Development of an eye tracker for simulation education in nursing and investigation of its efficiency: A double blind randomized controlled study

Objective: The aim of this research; The aim of this study is to develop an eye tracker for simulation training in nursing and to examine the effectiveness of an eye tracker in a wound dressing simulation scenario. This study is a double-blind randomized controlled experimental study and a post-test control group design was used. Material and Methods: The research was carried out between 01/04/2020-27/07/2022 with the nursing students of a university's faculty of health sciences. The research consisted of two stages. The first phase consisted of the development of the eye tracker, the preparation of the simulation scenario and the implementation of the pilot study. In the second stage, it consisted of the main application part to examine the effectiveness of the developed eye tracker. In the pilot study, the sample consisted of 10 students and was completed with 6 students. The sample size for the main application was calculated with G-power. The data of a similar study was used in the calculation and 30 people were included in the main application according to the calculation result. At the end of the research, the main application was completed with 26 students, 14 of whom were in the study group and 14 in the control group. Before the pilot and the main application, all students were given a face-to-face training on wound care. Then, a wound dressing simulation application was performed by using a standardized patient in the laboratory of the nursing department and by wearing an eye tracker to all students. After all the applications were completed, randomization was performed by a researcher outside the research group and the students were divided into two groups. Eye tracker analyzes and individual dressing checklist were shared with the study group, and individual dressing checklist with video feedback was shared with the control group. Then, both groups were asked to fill in a personal information form, a simulation design scale, and a student satisfaction and self-confidence scale in learning. SPSS program was used for statistical analysis of quantitative data in the study and non-parametric methods were applied as a result of the analysis. Number, percentage, mean and correlation analyzes were used. Mann Whitney U, Chi-square, Kruskal Wallis and Spearman's correlation methods were used. The significance level was taken as 0.05 in all analyzes. The software program developed for the analysis of the data recorded on the eye tracker was used. This software established a linear connection between the focal points and created a temperature map at the points where the eye looked. The data was uploaded to the computer as a video for visual replay, taking into account the students' focus. Results: The mean scores of the students in the study and control groups in the simulation design scale best design elements section were 4.49±0.33, respectively; 4.45±0.27(p>0.05), and the mean scores of the simulation design scale for the student's importance section were 4.50±0.30, respectively; It was found to be 4.61±0.28 (p>0.05). There was no statistically significant difference between the study and control groups. However, it was determined that the students in the control group showed a statistically significant difference in the mean scores of the support sub-dimension of the simulation design scale for the student section according to the groups (p<0.05). Student satisfaction in learning and self-confidence scale mean scores of the students in the study and control groups were 4.55±0.34, respectively; It was found to be 4.53±0.30 (p>0.05). There was no statistically significant difference between the study and control groups. When the inter-scale correlation analysis results of both groups were examined, it was determined that there was a statistically significant and positive relationship (r=0.770, p<0.05) between the best design elements of simulation design and satisfaction with current learning. It was determined that there was a statistically significant and positive (r=0.564, p<0.05) relationship between the importance of simulation design for the student and satisfaction with current learning. As a result of the comparison of the temperature map analysis of the students in the study group with the dressing application checklists marked by the independent researchers and the dressing application checklist applied during the simulation, the 1st and 2nd independent researchers (temperature analysis) were unable to hear a sound due to the absence of a microphone in the eye tracker, and some steps were incorrect. They stated that they marked it as /missing. It was determined that the results of dressing application steps of "explaining the procedure to the patient and asking for permission", "protecting the patient's confidentiality", "informing about the frequency and time of dressing change" and the 3rd independent researcher (simulation order) had different significance levels (p<0.05). Conclusion: According to these results; It was concluded that there was no difference between the simulation method with the eye tracker and the video feedback method. However, both methods were found to have similar effects and efficacy. Keywords: Eye, Nursing, Simulation Training, Track, Video Recording.