Effectiveness of a mixed reality simulation program for dyspnoea care on new nurses’ clinical competency: A mixed-methods study

Abstract

Aims

This study developed and evaluated a mixed reality (MR) simulation program for dyspnoea care (D-MRSim) to enhance new nurses’ competency.

Background

Managing dyspnoea requires advanced skills, which many new nurses lack. Innovative training, such as MR simulation, may bridge this gap.

Design

This study used a mixed-methods design combining a randomized controlled trial and focus group interviews (FGIs).

Methods

A total of 59 new nurses at a university hospital in South Korea participated, with random assignment to the experimental (n = 30) or control group (n = 29). The experimental group received D-MRSim (three 2-hour sessions over 6 weeks), while controls received equivalent traditional training. D-MRSim, developed using the ADDIE (Analysis, Design, Development, Implementation, Evaluation) model, was evaluated through surveys, performance assessments and FGIs.

Results

The experimental group demonstrated significant improvements over time in confidence (χ² = 82.27, p < 0.001), problem-solving ability (χ² = 23.06, p < 0.001) and knowledge (χ² = 33.34, p < 0.001). The experimental group showed significantly greater knowledge (F = 10.17, p = 0.002) and higher clinical performance both immediately (Z = -6.12, p < 0.001) and 3 months after the program (Z = -5.55, p < 0.001). FGIs identified four themes: (1) Realistic learning environment, (2) Effective learning approach, (3) Clinical competency enhancement and (4) Limitations and need for improvement.

Conclusions

D-MRSim effectively enhanced new nurses' clinical competency by providing an immersive learning environment with repeated practice opportunities, serving as a valuable educational tool for improving clinical skills and adaptability.