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IRCT20260602069618N1 IRCT 2026-06-14 Rasht University of Medical Sciences Effect of Virtual Reality-Based (VR) Training on Knowledge and Clinical Performance of Cardiopulmonary Resuscitation The Effect of Virtual Reality-Based (VR) Training on Knowledge and Clinical Performance of Cardiopulmonary Resuscitation among Nursing Students: A Randomized Controlled Trial 2026-06-23 anticipated 38 Complete https://irct.ir/trial/90619 interventional Randomization: Randomized, Blinding: Not blinded, Placebo: Not used, Assignment: Parallel, Purpose: Education/Guidance, Other design features: A Randomized Controlled Trial, Randomization description: All eligible nursing students will be allocated equally (1:1 ratio) to the traditional and virtual reality-based training groups using block randomization with block sizes of 4 and 6. The randomization sequence will be generated using the online randomization service Sealed Envelope Ltd. The students will be unaware of their group allocation. N/A Knowledge and clinical performance of cardiopulmonary resuscitation among nursing students. Intervention 1: Control group: Cardiopulmonary resuscitation (CPR) training based on the 2025 American Heart Association guidelines will be delivered using the traditional method, including lectures with PowerPoint presentations and hands-on demonstrations on a manikin. The training will be conducted over two 2-hour sessions, followed by one 90-minute supervised practical practice session in which students perform CPR procedures on a manikin under instructor supervision. Intervention 2: Intervention group: Cardiopulmonary resuscitation (CPR) training will be delivered using virtual reality (VR) technology. The educational program provides an interactive and intelligent simulation of the key steps of CPR, including scene safety assessment, evaluation of the patient's level of consciousness, activation of emergency medical services, assessment of pulse and breathing, identification of the correct chest compression site, evaluation of compression rate, depth (shallow, adequate, or excessive), rhythm, and chest recoil, airway opening using the Head Tilt–Chin Lift maneuver, performance of five cycles of 30:2 compressions-to-ventilations, and training in the use of an automated external defibrillator (AED).Participants will use equipment developed by Aras Mixed Reality, a knowledge-based company, including a virtual reality headset, VR-compatible computers, motion-tracking sensors, a CPR training manikin, and microcontroller-based processing units. The system consists of two components: training and assessment. For the assessment phase, four different simulated environments (street, classroom, shopping mall, and mosque) have been designed to enable participants to practice and evaluate their skills under a variety of environmental and psychological conditions, including situational stress. In each environment, a distinct cardiac arrest scenario is presented. For example, one scenario involves cardiac arrest following cigarette smoking, another following electrocution, and a third with no apparent cause. Participants are required to perform CPR according to the 2025 American Heart Association (AHA) Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. This VR simulator incorporates several advanced technologies, including alignment of the physical manikin with its virtual counterpart through augmented reality technology, detection of hand, finger, and pulse assessment movements using image-processing techniques, and the ability to palpate the chest, assess pulse, and perceive breathing through mixed reality technology. During chest compressions, the extent of chest depression is visually displayed, allowing participants to practice achieving the recommended compression depth of 5–6 cm accurately. In addition, environmental stressors are simulated through virtual characters exhibiting behaviors such as shouting, crying, and creating panic, thereby enabling participants to develop the skills necessary to perform CPR effectively in realistic and stressful situations. Each participant will use the VR system for a total of 12 minutes per session, including both training and assessment. Based on the sample size, completion of one full training round requires approximately 4 hours. Each participant will undergo the training process twice; therefore, the total intervention time for the intervention group will be approximately 8 hours. The intervention will be implemented in four sessions, each lasting 2 hours. Undecided - It is not yet known if there will be a plan to make this available Justification or reason for indecision in sharing IPD is The decision regarding sharing de-identified individual participant data (IPD) has not yet been finalized. Data sharing will be considered after completion of the study, publication of the primary results, and review of ethical, institutional, and participant confidentiality requirements.
public Saba Jahani
Saba Apartment, Corner of Ghasabian 22/1 Alley, Shahid Ghasabian St.
