Table 1.
IV simulators and instructional methods.
| Author Year |
Sample/setting | Purpose | Variables | Methods/analysis | Findings | Instructional methods |
|---|---|---|---|---|---|---|
| Bowyer et al. (2005) [5] |
N = 34 3rd year medical students, Maryland, USA |
Compare cannulation (skill) performance | INV1 4 groups: Each other (EO) Virtual IV (VIV) CathSim (CS) IV arm (IVA) DV2 Skill performance |
RCT; Pretest Posttest t-test ANOVA |
All groups improved: EO: p < .0003 VIV: p < .0003 CS: p < .02 IVA: p < .009 All: p < .00001 VIV greater improvement than IVA group p < .026 |
5-minute training video Pretest Random assignment Practice: EO: 1 hour 2 students per faculty VIV: 1 hour alone CS: 1 hour alone IVA: 1 hour alone Posttest Skill performance on the IVA |
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| Chang et al. (2002) [13] |
N = 28 community nurses, Hong Kong |
Compare outcomes between 2 instructional methods | INV 2 groups: IV Arm (IVA) CathSim (CS) DV Success rates Skill performance Anxiety |
Quasi-experimental; Posttest t-test |
Success rates on initial attempt: (%) IVA: 85.71 CS: 64.29 Successful cannulation rate: (%) IVA: 100 CS: 92.86 Skill performance: M (SD) IVA: 23.29 (1.54) CS: 22.86 (1.83) p = .509 Trait Anxiety Level: M (SD) IVA: 21.42 (1.69) CS: 21.14 (2.82) p = .418 State anxiety level: M (SD) IVA: 29.50 (5.00) CS: 28 (4.64) p = .749 |
Lecture Random assignment Practice: Supervised: 2 hours Independently: 1 week Posttests Skill performance on patient |
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| Engum et al. (2003) [6] |
N = 163 students, Indiana, USA n = 70 BS nursing students n = 93 3rd year medical students |
Compare outcomes between 2 instructional methods | INV 2 groups: IV arm (IVA) CathSim (CS) DV Cognitive gains Student satisfaction Self-efficacy/reliance Documentation Patient feedback Skill performance |
Quasi-experimental; pretest, posttest t-test χ2 |
All students IVA group higher scores: Cognitive gains: p = .013 Student satisfaction: p < .0001 Self-efficacy/reliance: p = .0146 Documentation: p = .014 Instruction helpful: p < .01 Skill performance not significant Nursing student group IVA group higher scores: Cognitive gains: p = .0064 Student satisfaction: p < .0002 Self-efficacy/reliance: p = .0167 Medical student group IVA group higher scores: Student satisfaction: p = .043 |
Pretest Only cognitive gains IVA group: Self-study module with video 90 min faculty instruction Practice CS group: Self-study module 90 min independent learning on CS Practice Posttest All DV Skill performance on volunteer |
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| Jamison et al. (2006) [9] |
N = 18 BS nursing students, Midwestern USA University |
Compare outcomes between 2 instructional methods | INV 2 groups: IV arm (IVA) CathSim (CS) DV Knowledge Skill performance Educational practices Design features |
Exploratory; pretest posttest t-test |
Knowledge Only CS group improved: p < .05 Skills performance CS group knowledge related to skill performance: p < .05 CS group Most important educational practices were feedback and diverse ways of learning Most important simulation design features were feedback and cues |
Lecture Pretest Knowledge Random assignment Both groups: Practice Skill performance on IVA or CS Posttests Knowledge Educational practices Design features |
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| Johannesson et al. (2010) [10] |
N = 24 BS nursing students, University of Linkoping, Sweden |
Investigate students' learning expectations before and after training related to IV catheterization | 3 measurement times: Pretraining Posttraining Postexam DV Learning expectations (pretraining) Fulfillment of expectations (posttraining and postexam) Curricular goal expectations (pretraining and postexam) Skill examination |
Descriptive; pretest posttest Wilcoxon signed rank test Open-ended questions |
Pretraining learning expectations: 20/21 looked forward to using CS 19/21 looked forward to using IVA Fulfillment of expectations was met after training: Learning support from teacher: p = .038 17/22 CS was valuable learning tool Fulfillment of expectations after exam: 4/20 CS was valuable learning tool Learning support from teacher: p = .038 Curricular goal expectations after exam: Decrease in ability to Organize actions: p < .001 Explain materials/procedure: p = .008 Interact with patient: p = .003 Be sensitive to patient: p = .004 8/20 felt prepared |
Randomization Lecture Pretraining learning expectations Training: Introduction Practice in pairs on CS and then IVA Practice on own Posttraining Fulfillment of expectations Posttest: Skills examinations Curricular goal expectations Skill examination on patient |
