Study design
The study was planned with randomized controlled design.
Sample And Setting
The study was performed at a Faculty of Nursing located in North Cyprus in march 2022. The nursing department in the University has online technology which makes the students enter online lectures and online exams and quizzes control by the advisors of the courses. The study was conducted among 80 international nursing students who were completed the first class. Total 80 students was assigned as randomly to the experimental grouping or control grouping (40 players in each group) via the census method. Students who decide to partake in the study choose to be comprised in this study.
Study Tools
ERAS Knowledge Evaluation Form
An assessment test was prepared and was developed by the researchers on the basis of the last update of ERAS prevention from the American Association of Nurse Anesthetists. A surgical perspective of ERAS guidelines in thoracic surgery, 2019. The first section is regarding demographics characteristics of nurse’s students and included 5 questions such as sex, age, course grade, Cumulative Grade Point Average (CGPA) and obtained ERAS lessons. The second division consisted of 33 questions about general understanding, risk factor, after surgery protocols, before surgery, and during the surgery protocols. The game was assigned by Kahoot website the students who will be entering the game was asked to enter the code of the game in order to enter the game. The range tool score was from 0–35, the true option rwas given one score, while the false option was given zero score. The questionnaire content and evaluation were revisited and approved by three experts from the surgical nursing fields.
Training Method Evaluation Form For Experimental Group
This evaluation form was related to student’s satisfaction from online education. The evaluation questionnaire was created and treated by the study authors’ following the recent update of ERAS and ERAS protocols 2021 and the American Association of Nurse Anesthesiology 2022.
Educational Content And Tools
The schooling content contained the heeding three parts outline of ERAS and the idea of
ERAS protocols:
Module 1: Introduction of surgeries (Basics of surgeries stages and surgery preparation).
Module 2: ERAS overviews (ERAS definition, maintaining normal physiology, stress during surgery, complications or readmissions, Clinical feature).
Module 3: Evidence-Based Guidelines for ERAS.
The syllabus will be the same for study and control groups.
Funding Statement: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Acknowledgements: Iam grateful to thank Prof.Nurhan BAYRAKTAR and Prof.Burcu DİKMEN and Ibrahim ABUMETTLEQ for their participation in this study and to the pupils who participated and offered such rich insights.
Application of the study
The ERAS education program was conducted with three-phase for both groups (pre-and Intra post-test). In the pre-phase, the researchers then was arranged with the nursing faculty to reserve a proper time for the game, and to explain for students the purpose and aim of the study and how to create account on online education; after assign to participate, we divided the participant’s randomly into two control and experimental groups.
Experimental group
Pre-test
The experimental group obtained an email to complete an account in an online game. After the student’s creation of the account, the completion of the game took 40 minutes.
Intra- phase
During the intra phase, there was an online classroom for students to clarify the contents and how to use the game ranged in length from 20 to 25 minutes. Moreover, the students should enter kahoot application or the official website to play from the website page. The completion of the game took 30-45 minutes. The online game will be design by kahoot It is a game-based learning platform, used as educational technology in schools and other educational institutions. The questions were true and false and were be related to the enhanced recovery after surgery. By the end of the game, the students can also rate the quiz with one to five stars.
Post-test
The posttest part of the study, phase 3, essentially repeat the pretest measure (second part of the ERAS Knowledge Evaluation Form), students in the online classroom grouping were asked to answer two open-ended inquiries about ERAS advantages and disadvantages.
Control group
Pre-test
In control groups, a pre-test exam (ERAS Knowledge Evaluation tool) will be conducted in the online lecture.
Intra- phase
The instructor will arrange the time for the online classroom and pre-week will held a lesson which contain the exact content through power point display slides, and give them printouts for each subject.
Post-test
In the end, the pretest material (the second part of the ERAS Knowledge Evaluation Form) will be reprised in the online classroom.
Ethical aspects
The students should at no point feel any coercion to participate in a study and the student's information will be confidential. This study will not affect the students' grades and their GPA. The institutional review board (IRB) and ethical committee approval from "[blinded for review]" it obtained to apply the study.
Analysis of data
Statistical Package of Social Sciences (SPSS) software version 20.0. Descriptive statistics frequency and percentages were operated to interpret the data also the independent-sample t-test and T-test were used to the comparison between the control groups and intervention.
When finding statistic was significant, the chosen level of significance is p < .05. Knowledge category was established on the average correct answers for each part as follows: (a) the average correct answers of 80% or greater are ranked as Excellent knowledge grade; (b) the average correct answers between 60% and 79% are categorised as Very Good knowledge level; (c) the average correct answers between 40% and 59% are categorised as Good knowledge grade and (d) the average correct answers of 39% or less is categorised as Weak knowledge grade.
Ethical approval
The institutional review board (IRB) and ethical committee approval were obtained to apply the study from "[blinded for review]".