Improving the psychomotor performance of student nurses using remote clinical skills practice: a mixed-methods study

Innovative approaches are essential in nursing education to ensure the continuity of skill acquisition, particularly in situations where traditional face-to-face teaching methods are not feasible.

This study aimed to evaluate the effectiveness of remote learning in enabling student nurses to acquire psychomotor skills, with a focus on 'blood pressure measurement'-a noninvasive procedure that can be practiced safely at home.

Using an experimental design with group randomization and a mixed-method approach, 44 first-year nursing students participated, with 22 in the experimental group and 22 in the control group. After a theoretical course on blood pressure measurement, the control group followed a licensed video program, while the experimental group practiced with a simulated patient under an educator's guidance in an remote environment. The research was conducted between March 2021 and October 2021, encompassing all phases of the study. These phases included preliminary information, remote training, and feedback sessions in March 2021, the first assessment in April 2021, and the second assessment in October 2021. The 'Descriptive Characteristics Form,' 'Blood Pressure Measurement Skill Checklist,' and 'We Practice Remote Clinical Skills Together Online Comments Form' were used for data collection. Descriptive statistics (means, standard deviations, frequencies, percentages) and the Mann-Whitney U test were applied for quantitative data analysis, while qualitative data were analyzed inductively based on student opinions from both groups.

The first performance assessment showed no significant difference between the control and experimental groups' mean scores (p = 0.440). However, the second assessment revealed a significant difference favoring the experimental group (p = 0.001). The qualitative data were categorised into three main themes: emotions, learning and confidence, with a total of 34 codes. Emotions accounted for 50% of the codes, including happiness, stress, comfort and anxiety. Learning accounted for 41% and included awareness, interaction-communication, skill acquisition and information retention. Finally, self-confidence, represented by skill practice in the laboratory, accounted for 9% of the codes.

This study demonstrates that educator-guided remote skill training can positively impact students' psychomotor skill acquisition. It highlights the potential for effectively teaching specific nursing skills in remote environments when guided by an educator.