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| Jung et al. (2012) [8] | N = 114 nursing students, Korea | Compare outcomes between 3 instructional methods | INV: 3 groups: IV arm (IVA) IV Sim (IVS) IVA/IVS DV: Anxiety Skills performance Satisfaction Knowledge |
RCT t-test Mann–Whitney U test One-way ANOVA |
State-anxiety decreased IVA: p = .004 IVA/IVS: p = .002 VAS-anxiety decreased IVA: p = .012 IVS: p = .006 IVA/IVS: p < .001 Skills performance IVA/IVS group: Scores > than other groups: p = .015 Task time < than IVS: p = .007 Satisfaction Overall teaching effectiveness: IVA/IVS and IVA > IVS: p = .005 Learning procedure: IVA/IVS group most satisfied: p = .014 |
Random assignment Lecture and video Pretest anxiety Demonstration on a healthy volunteer Demonstration on training aid Practice Posttest anxiety Skills performance on volunteer |
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| Loukas et al. (2011) [16] | N = 53 medical students and nurse experts, Athens, Greece | Compare outcomes between groups using VIV | INV: 3 groups: Novice (N) Intermediate (I) Experts (E) DV: Performance on VIV: Learning Curve Procedure Time Errors Efficacy Confidence |
Quantitative and qualitative mixed method Friedman, Kruskal-Wallis, Kuder-Richardson tests |
Performance Learning curve plateaus after N = 23 attempts I = 15 attempts Procedure time decreased p < .01 Errors decreased: Critical: p < .01 Noncritical: p < .05 Posttraining performance N = I = E: p > .01 Efficacy Learning principles: p < .05 Realism and content: p < .05 Confidence Increased: p < .05 |
Pretest: 3 scenarios on VIV Intervention: Groups N and I: Lecture Practice 9 different scenarios Posttest: 3 scenarios on VIV |
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| Reinhardt et al. (2012) [4] |
N = 94 BS nursing students, New Mexico, USA |
Compare outcomes between 3 instructional methods and sequencing of methods | INV: 3 Groups: IV arm only (A) VIV then A (VA) A then VIV (AV) DV: Skill performance Confidence Clinical proficiency |
RCT ANOVA t-test χ2 Pearson correlation |
All groups were similar on skill and confidence scores. Clinical proficiency: A 87.5% VA and AV 84.2% |
Random assignment Lecture Demonstration on A Practice Skills performance on patient |
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| Reyes et al. (2008) [15] |
N = 28 LPN student nurses, Washington, USA |
Compare outcomes between 2 instructional methods | INV: 2 groups: Virtual IV (VIV) IV arm (IVA) DV: Cognitive gain Skill performance Student satisfaction |
RCT t-test Fisher's Exact |
Cognitive gain within groups: M (SD) VIV: 14.7 (11) IVA: 11.6 (11.26) p < .001 Skill performance: success rate on initial attempt (%): VIV: 64 IVA: 78 Student satisfaction: Recommend continued use of VIV (%) VIV 79 IVA 66 |
Random assignment Pretest Cognitive gain Review IV competency VIV: Orientation on VIV Practice IVA: Faculty instruction and demonstration Posttest Skills performance on volunteer IVA: VIV training opportunity IVA and VIV: Cognitive test Satisfaction survey |
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| Sotto et al. (2009) [7] |
N = 40 medical students, Manila, Philippine |
Compare outcomes between 2 instructional methods | INV: 2 groups: See-1Do-1 (S1D1) VIV DV: Success rate Skill performance Band constriction time Procedure time |
Randomized posttest t-test χ2 |
Success rates (%): S1D1: 15 VIV: 40 p < .05 Skill performance score: M (SD) S1D1: 44 (15.3) VIV: 56 (19.2) p < .03 Band constriction time: M (SD) S1D1: 240 (38) VIV: 159 (31) p < .05 Procedure time: M (SD) S1D1: 380 (48) VIV: 277 (53) p < .05 |
Instructional video on VIV Stratified random assignment S1D1: Demonstration on a patient VIV: Practice until successful Posttest Skill performance on patient |
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| Wilfong et al. (2011) [3] | N = 46 registered nurses, Pennsylvania, USA | Compare outcomes between 2 instructional methods | INV: 2 groups: VIV and patient manikin (VIVPM) Each other (EO) DV: Skill performance Success Rate Complication |
RCT t-test Mann–Whitney U test χ2 |
Success rate on 1st attempt: VIVPM (median = 1.00) EO (median = 2.00): U = 143; p < .043 Complications on initial attempt (%) VIVPM: 21 EO: 33 |
Random assignment pretest Self-assessment VIVPM: Presentation Review policies and procedures Practice Perform IV on simulators EO: Presentation Review policies and procedures Practice on each other Post training: IV attempts on patients |
1INV: independent variable.
2DV: dependent variable.