[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-study-detail:100659293":3},{"organization":4,"outcomesModule":7,"designInfo":35,"detailedDescription":45,"studyPopulation":34,"armGroups":46,"interventions":59,"overallOfficials":67,"centralContacts":71,"locations":77,"responsibleParty":93,"collaborators":34,"id":95,"slug":96,"hasResults":97,"nctId":98,"briefTitle":99,"officialTitle":100,"acronym":34,"eligibilityCriteria":101,"healthyVolunteers":102,"sex":103,"minAge":34,"maxAge":34,"enrollmentInfo":104,"targetDuration":34,"studyType":107,"phases":108,"briefSummary":110,"conditions":111,"keywords":113,"overallStatus":119,"whyStopped":34,"lastUpdateSubmitDate":120,"lastUpdatePostDateStruct":121,"startDateStruct":124,"completionDateStruct":126,"leadSponsor":128,"locationsCount":129},{"fullName":5,"class":6},"Taoyuan General Hospital","OTHER_GOV",{"primaryOutcomes":8,"secondaryOutcomes":17,"otherOutcomes":34},[9,13],{"measure":10,"description":11,"timeFrame":12},"Advanced Cardiac Life Support Knowledge","Advanced Cardiac Life Support (ACLS) knowledge will be assessed using researcher-developed 20-item single-choice tests. The baseline knowledge test assesses fundamental ACLS knowledge, including cardiopulmonary resuscitation procedures, electrocardiogram rhythm recognition, defibrillation, and emergency medications. The post-intervention knowledge test includes ACLS knowledge as well as clinical scenario-based questions assessing rhythm recognition, emergency response procedures, medication selection and use, team communication, and clinical decision-making. Each correct response receives 1 point, while an incorrect or unanswered item receives 0 points, resulting in a total score ranging from 0 to 20. Higher scores indicate greater ACLS knowledge. The same post-intervention knowledge test will be used at the one-month follow-up.","Baseline, immediately after the intervention, and 1 month after the intervention",{"measure":14,"description":15,"timeFrame":16},"Advanced Cardiac Life Support Skills","Advanced Cardiac Life Support (ACLS) skills will be assessed using a researcher-developed 20-item structured skills performance checklist. The checklist evaluates the correct performance of ACLS procedures, including endotracheal intubation assistance, electrocardiogram rhythm recognition, defibrillation, cardiopulmonary resuscitation, and emergency medication-related assessment, decision-making, and technical performance. Each correctly performed item receives 1 point, while each incorrectly performed or omitted item receives 0 points, resulting in a total score ranging from 0 to 20. Higher scores indicate better ACLS skills performance.","Post-intervention skills assessment and 1 month after the post-intervention skills assessment",[18,21,24,28,31],{"measure":19,"description":20,"timeFrame":12},"Resuscitation Self-Efficacy","Resuscitation self-efficacy will be assessed using the 17-item Resuscitation Self-Efficacy Scale developed by Roh et al. (2012). The scale includes four domains: recognition, debriefing and recording, responding and rescuing, and reporting. Each item is rated on a 5-point Likert scale from 1 to 5, resulting in a total score ranging from 17 to 85. Higher total scores indicate greater resuscitation self-efficacy.",{"measure":22,"description":23,"timeFrame":12},"Critical Reflection Competency","Critical reflection competency will be assessed using the 19-item Critical Reflection Competency Scale developed by Shin et al. (2022). Each item is rated on a 5-point Likert scale from 1 to 5, resulting in a total score ranging from 19 to 95. Higher total scores indicate greater critical reflection competency.",{"measure":25,"description":26,"timeFrame":27},"Intrinsic Cognitive Load","3 items from the 10-item Cognitive Load Scale","Immediately after the intervention",{"measure":29,"description":30,"timeFrame":27},"Extraneous Cognitive Load","3 items from the same 10-item Cognitive Load Scale",{"measure":32,"description":33,"timeFrame":27},"Germane Cognitive Load","4 items from the same 10-item Cognitive Load Scale",null,{"allocation":36,"interventionModel":37,"interventionModelDescription":38,"primaryPurpose":39,"observationalModel":34,"timePerspective":34,"maskingInfo":40},"RANDOMIZED","PARALLEL","Participants will be randomly assigned in a 1:1 ratio to either the two-tier test-based virtual reality instruction group or the traditional interactive virtual reality instruction group using computer-generated block randomization.","OTHER",{"masking":41,"maskingDescription":42,"whoMasked":43},"SINGLE","The assessor conducting the ACLS skills assessments will be blinded to participants' group assignments.",[44],"OUTCOMES_ASSESSOR","This study is a two-group randomized controlled trial designed to evaluate the effectiveness of two-tier test-based virtual reality (VR) instruction for Advanced Cardiac Life Support (ACLS) education among clinical nurses. A total of 100 clinical nurses will be randomly assigned in a 1:1 ratio to either the experimental group or the control group using computer-generated block randomization.