Effects of Developing a Mobile-based Interactive Simulation Scheme for Assisting the Personalized Hands-on Learning of Nasogastric Tube Insertion: a randomized controlled trial (Preprint)

Abstract

Nasogastric tube (NG) insertion is one of the essential clinical skills. Unfortunately, it’s a blind procedure, as one cannot directly visualize the tip of the NG during the insertion process. Thus, the most significant risk was malposition. Suppose blind insertion can be broken through in teaching strategies so that learners can see through the internal structure of the human body when performing technology. In that case, students can have better memory and comprehension and simultaneously provide real-time feedback, both of which are conducive to conceptualizing invasive surgical execution.

A mobile-based interactive simulation scheme (MISS) was proposed, and a MISS-based learning system was developed to investigate its effects on facilitating hands-on learning of nasogastric tube (NG) insertion in Taiwanese undergraduate medical students.

A randomized controlled trial (RCT) design was adopted for this research, for which 73 grade-five medical students were recruited. An interactive simulation scheme with a hands-on learning design in a MISS model was built on a web-based application running on mobile devices equipped with the touchscreen. Learning performance including the conceptual knowledge, self-confidence scales, and practical skills (an OSCE-based test) were evaluated to investigate the differences between experimental and control groups. The MISS-based learning system was also evaluated in terms of learning satisfaction, system usability, and task load. The statistical methods used in this work included t-test, ANCOVA, and the Johnson-Neyman analysis.

he results showed significant differences between the experimental and control groups in terms of both knowledge and self-confidence (P < .001). The levels of image, perceived enjoyment, perceived usefulness, and intention to use scales in the technology acceptance model (TAM) were higher in the high progress group than in the low progress group. Besides, the score of the OSCE test in the experimental group were higher than those in the control group, which had significant difference (t=3.079, P=.003).

The proposed MISS-based learning system can efficiently assist students in hands-on learning of nasogastric tube insertion. Accordingly, the learning outcomes and self-confidence can be significantly improved. Moreover, experimental results also show that the useful diagnostic and enjoyment features in the system enhance learners' intention toward use.