Although the number of students in institutions providing nursing education is on the rise, the materials used remain inadequate and the clinical practice environments are complex, which reduces students’ opportunity to apply their skills. In addition, clinical practice areas may be more challenging and troublesome for nursing students due to factors such as fear of giving harm to the patient, difficulty in transferring theoretical knowledge to clinical settings and lack of adequate supportive relationships [1].
These shortcomings suggest that students do not have much chance to put their professional skills into practice sufficiently. With the advancements in technology which require the use of new learning methods and tools, it would be possible to overcome these difficulties in clinical practices [2].
Simulation used in medical and nursing education both in our country, Turkey, and in the other countries of the world is one of the most innovative and interactive education methods. Simulation, which varies from low reality to high reality, creates an environment similar to an actual clinical setting with the use of people or mannequins [3].
To achieve this purpose, different methods such as gamification, interactive videos and mannequins are used [1]. Among the advantages of simulation education for nursing students are increases in self-learning and critical thinking skills, improvement in technology use, integration of the theoretical knowledge into skills and correction of difficulties experienced by students in clinical settings [4].
In addition, simulation ensures that practices which are taught are more realistic, that the acquired knowledge is long lasting and that critical thinking and decision-making processes develop more easily [1].
Role-playing with simulation technology (with real or simulated patients), computer-based simulation, video, DVD or virtual reality creation, computer-assisted simulators and interactive patient simulators can be cited among the simulation applications that are used in nursing education [4, 5]. The simulation method is one of the computer-based technological methods that present virtual objects and environments mimicking natural real environments. It is a highly effective technology developed to improve communication between man and machine and plays a significant role in learning. This technology tries to increase interaction between human and machine not only through visual and auditory information transmission but also through sensation. Today, education is given through simulators in many different branches of medicine [6.7.8]. In the literature, simulators are used in medicine, dentistry and veterinary medicine [9]. In some nursing schools out of Turkey, simulators are used in gaining nursing practice skills [6].
Simulators used to gain students blood pressure measurement technique skills are a reality and touch-operated system including text, audio and video components. These simulators produce realistic sounds which are like Korotkoff sounds heard during blood pressure measurement and thus enable students to develop their cognitive and psychomotor skills in case scenarios. They also allow students to perform repeated blood pressure measurements before they measure the actual patient’s blood pressure. Thus, they improve students’ pre-clinical skills and then their self-confidence [1].
Video education, another information technology, has several benefits such as providing cognitive and psychological benefits and helping to visualize information. Videos help students develop cognitive ability such as interpretation, critical thinking, and problem solving skills [10]. They help students to keep their scientific knowledge in mind and thus focus on the subject to be taught. They also have a positive effect on student motivation [11, 12]. Van Alten’s (2020) research which investigated the advantages of videos in the learning environment determined that video education was more effective compared to traditional education [13].
Students benefited from videos in video education by using such features of video recorders as pausing, replaying, rewinding, and changing the speed. They also observed that students used the features of video recorders such as stopping, replaying, rewinding, or changing the speed to adapt to the speed of video displaying. Simulation education is a method recommended to be used in skill education due to its several advantages: it enables the student to observe skills hard to follow because they should be performed fast, and allows the student to follow the process without the supervision of an instructor [1, 14].
Results of several studies have demonstrated that nursing students, medical students, and graduate nurses lack knowledge and skills of measuring blood pressure [15, 16]. In the literature, an answer to the question of what changes can be made in teaching in order to eliminate these deficiencies has also been sought. To achieve this goal, blood pressure trainings given through different methods such as interactive video, CD-ROMs or simulation were compared and the effects of such methods on education were tried to be determined [17, 18]. Based on these problems, it was concluded that nursing students and nurses had insufficient blood pressure measurement skills, and thus studies should be carried out on how to give more effective trainings on blood pressure.
Making use of simulation in nursing education allows for experience-based learning and active participation of nursing students, provides nursing students with opportunities to improve their self-confidence and develops their clinical decision-making skills. It gives nursing students the opportunity to perform holistic care in a safe setting without having any qualms in regards to failing the patient or misreading the patient’s existing situation while it ensures that nursing students gain technical skills, decision-making skills, assessment skills, team working skills and management skills. Regular feedback to students during the application is also of importance, because this enables them to be informed about such applications [19, 20]. Education given with video helps students to develop cognitive skills such as interpretation, critical thinking, and problem solving skills [10]. Students can use the video's features such as pausing, replaying, rewinding and changing the speed of the video player in teaching with video, which helps students to keep their scientific knowledge in memory and enables them to focus on the subject to be taught.
Blood pressure assessment, which is widely used in clinical practices, is an important practice that is under the responsibility of the nurse. Blood pressure measurement is also one of the most important indicators affecting nursing practices and many medical decisions during the evaluation of the health of the society [21].
However, inaccurate measurement of blood pressure can lead to wrong decisions in the provision of care and treatment to the patient and thus it can adversely affect safety and quality of patient care [22]. Therefore, use of the simulators with feedback quality, which has become widespread in nursing education in our country, Turkey, has gained importance in the improvement of the psychomotor skills of first year nursing students while they receive the blood pressure training. This study aimed to compare the effect of teaching with the blood pressure measurement-training simulator and the effect of teaching with video education on nursing students’ skill levels while they were being trained to measure blood pressure.