\n\nBoth groups will receive tablet-based, non-immersive VR instruction using the same ACLS clinical scenario, learning content, equipment, and intervention duration. The VR scenario simulates the emergency management of a hospitalized patient and incorporates ACLS-related knowledge, clinical decision-making, and interactive questions with immediate feedback.\n\nIn the experimental group, participants will receive two-tier test-based VR instruction. Each embedded question consists of two levels: the first tier assesses ACLS knowledge or clinical decisions, and the second tier assesses the reasoning underlying the first-tier response. Both tiers use single-choice questions, and the system provides immediate feedback based on participants' responses. In the control group, participants will receive traditional interactive VR instruction using the same first-tier ACLS questions and immediate feedback but without the second-tier reasoning questions.\n\nThe study includes three assessment periods. Before the intervention, participants will complete assessments of ACLS knowledge, resuscitation self-efficacy, and critical reflection ability, along with demographic information. Immediately after the VR intervention, participants will complete assessments of ACLS knowledge, resuscitation self-efficacy, critical reflection ability, and cognitive load. Cognitive load will be assessed only after the intervention.\n\nACLS skills will be evaluated using a one-to-one, integrated simulation scenario rather than a multi-station assessment. Participants will be required to perform patient assessment, emergency response activation, cardiopulmonary resuscitation, ventilation, rhythm recognition, defibrillation, medication administration, and advanced airway management. A trained assessor will evaluate performance using a standardized scenario script and structured skills checklist without providing additional prompts or correctness feedback. To maintain consistency in assessment conditions, participants will undergo the post-intervention ACLS skills assessment on a scheduled assessment day after completion of the intervention phase, and the follow-up ACLS skills assessment will be conducted approximately one month later under the same standardized conditions.\n\nAt the one-month follow-up, ACLS knowledge, ACLS skills, resuscitation self-efficacy, and critical reflection ability will be reassessed to evaluate changes and retention of learning outcomes over time.",[47,53],{"label":48,"type":49,"description":50,"interventionNames":51},"Two-Tier Test-Based Virtual Reality Instruction","EXPERIMENTAL","Participants in this arm will receive tablet-based, non-immersive virtual reality (VR) instruction using a simulated Advanced Cardiac Life Support (ACLS) clinical scenario. The VR instruction incorporates two-tier test questions. The first tier consists of single-choice questions assessing ACLS knowledge and clinical decision-making, while the second tier consists of single-choice questions assessing the reasoning underlying the first-tier responses. The system provides immediate feedback based on participants' responses. The VR instruction will last approximately 20-25 minutes.",[52],"Behavioral: Two-Tier Test-Based Virtual Reality Instruction",{"label":54,"type":55,"description":56,"interventionNames":57},"Traditional Interactive Virtual Reality Instruction","ACTIVE_COMPARATOR","Participants in this arm will receive tablet-based, non-immersive virtual reality (VR) instruction using the same simulated Advanced Cardiac Life Support (ACLS) clinical scenario, learning content, equipment, and intervention duration as the experimental group. The VR instruction incorporates single-tier, single-choice questions assessing ACLS knowledge and clinical decision-making. The system provides immediate feedback after participants respond. Unlike the experimental group, this arm does not include second-tier questions assessing the reasoning underlying the first-tier responses. The VR instruction will last approximately 20-25 minutes.",[58],"Behavioral: Traditional Interactive Virtual Reality Instruction",[60,64],{"type":61,"name":48,"description":62,"armGroupLabels":63,"otherNames":34},"BEHAVIORAL","Participants will receive a single session of tablet-based, non-immersive virtual reality (VR) instruction lasting approximately 20-25 minutes. The VR program presents a simulated Advanced Cardiac Life Support (ACLS) scenario involving the emergency management of a hospitalized patient.