Virtual Reality Training in Nasogastric Tube Application for Nurses

NCT07101692 | Completed

• 2 other identifiers: 28.07.2025-12025/599
• Study Type: interventional
• Target: 65
• Locations: 1 country
• Sites: 1

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.

Conditions

Nurses; Nurse Education; Clinical Competence

Keywords

nursing; virtual realtiy; nasogastric catheter; in-service training

Outcome Measures

Primary Outcomes (1)

• Change in Nasogastric Catheter Application Skill Score

  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.

  Baseline (pretest) and at least two weeks after the free practice session (posttest)

Secondary Outcomes (5)

• 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

Study Arms (2)

Virtual Reality Group

EXPERIMENTAL

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.

Behavioral: Immersive Virtual Reality Training

Conventional Training Group

ACTIVE COMPARATOR

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.

Behavioral: Conventional Simulator Practice

Interventions

Immersive Virtual Reality Training BEHAVIORAL

An immersive virtual reality application developed in Unity 2022.3.18f1 with the XR Interaction Toolkit 2.1 for the Oculus Quest 2 platform, presenting a virtual patient room in which the user performs 53 nasogastric tube insertion steps and 32 removal steps in a fixed sequence. Written instructions in the user's field of view and simultaneous audio narration guide each step. The system requires the interaction defining a step to be completed before the next step loads, so steps cannot be skipped or reordered. Performance was not scored within the application and session data were not recorded.

Virtual Reality Group

Conventional Simulator Practice BEHAVIORAL

Individual practice of nasogastric tube insertion and removal on a medium-fidelity simulator, following the theoretical instruction and demonstration delivered by the researcher in accordance with the Nasogastric Catheter Application Checklist.

Conventional Training Group

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• 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

You may not qualify if:

• \- Working in outpatient clinics, physical therapy, psychiatry or paediatric clinics

Sponsors & Collaborators

• Ayşe Eminoğlu: lead

Study Sites (1)

Eskisehir Osmangazi University Health Practice and Research Hospital

Eskişehir, Turkey (Türkiye)

Location

Study Officials

• Ayşe Eminoğlu, Dr.

  ayse.eminoglu@gibtu.edu.tr

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: 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.
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Assistant Professor

Model Details: Participants were allocated to the two groups using the minimization technique, with age, sex, clinic of employment, pretest knowledge test score and pretest skill checklist insertion and removal scores as balancing variables. Each participant was assigned to the group producing the lowest overall imbalance; where both groups yielded equal imbalance, allocation was decided by lot. Minimization was performed by an independent statistician in Microsoft Excel after recruitment and all pretest measurements had been completed. Which group served as the intervention arm was then determined by drawing lots.

Study Record Dates

• First Submitted: July 28, 2025
• First Posted: August 3, 2025
• Study Start: July 7, 2025
• Primary Completion: September 10, 2025
• Study Completion: September 10, 2025
• Last Updated: September 17, 2026

Record last verified: 2026-09

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)