The Effect of an Immersive Virtual Reality on Nasogastric Tube Feeding Skills and Self-efficacy Among Nursing Students

ISSN 2354-8428 e-ISSN 2598-8727 JURNAL KEPERAWATAN KOMprEhEnsIF COMPREHENSIVE NURSING JOURNAL Vol. 9 No. 4, October 2023 Published by : Sekolah Tinggi Ilmu Keperawatan PPNI Jawa Barat JURNAL KEPERAWATAN KOMPREHENSIF VOL. 9 NO. 4 Bandung October 2023 ISSN 2354-8428 e-ISSN 2598-8727 430 p-ISSN : 2354 8428 | e-ISSN: 2598 8727 Jurnal Keperawatan Komprehensif Vol. 9 No. 4 October 2023 Research Article The Effect of an Immersive Virtual Reality on Nasogastric Tube Feeding Skills and Self-efficacy Among Nursing Students Yohanes Andy Rias1* │ Wildan Akasyah2 │ Bagus Sholeh Apriyanto3 1,2,3Nursing Study Program, Faculty of Health, Institut Ilmu Kesehatan Bhakti Wiyata, Kediri, Indonesia *contact Received : 04/09/2023 Revised : 18/10/2023 Accepted : 30/10/2023 Online : 31/10/2023 Published : 31/10/2023 Abstract Aims: Video-based learning as a preparatory method for nasogastric tube feeding is prevalent among nursing students. Interestingly, there is a growing interest in incorporating immersive virtual reality (IVR) simulators into educational practices. Aims of this study to examine the effect of an IVR on nasogastric tube feeding skills and self-efficacy among nursing students. Methods: A quasi experimental study with trial two-arm. 108 nursing students were recruited from two universities in Central Java. The IVR group (n=54) received nasogastric tube feeding skill practice through IVR, whereas the control group (n=54) watched a 15-minute video. Both groups received online nasogastric tube feeding lectures. The outcomes were nasogastric tube feeding skills and self-efficacy, with evaluated immediately before and after interventions. The Chi-square test, and independent t-test were employed. Results: The results indicated a considerable improvement in nasogastric tube feeding skills in the IVR and the video groups, with significant differences found between the two groups. Additionally, the group that utilized IVR demonstrated higher scores in self-efficacy compared to the group that used video, with statistically significant differences reported between the two groups. Conclusion: The IVR education and video enhanced the skills and selfefficacy. IVR can be recommended as an intervention to improve the quality of long-term education nursing care through technological advances. Keywords: Immersive virtual reality, nasogastric tube, self-efficacy, skill. INTRODUCTION Nasogastric tube feeding is the most commonly used method of enteral feeding, mainly if feeding will be used within the procedure time, which should be relatively short and accurate (1). Notably, the skills of nurses in nasogastric tube feeding and further care are essential to ensure the safety of patients (2, 3). Compliance with standard protocols in managing nasogastric tube feeding is crucial in the quality chain of health and safety delivery remains a significant challenge (2). El-Meanawi et al, https://doi.org/10.33755/jkk 2017 revealed that 62% of nurses in Egypt have unsatisfactory knowledge of nasogastric tube feeding (4). Moreover, nurses' skill of nasogastric tube feeding is not good enough, with some unsafe practices (1, 2). In Indonesia, professional nurses are taught standard nursing protocols for nasogastric tube feeding by the curriculum of Nursing Councils (5). Interestingly, a lack of research has explored the nasogastric tube feeding skills among nursing students in Indonesia. Based on the above problems, effective learning methods are needed to follow the This is an open access article under the CC BY-SA license 431 p-ISSN : 2354 8428 | e-ISSN: 2598 8727 development of learning technology by following cognitive–affective learning theory to solve problems. Conventional educational approaches have been criticized for their inability to adapt to climate change-related modernization (6, 7). Immersive Virtual reality-based learning (IVR) has gained popularity, allowing users to create IVR environments and facilitating efficient and effective student learning applications. Students can partake in the learning process anywhere, including at home, because IVR-based learning is not time- or location-dependent (7). IVR can practice indefinitely with feedback and selfcorrection until they acquire special skills (8), thereby personalizing the learning process (9). This fact, coupled with the low cost of clinical implementation, suggests that virtual reality can be a competitive addition to extant learning approaches (9, 10). Several studies examine the efficacy of IVR in enhancing learning outcomes (11), particularly in the nursing field (12). Numerous systematic studies and metaanalyses have demonstrated that, compared to traditional classroom learning and other forms of digital learning, IVR learning enhances the skills of nursing students and healthcare professionals (10, 13) and their learning satisfaction (14, 15). Several studies argue that VR and conventional classroom learning outcomes do not differ substantially (14, 16). However, the uniqueness of previous research states that effective IVR learning enhances skills in nursing education. The urgency of this research is not much in exploring learners' competence and selfefficacy skills (17). Similarly, a systematic review of 18 studies indicates that although IVR is an effective tool to enhance clinical skills and self-efficacy in students, it is still unclear (18). The above statement shows that most studies have not adopted the appropriate learning theory concepts for verification and seldom explore how IVR affects skill and self-efficacy. Loading. Therefore, more empirical studies are needed to examine the effects of IVR on https://doi.org/10.33755/jkk Jurnal Keperawatan Komprehensif Vol. 9 No. 4 October 2023 learning outcomes from various health professionals, including nursing students. Nasogastric tube care is a fundamental skill for nurses. Correct nasogastric tube maintenance can nourish patients and prevent the development of comorbidities. In addition to learning how to insert a nasogastric tube, nursing personnel in the home care service must also instruct caregivers on performing the procedure (12). This study investigated the IVR for nasogastric tube care education and provided nursing students with video-based learning materials. In addition, the researchers explored the students' skills and self-efficacy using the IVR. METHODS Design and Participants The research design uses quasiexperimental design with pre- and post-test designs. Population of this study includes the nursing undergraduate program in two universities in Central Java. The inclusion criteria are nursing students who are ≥ 20 years of age, have never acquired the nasogastric tube feeding procedure skills, and are in the second year (3rd and 4th semesters). Based on the sample size calculation using the G*Power 3.1.9 (19) program, with a type I error rate of 0.05, a power of 0.80, and an effect size of 0.71 (20), the minimum sample size estimat (...truncated)