Artificial Intelligence-Based Emergency Triage Education Tool in Enhancing Clinical Critical Thinking and Triage Practice

Instructor-led Artificial Intelligence-Based Emergency Triage Education Tool in Enhancing Clinical Critical Thinking and Triage Practice: Randomized Control Trial

The study aims to develop an artificial intelligence (AI) based emergency triage education tool for providing critical thinking and questioning skills training to nursing students. It also aims to contribute valuable implications by collecting the knowledge, attitudes, and compassion aspects of nursing students toward AI-based education

The objectives of the study:

1. To evaluate the effectiveness of instructor-led and self-play pedagogy approaches in enhancing students' critical thinking by an AI-based emergency triage education tool.
2. To evaluate the effectiveness of instructor-led and self-play pedagogy approaches in enhancing students' triage skill retention by an AI-based emergency triage education tool.
3. To evaluate students' learning motivation, simulation-based experience, and usability towards AI-based technology learning.

Participants will

1. play the education tool in different pedagogy approaches
2. answer the questionnaires and receive a qualitative interview

Study Overview

• Status: Not yet recruiting
• Conditions: Nursing Teaching Pedagogy; Conversational AI Nursing Education Serious Game
• Intervention / Treatment: Behavioral: Instructor-led AI-Triage educational serious game; Behavioral: Self play AI-Triage educational serious game

• Study Type: Interventional
• Enrollment (Estimated): 350
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Chun Kit Danny Hung, MN, BN; Phone Number: 85235887917; Email: dhung@hkmu.edu.hk

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

1. Aged 18 or above;
2. Currently studying the NURS 225F of the Bachelor of Nursing (General) at Hong Kong Metropolitan University;
3. Able to use electronic devices to accomplish an online survey and participate in the AI-based emergency triage education tool

Exclusion Criteria:

• Currently working in emergency department

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Instructor-led	Behavioral: Instructor-led AI-Triage educational serious game; Participants will use the AI-triage serious game guided by the instructors.
Experimental: Self-play	Behavioral: Self play AI-Triage educational serious game; Participants will self-play the AI-Triage serious game during the class.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Triage skill retention	short-term and long-term triage skill retention based on different pedagogy approaches The checklist is based on the Hospital Authority, Hong Kong triage guidelines. There are a total of 35 items that test the triage practice's specificity, which focuses on triage questioning and assessment selection in the game scenarios. For every corrected item, 1 score will be given. Therefore the maximum value is 35, presenting the best outcome in skill specificity; the minimum value is 0, the worst outcome. Moreover, 4 items are testing the triage accuracy of decision-making and management. The maximum value is 4, presenting the best outcome in skill accuracy; the minimum value is 0, the worst outcome.	Baseline, 1 month and 1 year

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Cognitive Engagement	The cognitive engagement will be using the Situational Cognitive Engagement Measurements tools to evaluate. The tool consisted of three elements, measured by four items: (1) engagement with the task at hand, (2) effort and persistence, and (3) experience of flow or having been totally absorbed by the activity. The items were scored on a 5-point Likert scale: 1 (not true et al for me), 2 (not true for me), 3 (neutral), 4 (true for me), and 5 (very true for me). A higher total score presents a better cognitive engagement. Moreover, qualitative interviews to ask about their feeling and experiences towards cognitive engagement during the intervention.	Immediately post intervention
Critical thinking	To evaluate the effectiveness of different pedagogies on students' critical thinking, the tool of Northeastern Illinois University's Critical Thinking Rubric is used to assess. Student performance is evaluated across four proficiency levels, ranging from 'limited or no proficiency' (scored at one point) to 'high proficiency' (scored at four points). The total rubric scores for a simulated scenario ranged from 6 to 24 (Higher scores represented a better critical thinking performance). is a comprehensive tool to assess critical thinking skills in six key dimensions.	Base-line and 1 Month
Self-rated critical thinking	by different pedagogies, the tool of Short Form English version of the Critical Thinking Disposition Inventory will be used to evaluate students' self-rated critical thinking index. It includes a series of statements related to critical thinking on a Likert scale (1: strongly disagree; 5: strongly agree), The tool may cover systematic analysis (5 items), thinking within the box (8 items) and outside the box (5 items). A higher score means better self-rated critical thinking.	Baseline, 1 month
Usability	The usability will be using the System Usability Scale tools to evaluate. The tool measured 10 items. The items were scored on a 5-point Likert scale: 1 (strongly disagree) to 5 (strongly agree). A higher total score presents a better system usability. Moreover, qualitative interviews to ask about their feeling and experiences towards system usability during the intervention.	Immediately post intervention
simulation-based experience	The simulation-based experience will be using the Simulation Effectiveness Tool - Modified tools to evaluate. It is a 19-item tool that includes a 2-item pre-briefing, a 12-item scenario and a 5-item debriefing. A higher score on the tool reflects students' favourable perceptions of the simulation. Moreover, qualitative interviews to ask about their feeling and experiences towards simulation-based experience during the intervention.	Immediately post intervention

Collaborators and Investigators

• Sponsor: Hong Kong Metropolitan University

Study record dates

Study Major Dates

• Study Start (Estimated): March 6, 2025
• Primary Completion (Estimated): June 30, 2026
• Study Completion (Estimated): August 30, 2026

Study Registration Dates

• First Submitted: January 16, 2025
• First Submitted That Met QC Criteria: February 2, 2025
• First Posted (Actual): March 25, 2025

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: February 2, 2025
• Last Verified: January 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Emergencies
• Other Study ID Numbers: HE-SF2024/57

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No