RESUMO
BACKGROUND: Clinical skills training is an essential component of nursing education. However, sometimes education does not sufficiently prepare nurses for the real world. Virtual reality (VR) is an innovative method to complement existing learning strategies, yet few studies investigate its effectiveness. This study compared educational outcomes achieved by three groups learning with either of two different VR simulation variants, with varying technological features, or a video training on the endotracheal suctioning skill. METHODS: The investigated outcomes were knowledge and skill acquisition, learner satisfaction, and technology acceptance. 131 undergraduate nursing students were randomised into three groups, based on the interventions they received. Knowledge was assessed through a pre-post-test design, skill through a post-intervention objective structured clinical examination on a manikin, learning satisfaction and technology acceptance through standardised questionnaires, and qualitative feedback through focus groups. RESULTS: All interventions led to a significant knowledge acquisition, with no significant difference between the groups. The video intervention group performed significantly better than the VR groups in skill demonstration. One of the two VR intervention groups had a significantly higher learner satisfaction than the video group. Technology acceptance was high for both VR groups, with the simpler VR simulation resulting in higher technology acceptance than the one with more experimental features. Students described the VR experience as realistic, interactive, and immersive, and saw the opportunity to practise skills in a safe environment, learn from mistakes, and increase knowledge and confidence. CONCLUSIONS: For the development of VR trainings, we recommend keeping them simple and targeting a specific educational outcome since trying to optimise for multiple outcomes is resource intensive and hard to achieve. Psychomotor skills were easier for participants to learn by watching a video on the procedure rather than practically learning it with the VR hardware, which is a more abstract representation of reality. We therefore recommend using VR as a complementing resource to skills labs, rather than replacing existing learning strategies. Perhaps VR is not ideal for practising practical psychomotor skills at the moment, but it can increase knowledge, satisfaction, motivation, confidence and prepare for further practical training. TRIAL REGISTRATION: Not applicable.
RESUMO
A simultaneous EPG/EMA study of tongue gestures of five speakers was conducted to investigate the kinematic events accompanying alveolar stop reductions in the context of a velar plosive /k/ and in the context of a laryngeal fricative /h/ in two languages, English and German. No systematic language differences could be detected. Alveolar productions before a following /h/ showed only a marginal weakening of the formation of complete occlusion, while alveolar productions before a following /k/ showed a wide range of reductions, including instances of a complete deletion of the alveolar gesture. The extension of movement reduction varied between and within subjects. Importantly, while speakers were consistent with themselves, they employed different articulatory patterns with respect to the timing relationship between movement initiation, overall movement duration, peak velocity as well as closure duration. An attempt is made to relate the observed movement patterns to the dynamic factors of the speech mechanism.
