This study explores how nursing students learn to insert a nasogastric tube (NGT), a common but potentially risky clinical procedure. The goal is to compare three different teaching methods:
Mixed Reality (MR) glasses with virtual instructions Video-based learning Traditional instructor-led training
The study investigates which method leads to better learning outcomes, how usable the technologies are, and how students experience MR in their learning.
Participants will be first-year nursing students with no prior experience in NGT insertion. They will be randomly assigned to one of the three training methods, complete the procedure, and answer questionnaires about their performance and experience. Six months later, they will repeat the procedure to assess long-term learning.
First-year nursing student
Performing nasogastric tube (NGT) insertion for the first time
No prior theoretical education or pre-material on NGT insertion procedure
Previous nursing education (e.g., practical nurse qualification)
Diagnosis of epilepsy
Presence of a pacemaker
Parallel
Mixed Reality NGT Training
DeviceParticipants use Meta Quest 3 mixed reality glasses with a stepwise instructional application developed in CTRL Studio. The application provides interactive virtual guidance for nasogastric tube (NGT) insertion. Students receive technical familiarization before practice. Content is standardized and identical to other groups.
Video-Based NGT Training
DeviceParticipants watch a video of the NGT insertion procedure recorded from the operator's point of view using a head-mounted, voice-controlled smart camera. The video is identical to the MR and instructor-led groups and can be replayed during practice. No verbal guidance is provided during the procedure.
Instructor-Led NGT Training
BehavioralParticipants receive classroom-based instruction including theoretical slides and a live demonstration of the NGT insertion procedure. Students practice individually on a manikin under teacher supervision. The teacher answers questions but does not provide step-by-step coaching.
NGT Checklist Performance Score
Student performance in nasogastric tube (NGT) insertion is assessed using a structured NGT checklist. Total score on the NGT checklist is 38 point. Higher scores indicate better procedural performance. The checklist evaluates both technical and non-technical procedural steps to determine clinical competence. Assessment is conducted immediately after the intervention (M1) and again six months later (M2) without instructional support. Checklist completed by a research assistant or staff member observing the student performing the NGT procedure on a manikin. The NGT checklist is based on validated tools (e.g., Kebede et al., 2024) and is designed to objectively measure students' ability to perform NGT insertion safely and correctly.
User Experience Questionnaire (UEQ)
Students complete the User Experience Questionnaire (UEQ) after performing the NGT insertion procedure. The UEQ measures six dimensions of user experience: attractiveness, perspicuity, efficiency, dependability, stimulation, and novelty. Each dimension is scored from -3 to +3, with higher scores indicating a more positive experience. The questionnaire is used to evaluate the perceived quality and usability of the Mixed Reality and Video-Based Learning environments.
System Usability Scale (SUS)
Students complete the SUS questionnaire after performing the NGT procedure. The SUS is a standardized 10-item Likert-scale tool that measures perceived usability of the Mixed Reality and Video-Based Learning environments. Scores range from 0 to 100, with higher scores indicating better perceived usability.
NASA Task Load Index (NASA TLX)
NASA Task Load Index (NASA TLX), a multidimensional workload assessment tool. Scores range from 0 to 100, with higher scores indicating greater cognitive workload Students complete the NASA TLX questionnaire to assess cognitive workload during the NGT procedure. The tool includes six dimensions: mental demand, physical demand, temporal demand, performance, effort, and frustration.
Student Reflection Texts
Students who used MR glasses submit written reflections describing their learning experience, including factors that facilitated or hindered skill acquisition.
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University of Turku
Lead sponsor
Turku University of Applied Sciences
Collaborator
