Using 360-Degree Interactive Video for Bleeding First Aid in Nursing Education: Effects on Knowledge, Self-Efficacy, and Learning Experience

360 Derece Etkileşimli Video Teknolojisinin Hemşirelik Eğitiminde Kullanımı: Bir Karma Yöntem Araştırması

The goal of this clinical trial is to learn if a 360-degree interactive virtual reality (VR) video simulation works to improve first aid knowledge, knowledge retention, and self-efficacy in stopping severe bleeding among first-year undergraduate nursing students. The main questions the study aims to answer are:

• Does experiencing the interactive VR video simulation increase students' knowledge of bleeding first aid?
• Does the VR video simulation increase students' long-term retention of first aid knowledge?
• Does the VR video simulation improve students' self-efficacy in bleeding first aid? Researchers compared four groups using a Solomon four-group design to evaluate the effectiveness of the VR simulation, while also testing whether taking a pre-test affected the final outcomes.

Participants:

• Completed an introductory survey and possibly a baseline test measuring first aid knowledge and self-efficacy.
• Attended a 1-hour standard classroom lecture about first aid for bleeding.
• (Intervention groups only) Completed a 5-minute interactive 360-degree video simulation of a severe bleeding emergency using an Oculus Quest 2 VR headset, which required answering 7 clinical decision-making questions.
• Completed follow-up tests 4 weeks and 8 weeks after the training to measure their bleeding first aid knowledge and self-efficacy.

Study Overview

• Status: Completed
• Conditions: Hemorrhage; Nursing Education; Virtual Reality; First Aid; Self Efficacy
• Intervention / Treatment: Other: 360-degree VR video simulation

• Study Type: Interventional
• Enrollment (Actual): 152
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Izmir, Turkey (Türkiye)
    • Ege University Faculty of Nursing

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Being a volunteer participant
• Being a first-year nursing student enrolled at Ege University Faculty of Nursing during the 2021-2022 academic year.
• Having successfully completed the "First Aid Module" (First Aid Course) within the current curriculum

Exclusion Criteria:

• Having any pre-existing health or visual conditions that prevent the safe use of virtual reality (VR) equipment (such as active epilepsy, severe uncorrected visual impairment, or pre-existing psychiatric disorders).
• Requesting to withdraw from the study or refusing to participate at any stage of the research

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Intervention Group 1 (Pre-tested); Receives the pre-test, standard classroom instruction (lecture), the 360-degree VR video simulation, the post-test, and the retention test	Other: 360-degree VR video simulation; A 5-minute interactive 360-degree video simulation of a severe bleeding emergency using an Oculus Quest 2 VR headset, which requires answering 7 clinical decision-making questions
Experimental: Intervention Group 2 (Unpre-tested); Receives standard classroom instruction, the 360-degree VR video simulation, the post-test, and the retention test	Other: 360-degree VR video simulation; A 5-minute interactive 360-degree video simulation of a severe bleeding emergency using an Oculus Quest 2 VR headset, which requires answering 7 clinical decision-making questions
No Intervention: Control Group 1 (Pre-tested); Receives the pre-test, standard classroom instruction, the post-test, and the retention test
No Intervention: Control Group 2 (Unpre-tested); Receives standard classroom instruction, the post-test, and the retention test

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Bleeding First Aid Knowledge	Assessed using the "First Aid for Bleeding Knowledge Test" developed and validated by the researchers. This is a 20-item multiple-choice test designed to measure cognitive learning. Correct answers are scored as 1 and incorrect answers as 0. The total score ranges from 0 to 20, with higher scores indicating higher levels of bleeding first aid knowledge.	Baseline (Pre-test), 4 weeks post-intervention (Post-test), and 8 weeks post-intervention (Retention test)
Bleeding First Aid Self-Efficacy	Assessed using the "First Aid for Bleeding Self-Efficacy Scale" developed and validated by the researchers. This is a 19-item, five-point Likert-type scale (ranging from 1=completely insufficient to 5=completely sufficient) that measures students' perceived competence in managing bleeding situations. The total score ranges from 19 to 95, with higher scores reflecting greater clinical self-efficacy.	Baseline (Pre-test) and 4 weeks post-intervention (Post-test)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Perception of Simulation Design	Assessed using the 20-item Simulation Design Scale (adapted into Turkish by Unver et al., 2017) only for the intervention groups. The scale evaluates five key elements of simulation design: objectives/information, student support, problem-solving, guided reflection/feedback, and fidelity. Items are rated on a five-point Likert scale (1=strongly disagree to 5=strongly agree). The overall score ranges from 20 to 100, where higher scores reflect a stronger presence of effective simulation design components.	Immediately after the virtual reality simulation session
Student Satisfaction and Self-Confidence in Learning	Assessed using the 12-item Student Satisfaction and Self-Confidence in Learning Scale (adapted into Turkish by Unver et al., 2017). It includes two subscales: satisfaction with current learning (5 items) and self-confidence in learning (7 items). Items are rated on a five-point Likert scale (1=strongly disagree to 5=strongly agree). The total score ranges from 12 to 60, with higher scores indicating greater learning satisfaction and self-confidence.	Immediately after the virtual reality simulation session
Video Engagement and Immersion	Assessed using the 15-item Video Engagement Scale (adapted into Turkish by Deryakulu et al., 2019) to measure the student's emotional and cognitive immersion. It consists of five subscales (attention, going into a narrative world, identity, empathy, and emotion) rated on a seven-point Likert scale (1=strongly disagree to 7=strongly agree). The total score ranges from 15 to 105, with higher scores indicating stronger engagement with the VR environment.	Immediately after the virtual reality simulation session
Occurrence of Cybersickness / Simulation Side Effects	Assessed using a structured Researcher Observation Form to track any simulator-related physical discomfort (such as dizziness, nausea, headache, or neck pain) experienced by participants during or immediately after the VR headset experience. Side effects are recorded categorically as present/absent and graded by severity (none, mild, moderate).	During and up to 15 minutes immediately following the virtual reality experience

Collaborators and Investigators

• Sponsor: Manisa Celal Bayar University
• Collaborators: Aliye Üster Foundation

Study record dates

Study Major Dates

• Study Start (Actual): May 10, 2022
• Primary Completion (Actual): August 2, 2022
• Study Completion (Actual): August 2, 2022

Study Registration Dates

• First Submitted: August 16, 2026
• First Submitted That Met QC Criteria: August 16, 2026
• First Posted (Actual): August 19, 2026

Study Record Updates

• Last Update Posted (Actual): August 21, 2026
• Last Update Submitted That Met QC Criteria: August 19, 2026
• Last Verified: August 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Pathological Conditions, Signs and Symptoms; Hemorrhage
• Other Study ID Numbers: EGE-2021-11/04-1081

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

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