The Effect of Artificial Intelligence-Supported Intramuscular and Subcutaneous Injection Training on Nursing Students

NCT07253571 | Not Yet Recruiting

• 1 other identifier: TBAEK-599
• Study Type: interventional
• Target: 80
• Locations: 1 country
• Sites: 1

Brief Summary

The complexity of healthcare services and technological advances today have necessitated the adoption of innovative approaches in nursing education. Among these innovative approaches, artificial intelligence (AI) has established itself as a technology that is increasingly present in nursing education processes, offering a supportive, personalized, and interactive learning experience. AI's contributions to nursing students' acquisition of fundamental competencies such as clinical decision-making, skill development, and critical thinking are rapidly increasing. Especially in high-risk, invasive, and clinically skill-intensive applications, AI-supported educational models both enhance learning quality and support patient safety. Intramuscular and subcutaneous injections are among the basic invasive skills that nursing students must learn. These applications require a high level of cognitive and psychomotor competence from students. Incorrect injection practices can lead to complications such as drug absorption problems, nerve damage, hematoma, or infection, making it critically important to teach these skills correctly and safely. In this context, AI-supported education systems stand out as an effective tool for teaching injection skills. Artificial intelligence-based chatbots provide students with both theoretical knowledge and practical guidance. For example, before injecting a muscle group, a student can learn about the anatomy of the muscle, determine the correct angle, and remember precautions against potential complications through the chatbot. Artificial intelligence also reinforces the learning process by instantly answering students' questions, preventing the acquisition of incorrect information. Recent studies emphasize that AI-supported learning tools positively influence students' attitudes toward learning, increasing their motivation and academic satisfaction levels. Accordingly, the integration of AI-based technologies in the process of training future nurses is no longer an option but a necessity. Particularly in complex and delicate skills such as intramuscular and subcutaneous injections, AI-supported chatbots can facilitate student learning, increase skill accuracy, and support clinical safety. Therefore, it is crucial for nursing education programs to combine artificial intelligence technologies with pedagogical foundations to provide student-centered, safe, and effective learning environments.

Conditions

AI Chatbot; Nursing Education; AI (Artificial Intelligence); Nursing Skills; IM Injection; OSCE (Objective Structured Clinical Examination); Clinical Reasoning

Outcome Measures

Primary Outcomes (5)

• Objective Structured Clinical Examination score

  The exam will be administered for psychomotor skill assessment. The Objective Structured Clinical Examination, an approach used to evaluate clinical skill performance, is a valid strategy used to assess students' readiness to perform the expected practices and skills at the required level during clinical practice. In this study, students will undergo one Objective Structured Clinical Examination each for subcutaneous and intramuscular injection ("Intramuscular Injection into the Ventrogluteal Region" and "Subcutaneous Injection into the Upper Arm Region"). Each application will be worth 50 points (Min.=0, Max.=50). Students will be considered successful if they receive a total score of 60 or above from the two procedures. Students will be considered insuccessful if they receive a total score of 40 or under from the two procedures.

  A week after IM and SC injections training in control group; a week and a month after IM and SC training in study group

• Clinically Oriented Reasoning Exam score

  The exam will be administered to assess clinical reasoning skills. This assessment method, designed to evaluate clinical reasoning and decision-making, is called the "Clinically Oriented Reasoning Exam." Clinically Oriented Reasoning Exam consists of scenarios based on problems that students may encounter in real clinical settings. Clinically Oriented Reason is an exam administered in stations containing written scenarios. The exam begins at the first station with the description of a clinically oriented written problem. The student is presented with alternative options to follow regarding this described problem. The student is asked to carefully examine the details and evaluate each of these options separately to reach a conclusion regarding their accuracy. The student has the right to choose more than one option at a station. Students can take scores Min.=0 and Max.=50. Total score of 50 is good in terms of clinically oriented reasoning of students.

  A week after IM and SC injections training in control group; a week and a month after IM and SC training in study group

• Subcutaneous and Intramuscular Injection Theoretical Knowledge Pre-Test

  The test, prepared with reference to the literature, consists of a total of 10 questions on subcutaneous (5 questions) and intramuscular (5 questions) injection techniques. Each question is worth 10 points, and students who score 60 points or above on the test will be considered successful. Expert opinions will be obtained from a total of 5 experts in the field of Nursing Fundamentals to ensure the suitability of the knowledge test.

  Before IM and SC injections training in control and study groups.