\n\nInteractive two-tier test questions are embedded within the VR scenario. The first tier consists of single-choice questions assessing ACLS knowledge and clinical decision-making, and the second tier consists of single-choice questions assessing the reasoning underlying the first-tier responses. After participants respond, the system provides immediate feedback to support learning and reflection.\n\nThe experimental and comparator interventions use the same tablet equipment, VR scenario, first-tier questions, core ACLS learning content, and intervention duration. The distinguishing feature of this intervention is the addition of second-tier reasoning questions.",[48],{"type":61,"name":54,"description":65,"armGroupLabels":66,"otherNames":34},"Participants will receive a single session of tablet-based, non-immersive virtual reality (VR) instruction lasting approximately 20-25 minutes. The VR program presents a simulated Advanced Cardiac Life Support (ACLS) scenario involving the emergency management of a hospitalized patient.\n\nSingle-tier, single-choice questions assessing ACLS knowledge and clinical decision-making are embedded within the VR scenario. After participants respond to each question, the system provides immediate feedback.\n\nThe comparator and experimental interventions use the same tablet equipment, VR scenario, first-tier questions, core ACLS learning content, and intervention duration. The distinguishing feature of this intervention is that it does not include the second-tier reasoning questions used in the experimental intervention.",[54],[68],{"name":69,"affiliation":5,"role":70},"CHENG-WEI CHEN, BSN","PRINCIPAL_INVESTIGATOR",[72],{"name":73,"role":74,"phone":75,"phoneExt":34,"email":76},"Cheng-Wei Chen, BSN","CONTACT","+886-972-608-263","g462113003@tmu.edu.tw",[78],{"facility":79,"status":34,"city":80,"state":34,"zip":81,"country":82,"countryCode":83,"cosmosGeoPoint":84,"geoPoint":89,"contacts":90},"Taoyuan General Hospital, Ministry of Health and Welfare","Taoyuan","33004","Taiwan","TW",{"type":85,"coordinates":86},"Point",[87,88],121.29696,24.99368,{"lat":88,"lon":87},[91,92],{"name":73,"role":74,"phone":75,"phoneExt":34,"email":76},{"name":69,"role":70,"phone":34,"phoneExt":34,"email":34},{"type":94,"investigatorFullName":34,"investigatorTitle":34,"investigatorAffiliation":34,"oldNameTitle":34,"oldOrganization":34},"SPONSOR","100659293","effects-of-two-tier-test-based-virtual-reality-instruction-on-acls-outcomes-among-clinical-nurses-100659293",false,"NCT07862322","Effects of Two-Tier Test-Based Virtual Reality Instruction on ACLS Outcomes Among Clinical Nurses","The Effects of Two-tier Test-based Virtual Reality Teaching on ACLS Knowledge and Resuscitation Self-efficacy Among Clinical Nurses","Inclusion Criteria:\n\n1. Clinical nurses holding a valid nurse or registered nurse license.\n2. Clinical nurses who have completed the hospital's emergency and resuscitation training courses.\n\nExclusion Criteria:\n\n1. Newly employed nurses within the first 3 months of employment.\n2. Instructors for the hospital's resuscitation training courses.",true,"ALL",{"count":105,"type":106},100,"ESTIMATED","INTERVENTIONAL",[109],"NA","This study aims to evaluate the effects of two-tier test-based virtual reality (VR) instruction on Advanced Cardiac Life Support (ACLS) learning outcomes among clinical nurses. Participants will be randomly assigned to either a two-tier test-based VR instruction group or a traditional interactive VR instruction group. Both groups will use tablet-based, non-immersive VR to learn and practice ACLS-related clinical scenarios.\n\nThe study will assess ACLS knowledge, ACLS skills, resuscitation self-efficacy, critical reflection ability, and cognitive load. Assessments will be conducted before and after the intervention, with follow-up assessments conducted one month later to evaluate the retention of learning outcomes.",[112],"Advanced Cardiac Life Support Education",[114,115,116,117,118],"Advanced Cardiac Life Support","Virtual Reality","Two-Tier Test","Nursing Education","Clinical Nurses","NOT_YET_RECRUITING","2026-10-01",{"date":122,"type":123},"2026-10-07","ACTUAL",{"date":125,"type":106},"2026-10",{"date":127,"type":106},"2027-05",{"name":5,"class":6},1]