least two weeks after the free practice session (posttest))
- Motivation Towards the Instructional Material(Posttest only, at least two weeks after the free practice session)
Investigators
Ayşe Eminoğlu
Assistant Professor
Gaziantep Islam Science and Technology University