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Published on: June 23, 2023
Effects of a self-determination theory-based mixed reality pressure injury nursing simulation program: A
1Department of Nursing, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, Republic of Korea; College of Nursing, Chonnam National University, 160, Baekseo-ro, Dong-gu, Gwangju, Republic of Korea.
Background:
Pressure injuries (PIs) remain a critical patient safety concern. This study integrates self-determination theory as a design framework for a mixed reality (MR)-based nursing simulation.
Objective:
To compare an SDT-based MR pressure injury nursing simulation (MR-PINS) with case-based education on nurses' competencies and explore their learning experiences.
Design:
A mixed-methods study using a non-equivalent control group pretest-posttest design due to convenience sampling and qualitative focus group interviews (FGIs).
Methods:
73 nurses were allocated to intervention (n = 37) and control (n = 36) groups. The intervention group received the MR-PINS program and the control group received case-based education. Outcomes were measured pre- and post-intervention; clinical performance by trained raters using a manikin-based simulation and qualitative data from 22 intervention participants using inductive content analysis.
Results:
Knowledge improved significantly in both groups (Z = -12.16, p < 0.001; Z = -11.68, p < 0.001). Post-test confidence was higher in the intervention group (t = 2.54, p = 0.013, ES = 0.59). Clinical performance was also higher in the intervention group (Z = -2.29, p = 0.022, ES = 0.63). Clinical reasoning improved in both groups (t = -10.33, p < 0.001, ES = 1.41), with no significant between-group difference after covariate adjustment. Qualitative findings indicated enhanced realism, skill mastery and engagement, alongside technical and ergonomic challenges.
Conclusions:
The MR-PINS supported competence development, motivation and practice readiness in PI nursing. The MR-PINS grounded in SDT may be a valuable addition to nursing curricula for fostering clinical skills and intrinsic motivation.
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