• Subcutaneous and Intramuscular Injection Theoretical Knowledge Post-Test

  The test, prepared with reference to the literature, consists of a total of 10 questions on subcutaneous (5 questions) and intramuscular (5 questions) injection techniques. Each question is worth 10 points, and students who score 60 points or above on the test will be considered successful. Expert opinions will be obtained from a total of 5 experts in the field of Nursing Fundamentals to ensure the suitability of the knowledge test.

  A week after IM and SC injections training in control and study groups; a month after IM and SC training in only study group.

• Productive Artificial Intelligence Usage and Competence Scale Score

  The scale consists of two factors and 19 items. The first factor measures Artificial Intelligence Usage Competence and includes items 1-2-3-4-5-6-7-8-9-10. The second factor measures Artificial Intelligence-Supported Learning Motivation and includes items 11-12-13-14-15-16-17-18-19. Items 7-17 and 18 on the scale are reverse-coded. The scale is a five-point Likert scale, and responses are scored as follows: 1-does not reflect at all, 2-reflects a little, 3-reflects moderately, 4-reflects a lot, 5-reflects completely. Scores obtained from the scale are interpreted as follows: 19-34 Very low level of AI use and proficiency, 35-49 Low level of AI use and proficiency, 50-64 Moderate level of AI use and proficiency, 65-79 High level of AI use and proficiency, and 80 - 95 Very high level of artificial intelligence use and proficiency. The Cronbach Alpha reliability coefficient of the scale is 0.83.

  A month after IM and SC injections training in only study group.

Study Arms (2)

Rutine IM and SC injections training

NO INTERVENTION

Students in the control group will be evaluated using the "Student Introduction Form," "Subcutaneous and Intramuscular Injection Theoretical Knowledge Test (pre-test - post-test)," "Subcutaneous and Intramuscular Injection Skill Assessment Form-OSCE," CORE score, and OSCE score. Before theoretical training, students will be given the "Student Introduction Form" and the "Subcutaneous and Intramuscular Injection Theoretical Knowledge Test (pre-test)". This will be followed by theoretical training (on Thursday) and laboratory training (on Friday). One week after these trainings, students will take the "Subcutaneous and Intramuscular Injection Theoretical Knowledge Test (post-test)", CORE, and OSCE. The scores obtained from these exams will not be reflected in the students' Overall Grade Point Average.

Intervention

EXPERIMENTAL

Device: Training of IM and SC injection skills via Chatbot

Interventions

Training of IM and SC injection skills via Chatbot DEVICE

The chatbot software to be used in this study will operate through the API service of ChatGPT, a generative artificial intelligence language model developed by OpenAI. The chatbot will be designed to support nursing students' theoretical knowledge, reasoning, and practical skills in intramuscular and subcutaneous injection training. The chatbot will be specifically fed with scientific content, teaching materials, and documents provided by faculty members related to injection practices; consistent, educational, and structured interaction with users will be provided through a specially developed behavioral prompt based on this content. Thus, the chatbot will function not only as a system providing general information but also as a customized guide tailored to the educational objectives defined within the scope of the study. The software will be accessible at least twice a week during the training period, able to answer questions frequently encountered by students.

Intervention

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Being a first-year nursing student,
• Taking the Fundamentals of Nursing-I course for the first time,
• Encountering the topic of intramuscular and subcutaneous injections for the first time,
• Agreeing to participate in the research voluntarily and willingly,
• Having a smart device and internet access to use the chatbot application regularly,
• Committing to participate in the research process at least 80% of the time (ensuring at least 2 uses per week for 4 weeks)

You may not qualify if:

• Having previously taken the Fundamentals of Nursing-I course or having received formal training in injection techniques
• Being unable to participate in theoretical or practical training during the research process
• Being unable to continue interactions with the chatbot for technical reasons
• Incomplete research data or being unable to complete the pre-test/post-test process .

Sponsors & Collaborators

• Akdeniz University: lead

Study Sites (1)

Akdeniz University

Antalya, 07070, Turkey (Türkiye)

Location

Central Study Contacts

Banu Terzi, Assoc. Prof.

CONTACT

+90 532 776 82 34; copurbanu@hotmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assoc. Prof.

Study Record Dates

• First Submitted: September 29, 2025
• First Posted: November 28, 2025
• Study Start: December 15, 2025
• Primary Completion: March 15, 2026
• Study Completion (Estimated): October 15, 2026
• Last Updated: December 3, 2025

Record last verified: 2025-11

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)