This quasi- experimental study was done in Kerman, Iran from September 2020 to January 2021. In the study, 100 nursing students were selected by simple random sampling. There were almost 500 nursing students in the School of Nursing affiliated to Kerman University of Medical Sciences. The sample size was determined based on previous studies [13] by using the formula for comparison of two averages and considering the following:
$$n=\frac{2{({z}_{1-\frac{\alpha }{2}}+{z}_{1-\beta })}^{z}{\sigma }^{2}}{{d}^{2}}$$
d = 0.15 β = 0. 80 α = 0.05
There were 50 nursing students in each of the intervention and control groups. The study could detect at least a 15 percent difference in clinical skills between the two groups, with a power of 80 percent.
To run simple random sampling, the researchers first listed the study population, gave numbers to the units, found random numbers on the table and selected their samples from the random number table. Finally, 50 nursing students were selected for each group. Passing at least two semesters in nursing was an inclusion criterion. Students, who participated in courses related to crisis skillswere excluded from the study. Therefore, second and third-year students were included in the study (Third to fifth-semester students) Fig. 1.
Intervention and Data collection
The students were divided into two groups. initially, the purpose of the study was explained to the students. The two groups completed the questionnaires related to demographic information and nursing clinical skills during crises before and after the intervention. Participants of the intervention group became members of a social network (whats App). The researcher taught first aid and crisis management with instructional videos, text files, recorded audio, and pre-prepared scenarios during a month. Each part of the training files was sent once every two days. A reminder text message was sent once a day. The researchers didn’t send any files to the control group. The content of the training file included the following:
1- Definition of crisis and its types
2- The structure of the emergency department
3- Nursing principles in crisis and application of the nursing process in crisis
4- Definition of triage, principles of triage, and the role of the nurse in triage
5- Safety, rescue, and relief in natural disasters
6- Cardiopulmonary Resuscitation (CPR)
7- Nursing skills in emergencies ( bandage, fracture reduction, and fixation techniques, transfer and relocation of the injured, etc).
In this study, the researchers used two questionnaires: 1) demographic questionnaire, including students' age, sex, semester, and grade point average, 2) Nurses' clinical skills in the face of crisis.
Nurses' clinical skills in crisis questionnaire designed by Shahabinejad et al. is an instrument for evaluating nurses' clinical skills in a crisis. The Questionnaire contains 30 items, each of which is graded from 1 to 4 based on the Likert scale. Score one represents “I have no skills” and score four represents “I am fully skilled”. The range of scores is between 30 and 120 points. Scores less than 80 are considered poor skills, 80-100 show moderate skills, and 100-120 show good skills. Shahabinejad reported reliability of 0.95 for this questionnaire [13]. This study was single-blinded, soonly the statistician did not know the sample allocation tothe intervention and control groups.
SPSS15 was used for data analysis. T-test and chi-square tests were used to evaluate the difference between the intervention and control group in terms of demographic characteristics before the study. A paired t-test was used to compare the mean pre-test and posttest scores of the nursing skills in each group. T-test was used to compare the mean score of the nursing skills between the two groups. The significance level was 0.05.