Case-Based Collaborative Learning for Arrhythmia Recognition in Novice Intensive Care Nurses
Effect of Case-Based Collaborative Learning on Arrhythmia Recognition and Patient Safety Attitudes Among Novice Intensive Care Nurses: A Randomized Controlled Trial
This randomized controlled trial evaluates the effectiveness of case-based collaborative learning (CBCL) in improving arrhythmia recognition and patient safety attitudes among novice intensive care nurses. Newly graduated nurses with less than one year of professional nursing experience working in coronary or cardiovascular surgery intensive care units are randomly assigned to an intervention or control group.
Both groups participate in the institution's routine orientation process for newly employed intensive care nurses. In addition, the intervention group receives a structured CBCL-based arrhythmia education program delivered in two 120-minute sessions over two consecutive weeks. The program uses clinical case scenarios, ECG tracings, individual assessment, small-group collaborative discussion, shared clinical decision-making, and structured feedback. The control group receives no additional study-specific arrhythmia education during the study period.
The primary outcome is arrhythmia recognition and awareness, and the secondary outcome is patient safety attitudes. Outcomes are assessed at baseline and at the three-month follow-up in both groups. An additional immediate post-intervention assessment is conducted in the intervention group to examine short-term changes following the educational program.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
Early recognition and appropriate interpretation of cardiac arrhythmias are important competencies for nurses working in intensive care settings, where changes in cardiac rhythm may require rapid clinical assessment and timely escalation of care. Novice nurses may have limited opportunities to develop these competencies through clinical experience alone. This study therefore evaluates a case-based collaborative learning (CBCL) approach designed to integrate arrhythmia recognition with clinical reasoning, nursing decision-making, and patient-safety principles.
The CBCL intervention uses clinically oriented arrhythmia scenarios accompanied by ECG tracings. Participants first assess each case individually and then work in small groups to discuss their interpretations and reach a shared clinical decision. Group conclusions are subsequently discussed with the educator, who facilitates analysis of the case, clarification of misconceptions, and structured feedback. Patient-safety principles, including recognition of hemodynamic instability, timely escalation of care, differentiation of true arrhythmias from monitoring artefacts, and assessment of the patient's clinical condition, are integrated throughout the educational activities.
The main effectiveness evaluation compares the intervention and control groups at the three-month follow-up while accounting for baseline outcome levels. An additional assessment immediately after completion of the educational program is conducted only in the intervention group to explore the immediate educational response and whether the observed improvement is maintained at three months.
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Naile Alankaya, Associate Prof. PhD
- Telefonnummer: +905334256510
- E-mail: naile.alankaya@gmail.com
Studiesteder
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Kartal
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Istanbul, Kartal, Tyrkiet (Türkiye), 17100
- Rekruttering
- Kosuyolu High Specialization Training and Research Hospital
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Kontakt:
- Huriye ARSLANER, PhD
- Telefonnummer: +905053027009
- E-mail: arslanerhuriye@hotmail.com
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
Inclusion Criteria:
- Newly graduated nurses with less than one year of professional nursing experience
- Currently working in the coronary intensive care unit or cardiovascular surgery intensive care unit
- Voluntary participation in the study
- Provision of written informed consent
Exclusion Criteria:
- Previous participation in a structured arrhythmia or ECG training program
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Andet
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
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Eksperimentel: Case-Based Collaborative Learning Group
Participants receive the institution's routine orientation for newly employed intensive care nurses in addition to a structured case-based collaborative learning (CBCL) program focused on arrhythmia recognition, ECG interpretation, clinical decision-making, and patient safety.
The CBCL program consists of two 120-minute sessions delivered over two consecutive weeks.
Each session incorporates clinical case scenarios, ECG tracings, individual assessment, small-group collaborative discussion, shared clinical decision-making, facilitator-guided analysis, and structured feedback.
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The intervention consists of two 120-minute educational sessions delivered once weekly over two consecutive weeks by a researcher with formal ECG training and certification in ECG interpretation.
Each session uses clinically oriented arrhythmia cases accompanied by ECG tracings.
Participants first assess the case individually and then work in small groups of 5-6 nurses to discuss their interpretations and reach a shared clinical decision.
Groups present their conclusions, followed by facilitator-guided whole-group analysis, clarification of misconceptions, and structured feedback.
The program addresses ECG interpretation, life-threatening rhythms, bradyarrhythmias, atrioventricular blocks, atrial tachyarrhythmias, medication- and electrolyte-related ECG changes, QT prolongation, and monitoring problems.
Patient-safety principles and appropriate nursing responses and escalation of care are integrated throughout the cases.
Andre navne:
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Ingen indgriben: Control Group
Participants undergo the institution's routine orientation process for newly employed intensive care nurses and continue their usual clinical practice.
They receive no study-specific CBCL intervention or additional arrhythmia-focused education from the research team during the study period.
After completion of the three-month follow-up and final data collection, participants in the control group are offered the same arrhythmia education program.
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Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
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Arrhythmia Recognition and Awareness Test (ARAT)
Tidsramme: Baseline and 3 months after randomization
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The Arrhythmia Recognition and Awareness Test (ARAT) consists of 27 items assessing arrhythmia recognition and awareness.
Each correct response is scored as 1 and each incorrect response as 0, yielding a total score ranging from 0 to 27.
Higher scores indicate better arrhythmia recognition and awareness.
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Baseline and 3 months after randomization
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
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Safety Attitudes Questionnaire (SAQ)
Tidsramme: Baseline and 3 months after randomization
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The Safety Attitudes Questionnaire (SAQ) is used to assess participants' attitudes toward patient safety.
The questionnaire includes 46 items rated on a 5-point Likert scale and comprises six dimensions: teamwork climate, safety climate, job satisfaction, stress recognition, perceptions of management, and working conditions.
Higher scores indicate more positive attitudes toward patient safety.
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Baseline and 3 months after randomization
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Efterforskere
Efterforskere
- Ledende efterforsker: Naile Alankaya, Associate Prof. PhD, Çanakkale Onsekiz Mart University, Faculty of Health Sciences
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- COMU-SBF-NA-04
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
IPD-planbeskrivelse
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
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