Effectiveness of a Multimodal Intervention With Simulation for Learning Home Health Nursing Care of Patients With Multimorbidity and Heart Failure

Not Applicable

Completed

• Conditions: Multimorbidity; Heart Failure

• Registration Number: NCT06855719
• Lead Sponsor: University of Cadiz

Brief Summary

The goal of this clinical trial is to evaluate the efficacy of a multimodal intervention with high-fidelity simulations on home health nursing in improving the care of multipathological patients with heart failure in nursing students. The main questions it aims to answer are:

* Does using validated simulation scenarios on multipathological patients with heart failure improve care competencies in nursing students?

* Does knowledge of scientific evidence and healthcare protocols improve nursing students' performance in the simulator?

Researchers will compare a multimodal intervention with high-fidelity simulations on home health nursing to conventional intervention (theoretical teaching) to see if nursing students better learn competencies related to the care of patients with multimorbidity and heart failure during the home health nursing.

Participants will:

* Experience simulations on validated simulation scenarios on multipathological patients with heart failure (All participants).

* Reflect on the intervention performed on the simulator through individual and group debriefings (Experimental Group).

* Learn about the main scientific evidence and international and national protocols related to comorbidities and health failure (Experimental Group).

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2025-02-22
• Study First Submitted QC: 2025-02-27
• Study First Posted: 2025-03-04
• Study Start: 2025-03-10
• Primary Completion: 2025-04-30
• Study Completion: 2025-05-23
• Status Verified: 2025-06
• Last Update Submitted: 2025-06-30
• Last Update Posted: 2025-07-03

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 80

Inclusion Criteria

• Nursing students enrolled in the subject "Family and Community Nursing I".

Exclusion Criteria

• Lack of attendance since the beginning of the course.
• Failure to follow the instructions of the instructors during the course of the study.
• Voluntary withdrawal from the study during the study or declaring non-participation.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Learning	From enrollment to the end of intervention at 4 weeks.	Learning will be analyzed through nursing students' performance during the simulations. Two independent observers with experience in tesching simulation will evaluate each simulation (pretest and posttest) through a validated checklist for each simulation scenario. The checklist evaluates the following aspects: (1) assessment of people and observation of the home (4 items), (2) nursing intervention (5 items), and (3) transversal competencies related to greeting, farewell, and communication skills (5 items). Each item will be evaluated by a dichotomous response (Yes/No) and a final overall evaluation (0-10 points). The observers' degree of agreement will be determined by Cohen's kappa.
Empathy	From enrollment to the end of treatment at 4 weeks.	Empathy toward patients presenting with pluripathologies and heart failure is essential for providing professional care. The general measure of the students' empathy level was measured by the Spanish version of the Jefferson Scale of Empathy, student version (JSE-S), with a Cronbach's alpha coefficient of 0.90. The JSE-S is a 20-item instrument specifically developed to measure empathy in health profession education and patient care for administration to health profession students and practitioners. Items are answered on a 7-point Likert-type scale (1 = Strongly Disagree, 7 = Strongly Agree). Half of the items are positively worded and directly scored, and the other half are negatively worded (reverse scored). The total score are range from 20 to 140, where a higher score indicates greater empathy.

Secondary Outcome Measures

Name	Time	Method
Self-confidence in learning	From enrollment to the end of treatment at 5 weeks	Immediately after the simulation was performed. This will be measured using the Student Satisfaction and Self-Confidence in Learning (SCLS) scale. The scale is based on a five-point Likert scale, ranging from "strongly disagree" to "strongly agree." The scores that can be obtained range from 13 to 65 points and were validated with a Cronbach's alpha of 0.90.
Quality of simulations	From enrollment to the end of treatment at 5 weeks	After the individual and group debriefings. The Educational Practices Questionnaire (student version) (EPQ) will be used. It consists of 16 items, assessed on two 5-point scales. Each item assessed quality and importance. The questionnaire is validated with Cronbach's alphas of 0.86 and 0.91 for the scales respectively.
Satisfaction on simulations	From enrollment to the end of treatment at 5 weeks	After the individual and group debriefings. For this purpose, the High Fidelity Clinical Simulation satisfaction scale in students (ESSAF) will be used. This scale contains 33 statements answered on a 5-point Likert-type scale, with a minimum score of 1 (strongly disagree) to 5 (strongly agree). The 33 items are grouped into 8 factors or dimensions of student perception of the simulation clinic: "Usefulness", "Characteristics of cases and applications", "Communication", "Perceived performance", "Increased self-confidence", "Relationship between theory and practice", "Facilities and equipment" and "Positive aspects". It is validated with a Cronbach's alpha of 0.857.

Trial Locations

Locations (1)

Faculty of Nursing; 🇪🇸 Algeciras, Cadiz, Spain