A fundamental skill required from nursing students is how to manage the insertion of in-dwelling urinary catheters, and this skill is a core competency for nurses. However, practice with conventional test models is insufficient for learning this skill and leads to inadequate proficiency among students. To address this problem, this study created an immersive virtual reality (IVR) scheme, based on the theory of situated learning, to simulate clinical situations. Innovative approaches were adopted to design clinical cases, construct three-dimensional environments, design character dialogs, and integrate artificial intelligence voice recognition. The effect of these design elements on students’ in-dwelling urinary catheter skills and learning satisfaction was explored. First, nursing experts assessed the quality of the IVR scheme. Over a 4-week period, 43 students in a post-baccalaureate nursing program used conventional test models to practice the management of in-dwelling urinary catheters in female patients, and their learning was supplemented by at least two practice sessions with IVR. Data were collected from in-class observation records, a questionnaire survey on student satisfaction, and focused group interviews. The results showed that the participating students were highly satisfied with the IVR scheme and stated that it provided a pleasurable learning experience and exerted a positive impact on them. The IVR scheme provided situations closely resembling real clinical environments, helping the students to memorize the steps for catheter management. The students also noted that the IVR scheme should incorporate other nursing skills, such as empathetical and solicitous care and patient companionship. This enables nursing students to fulfill their role and care for patients in clinical settings.

The dynamic hip screw (DHS) system is commonly used to treat intertrochanteric fracture of the hip joint. Breakage of the lag screw was noted in clinical practice and the length of lag screw as well as the length of the side plate in the DHS system appeared to play a role in the risk of breakage. Thus, the aim of this study was to investigate the biomechanical effect of different lag screw lengths and barrel plate lengths in the DHS implant system by finite element analysis (FEA). Four FEA simulation models were created according to different lengths of lag screw (79[Formula: see text]mm and 63[Formula: see text]mm) and different lengths of barrel side plate (43[Formula: see text]mm and 37[Formula: see text]mm). The von Mises stress was used as the observation indicator. The results showed that the maximum tensile stress on the long lag screw was slightly greater than that of the shorter lag screw. Use of a shorter barrel side plate may also cause high stress between the lag screw and the barrel side plate. This finding provides biomechanical reference data that may be of value to orthopedic surgeons with respect to choice of implant size and length in the treatment of intertrochanteric fracture with a DHS system to prevent complications such as implant failure caused by broken lag screws.

This study adopts the action research method to understand the impact of online teaching on the learning outcomes of working nursing students using the “Infection Control in Nursing Practice” course as the research context. The research design focuses on the learning activity process of online teaching. The study subjects consisted of 55 working nursing students, aged 25-55 years old, all of whom were taking the online courses for the first time. The results of the study show that the semester grades of online teaching courses were better than those of physical courses and the length of important learning activities such as audio-visual materials (AVMs) would best be produced within 5-12 minutes, while the key points of each section would best be explained within 5 minutes of the beginning of the AVMs. Working students may miss out a variety of online learning activities, so a reminder mechanism should be planned to prevent students from missing out learning activities. The teachers are facilitators and advisors in online teaching, so they may plan time outside of learning activities, such as office hours, to provide a channel for student consultation. The results of this study can be used as a direction to improve the subsequent online teachings and provide a reference for other teachers to implement online teaching.

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