Effectiveness of Hybrid Simulation in Developing Intramuscular Injection Skills: a Randomized Clinical Trial

Abstract

Background: Intramuscular injection (IMI) is a complex skill that requires knowledge, prob- lem-solving ability, and practical competency. The use of the hybrid simulation (HS) method in nursing education allows students to develop their procedural and operational skills in a safe and realistic environment. Aim: This parallel-randomized and clinical trial was evaluating the effect of HS on IMI knowl- edge, skills, self-confidence, and satisfaction levels of nursing students. Methods: Students were randomly assigned to either the intervention group (n = 63) or the control (n = 63) group. Students in the control group practiced IMI on a partial task trainer, whereas students in the experimental group practiced on HS (a digital half Buttock-mate IMI simulator-standardized patient). Data were collected with IMI Knowledge Test, IMI Skill Checklist, and the Student Satisfaction and Self-Confidence in Learning Scale. The data were analyzed using mean, median, number, and percentage values, Independent Sample t-test, Mann–Whitney U-test, Friedman test, and Chi-square tests. Results: The mean age of the students was 19.37 ± 0.68 in the intervention group and 19.54 ± 0.86 in the control group. The majority of students were female in both groups (inter- vention group = 81%, control group = 82.5%). The effect size of the IMI knowledge test (post- test) score (d = 0.31) and IMI administration skill (d = 0.71) of this study was medium, the effect size of satisfaction with learning (d = 1.64) and self-confidence (d = 1.82) was found to be strong. The students stated that the simulation provided a realistic environment, they were nervous during the simulation, and HS training was beneficial. Conclusions: The HS method increased the performance of students in IMI was effective on self-confidence and satisfaction in learning, but it did not improve knowledge acquisition compared to the traditional method. The findings suggest that the use of HS is an effective educational technique in IMI skill training.