Babolsar Iran (Islamic Republic of) 4741755096 +98 11 3525 1319 sabajahani70@gmail.com Rasht University of Medical Sciences scientific Marzieh Jahani
Shahid Beheshti School of Nursing and Midwifery, Daneshjoo St., Shahid Beheshti Highway.
Rasht Iran (Islamic Republic of) 41469-39814 +98 13 3255 3202 marziyeh_jahani@gums.ac.ir Rasht University of Medical Sciences Iran (Islamic Republic of) Sixth-semester students who provide informed consent to participate in the study. No previous participation in virtual reality-based cardiopulmonary resuscitation (CPR) training before the study. no limit no limit Both Students who have previously taken this course with an incomplete grade. Other Other Control group: Cardiopulmonary resuscitation (CPR) training based on the 2025 American Heart Association guidelines will be delivered using the traditional method, including lectures with PowerPoint presentations and hands-on demonstrations on a manikin. The training will be conducted over two 2-hour sessions, followed by one 90-minute supervised practical practice session in which students perform CPR procedures on a manikin under instructor supervision. Intervention group: Cardiopulmonary resuscitation (CPR) training will be delivered using virtual reality (VR) technology. The educational program provides an interactive and intelligent simulation of the key steps of CPR, including scene safety assessment, evaluation of the patient's level of consciousness, activation of emergency medical services, assessment of pulse and breathing, identification of the correct chest compression site, evaluation of compression rate, depth (shallow, adequate, or excessive), rhythm, and chest recoil, airway opening using the Head Tilt–Chin Lift maneuver, performance of five cycles of 30:2 compressions-to-ventilations, and training in the use of an automated external defibrillator (AED).Participants will use equipment developed by Aras Mixed Reality, a knowledge-based company, including a virtual reality headset, VR-compatible computers, motion-tracking sensors, a CPR training manikin, and microcontroller-based processing units. The system consists of two components: training and assessment. For the assessment phase, four different simulated environments (street, classroom, shopping mall, and mosque) have been designed to enable participants to practice and evaluate their skills under a variety of environmental and psychological conditions, including situational stress. In each environment, a distinct cardiac arrest scenario is presented. For example, one scenario involves cardiac arrest following cigarette smoking, another following electrocution, and a third with no apparent cause. Participants are required to perform CPR according to the 2025 American Heart Association (AHA) Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. This VR simulator incorporates several advanced technologies, including alignment of the physical manikin with its virtual counterpart through augmented reality technology, detection of hand, finger, and pulse assessment movements using image-processing techniques, and the ability to palpate the chest, assess pulse, and perceive breathing through mixed reality technology. During chest compressions, the extent of chest depression is visually displayed, allowing participants to practice achieving the recommended compression depth of 5–6 cm accurately. In addition, environmental stressors are simulated through virtual characters exhibiting behaviors such as shouting, crying, and creating panic, thereby enabling participants to develop the skills necessary to perform CPR effectively in realistic and stressful situations. Each participant will use the VR system for a total of 12 minutes per session, including both training and assessment. Based on the sample size, completion of one full training round requires approximately 4 hours. Each participant will undergo the training process twice; therefore, the total intervention time for the intervention group will be approximately 8 hours. The intervention will be implemented in four sessions, each lasting 2 hours. Knowledge score of cardiopulmonary resuscitation. Timepoint: before the intervention and 4 weeks after the intervention. Method of measurement: G. Spinelli's cardiopulmonary resuscitation knowledge questionnaire. Clinical performance score of cardiopulmonary resuscitation. Timepoint: before the intervention and 4 weeks after the intervention. Method of measurement: Observational checklist for cardiopulmonary resuscitation performance. Rasht University of Medical Sciences Approved 2026-05-13 Ethics committee of Gilan University of Medical Sciences Shahid Beheshti School of Nursing and Midwifery, Daneshjoo St., Shahid Beheshti Blvd. Rasht Guilan Iran (Islamic Republic of)