Abstract
BACKGROUND: Competence in mechanical ventilation management is a critical component of nursing education. Technology-enhanced learning strategies may support skill acquisition. This randomized clinical trial evaluated the effectiveness of an interactive mobile application compared with a non-interactive version in improving nursing students' knowledge, self-efficacy, and clinical performance related to weaning, extubation, and re-intubation procedures. METHODS: The study was conducted in the nursing skills laboratory and several affiliated ICUs at Mashhad University of Medical Sciences. Final-year undergraduate nursing students (7th-8th semesters) with no prior exposure to educational content or ICU experience related to mechanical ventilation were eligible. Students repeating the academic year or withdrawing before completing outcome assessments were excluded. Seventy-one students were randomly assigned to the interactive i-BreathGuard group (n = 36) or the non-interactive control group (n = 35). The intervention consisted of one week of app-based training. The primary outcome was clinical performance assessed using a structured OSCE checklist and supervised ICU procedure evaluation. Secondary outcomes were knowledge and self-efficacy measured pre- and post-intervention. Clinical assessors and the statistical analyst were blinded to group allocation. RESULTS: The intervention group showed greater improvement in knowledge scores (mean change: 17.02 ± 17.38) compared with controls (10.14 ± 15.61). Self-efficacy was also significantly higher in the intervention group (M = 73.45 ± 19.62) than in the control group (M = 52.91 ± 17.55; t = 4.62, p < 0.001, effect size = 1.1). Repeated-measures ANOVA demonstrated significant group-by-time interactions for all outcomes. CONCLUSION: An interactive mobile learning tool can effectively enhance nursing students' competence in mechanical ventilation management. Larger, longitudinal studies are recommended to validate and extend these findings. TRIAL REGISTRATION: This research was registered (27/11/2023) in the https://irct.behdasht.gov.ir with registration number: IRCT20231001059571N1.