Related Experiment Video
Updated: Jul 11, 2025

Setup and Execution of the Rapid Cycle Deliberate Practice Death Notification Curriculum
Published on: August 5, 2020
Crossover design in triage education: the effectiveness of simulated interactive vs. routine training on student
Mohsen Masoumian Hosseini1,2, Seyedeh Toktam Masoumian Hosseini3,4, Karim Qayumi5
1Department of E-learning in Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran.
Introduction:
This study investigates the effectiveness of incorporating simulated interactive guidelines in nursing students' performance during disaster situations, compared to routine training.
Method:
This study was a crossover design with pre-and post-tests for two groups. Each group consisted of 60 students selected using the census method. SIG and routine (Face-to-Face) training sessions were conducted as a crossover design. Triage knowledge questionnaires were used in the pretest to assess triage knowledge. An OSCE test was administered in the posttest to assess student performance, followed by a triage skills questionnaire. Both questionnaires were highly reliable, as indicated by Cronbach's alpha coefficients (0.9 and 0.95, respectively). Statistical analysis was performed using SPSS version 26 software at a significance level 0.05.
Result:
The chi-square test showed that the two groups were homogeneous regarding age. Regarding knowledge level, both groups were homogeneous before the intervention (P = 0.99). Nevertheless, the results of the OSCE test showed that the students in Group A had a higher level of skill than the students in Group B (93% versus 70%). Also, 18% of the students in group B had low skills.
Discussion:
The study found that student outcomes improved in both groups receiving SIG, suggesting that interaction and simulation improve learning. However, gamification is an ideal precursor to learning and not a substitute for education. Therefore, gamification should not be used as a stand-alone teaching method.
Conclusions:
The crossover study found that simulators and games should not be considered stand-alone teaching methods but can contribute to learning sustainability when used alongside instruction.
Related Concept Videos
Crossover Experiments
Crossover designs are performed even with smaller sample sizes since the samples can act as their controls. These are better than simple randomized trials since patients are exposed to all the treatments.
Nursing Process for Patient and Caregiver Teaching II: Planning and Implementation
Current Trends in Nursing II

