The purpose of this clinical trial is to determine the effect of a virtual reality application on nursing students' skills in breaking bad news and approaching crying patients at a nursing faculty in western Turkey. The primary questions to be addressed are: Is there a significant difference in breaking bad news skills between students receiving the virtual reality intervention and those receiving the standard curriculum? Is there a significant difference in skills related to approaching crying patients between students receiving the virtual reality intervention and those receiving the standard curriculum? Comparison group: The researchers will compare the intervention group, which receives the virtual reality application, with the control group, which follows the standard curriculum, to assess differences in skill development. Participants: Nursing students aged 18 years or older, who are taking a communication course for the first time and voluntarily participating. Participants will be randomly assigned to the intervention or control groups. Participants in the intervention group will: Attend an orientation session for the virtual reality application, Engage in a virtual reality scenario based on the SPIKES protocol involving breaking bad news and approaching a crying patient, Participate in a debriefing session to discuss their experiences. Participants in the control group will receive the standard curriculum course.
Additional Details Study Design: This randomized controlled trial employed a pre-test and post-test model. Data for the intervention group were collected at baseline (T1) and immediately after the virtual reality intervention (T2). Similar data collection timings were applied to the control group. Sample and Inclusion Criteria: Study population consisted of 260 third-year nursing students enrolled in a communication course during the Fall Semester of the 2024-2025 academic year at a nursing faculty in western Turkey. Inclusion criteria: nursing students aged 18 years or older, taking the communication course for the first time, and volunteering to participate. Exclusion criteria: any health condition preventing the use of VR devices, experience of nausea or vomiting due to VR headset use, and prior participation in training on breaking bad news. Sample size was calculated as 60 students (30 in the intervention group and 30 in the control group) based on power analysis using G-Power software and previous study parameters. Assessment Instruments: Student Descriptive Information Questionnaire Questionnaire on Knowledge of Breaking Bad News (33 items, Likert-type scale, Cronbach's alpha = 0.86, content validity index = 0.82) Questionnaire on Knowledge of Approaching a Crying Patient (19 items, Likert-type scale, Cronbach's alpha = 0.71, content validity index = 0.81) Intervention Protocol: The intervention consisted of three sessions: orientation, virtual reality viewing (15 minutes), and debriefing (40 minutes). The scenario involved delivering a lung cancer diagnosis to a young female patient and approaching a crying patient. The scenario was structured according to the SPIKES protocol. Virtual reality content was produced using 360° high-resolution videos and audio recordings filmed in real settings. The development team included oncology and psychiatric nursing specialists as well as researchers experienced in animation and virtual reality. Control Group: The control group received the standard curriculum course. After the study, control participants were offered the opportunity to voluntarily participate in the virtual reality application.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
60
Standard virtual reality applications rely on computer-generated animation environments and avatars; however, in the present study, the content created by actors/actresses with theater training by using cameras and audio recording devices suitable for creating virtual reality content included images of real environments and people.
While the participants in the intervention group received training on virtual reality, those in the control group took the standard curriculum course. Students in the control group received no training. The students in the control group were told that the program would be implemented to those who volunteered after the study was completed.
Change in the Questionnaire on Knowledge of Breaking Bad News
The level of knowledge and skills in breaking bad news and approaching a crying patient will be assessed using validated questionnaire: the Questionnaire on Knowledge of Breaking Bad News
Time frame: Pre- and post-intervention assessments conducted within 15 days.
Change in the Questionnaire on Knowledge of Approaching a Crying Patient
The level of knowledge and skills in breaking bad news and approaching a crying patient will be assessed using validated questionnaire: the Questionnaire on Knowledge of Approaching a Crying Patient.
Time frame: Pre- and post-intervention assessments conducted within 15 days.
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