Comparing Mixed Reality, Video-Based, and Instructor-Led Training for Nasogastric Tube Insertion in Nursing Students
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Mixed Reality NGT Training, Video-Based NGT Training, Instructor-Led NGT Training.
- Who it may be relevant to
- Registry conditions: Education, Nursing Students, Clinical Competence, Teaching Innovation, Nasogasrtic Tube Insertion. Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Finland
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Comparing Mixed Reality, Video-Based, and Instructor-Led Training in Nasogastric Tube Insertion: A Randomized Controlled Trial Assessing Learning Outcomes, Usability, and Student Experiences in Nursing Education
Overview
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
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.
Interventions
- Device 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. - 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. - Behavioral 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.
Primary outcome measures
- NGT Checklist Performance Score [Time frame: Immediately after training; 6 months after training]
Secondary outcome measures (5)
- User Experience Questionnaire (UEQ) [Time frame: Immediately after intervention]
- System Usability Scale (SUS) [Time frame: Immediately after intervention]
- NASA Task Load Index (NASA TLX) [Time frame: Immediately after intervention]
- Student Reflection Texts [Time frame: Immediately after intervention]
- Nasogastric Tube (NGT) theory pre- and post-test [Time frame: Baseline; Immediately after intervention]
Eligibility criteria
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
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: Yes
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Single blind
- Primary purpose
- Treatment
Study locations
Finland · 1 center
- Turku University of Applied Sciences — Turku
Identifiers
NCT: NCT07293663 · TY1218-RCT · TY/1218/06.01.01/2024