This study aims to evaluate and compare the effects of using standardized patients versus static manikins in nursing education for arterial blood pressure monitoring and stabilization training. The primary objective is to investigate the impact of these two different simulation methods on students' cognitive load, clinical skills, and self-efficacy levels.
Arterial pressure monitoring is a critical, invasive intervention commonly performed in intensive care units and operating rooms, requiring a high degree of precision. While traditional technical skill assessments usually focus solely on procedural success scores or completion speed, this study utilizes the framework of Cognitive Load Theory to examine the mental toll (intrinsic, extrinsic, and germane load) and psychological readiness (self-efficacy) experienced by nursing students during the procedure.
The study will be conducted as a randomized controlled experimental trial with 3rd-year nursing students who have successfully completed their Medical-Surgical Nursing course. Participants will be randomly assigned to either the experimental group or the control group:
The Experimental Group will receive theoretical and practical training, followed by performing the arterial pressure monitoring line stabilization on a "Standardized Patient" (an experienced healthcare professional acting a scenario with a moving limb to mimic real clinical chaos without any actual invasive intervention).
The Control Group will receive the same training but will perform the stabilization procedure on a traditional static medical manikin.
Data will be collected using a Descriptive Information and Performance Recording Form (to measure procedural time and error rates), the Cognitive Load Scale, and the Self-Efficacy Scale for Clinical Skills. Measurements will be taken at baseline (pre-test) and immediately after the intervention (post-test). The findings of this study are expected to provide evidence-based guidance for developing "mind-friendly" nursing curricula and safer, more realistic simulation protocols that enhance student self-efficacy while ensuring patient safety before entering actual clinical environments.
Being a undergraduate nursing student currently enrolled in the specified nursing department/faculty.
Volunteering to participate in the study and providing written informed consent.
Taking the relevant clinical nursing course for the first time.
Having successfully completed the baseline theoretical lectures related to vital signs and basic invasive procedures.
Having prior formal clinical experience or advanced training regarding invasive arterial blood pressure monitoring or line stabilization.
Having a known physical or visual impairment that would prevent the participant from performing psychomotor simulation tasks.
Repeating the academic year or the clinical course due to prior failure. --Withdrawing from the study voluntarily or failing to attend the mandatory 45-minute baseline theoretical training session.
Parallel
Arterial Pressure Monitoring Training
BehavioralThis behavioural intervention consists of an advanced simulation session following standard theoretical and practical training.
Cognitive Load Level
Assessed using a standardized Cognitive Load Scale (or Cognitive Load Questionnaire). This scale measures the mental effort and cognitive burden experienced by students during the arterial pressure monitoring stabilization procedure. The total score ranges from a minimum score to a maximum score \[10 to 100\]. Higher scores indicate a higher level of cognitive load and mental fatigue during the clinical task.
Clinical Self-Efficacy Level
Assessed using a standardized Clinical Self-Efficacy Scale to measure nursing students' self-confidence and perceived competence regarding invasive arterial blood pressure monitoring and line stabilization. The total score ranges from a minimum score to a maximum score \[5 to 25\]. Higher scores indicate greater self-efficacy and clinical confidence.
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