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Objective: The aim of this study is to determine the steps of a training program utilizing Head-Mounted Display (HMD) based Virtual Reality Technology to enhance nursing students' skills in surgical hand scrubbing, wearing surgical cap and surgical mask, gowning and gloving, and to evaluate students' perceptions toward the program. Methods: The study aimed to investigate the potential applications of HMD-Based Virtual Reality Technology in Surgical Hand Scrubbing, Wearing Surgical Cap and Surgical Mask, Gowning and Gloving Program for nursing students, as well as students' perceptions toward this technology. The research was conducted with a focus group consisting of second-year nursing students in Osmaniye/Turkey, between January and June 2022, and the training program was implemented in five stages: Analysis, Design, Development, Implementation, and Evaluation. The program was evaluated with a focus group of nursing students. Focus group discussions were conducted to provide insights into students' experiences, feedback, and perceptions of the program. Results: A vast majority of participants (92.5%) reported feeling fully immersed in the operating room environment during the virtual reality (VR) experience. Notably, all students acknowledged the potential of HMD-Based Virtual Reality Technology to enrich their understanding of surgical hand scrubbing, wearing surgical cap and surgical mask, gowning and gloving procedures, surpassing conventional instructional models. While many participants found the experience exhilarating (85.1%), a considerable portion reported a decline in engagement after repeated exposures (88.8%). Overall, participants welcomed the integration of VR technology into education, expressing optimism about its capacity to facilitate additional instructional modules (74.4%). Moreover, they conveyed satisfaction with the opportunity to engage with the VR application, emphasizing its significant educational value (81.4%). Conclusion: Based on these findings, we can suggest that virtual reality technology has the potential to have an impact on nursing students' education. The majority of students expressing a sense of presence in the operating room highlights the value of this method in education. However, the reported boredom after repeated experiences by most participants underscores the importance of diversifying the program and introducing innovative approaches to keep students engaged.

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Mastery of basic skills is critical for surgical training. Such training is best obtained by experiential learning, which requires an element of self-reflection. Self-reflection is not always an automatic process, however; guidance may be required. This article sought to determine whether guided self-assessment would help facilitate student mastery of learned skills in a veterinary basic surgery course. The course consisted of 18 lectures and eight laboratories. Students were provided with written notes and presentation slides before the course. At the end of each lab, students completed a self-assessment of their skills. Skills were practiced in multiple labs; at the end of the course, each student was given a graded, practical examination to evaluate skills mastery. Statistical analysis was performed to compare students' mean self-assessment over the eight labs and to determine whether self-assessment scores correlated with examination grades. Results from 80 students were included. Students' overall self-assessments improved significantly from lab 1 to lab 8, and their self-assessment of two specific skills (closed gloving and simple continuous suture pattern) also improved. Students' self-assessments after the eighth lab were predictive of their practical exam scores. These results suggest guided reflection in the form of self-assessment could help facilitate student mastery of basic surgery skills. Correlation between self-assessment and practical examination results suggests instructors may use these self-assessments to detect students who need extra practice or instruction.

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BACKGROUND: Healthcare-associated infections (HAI) is a major problem for patient safety and surgical site infection (SSI) is a type of HAI and the most common form of infection related to surgical health care. Transmission of microorganisms can be minimized by aseptic procedures. The main objective of this study is to compare adherence to preoperative sterile gowning and hand hygiene technique among consultant surgeons, surgical residents, and nurses. METHODS: This research was conducted by observing the implementation of the pre-operative sterile gowning and hand hygiene technique of abdominal surgery by consultant surgeons, surgical residents, and nurses using aseptic instrument tests of the Objective Structured Clinical Examination (OSCE) Faculty of Medicine Universitas Gadjah Mada from August 10, 2018 to September 10, 2018. Observations were made when participants performed hand scrubbing, gowning, and donning the gloves procedures. The observer completed mobile online forms, so that the medical personnel under observation did not know that they were being observed. RESULTS: Twelve consultant surgeons, 16 surgical residents, and 12 nurses were observed. All of the medical personnel showed a good score with total percentage mean 83.58%. The highest total mean score was achieved by consultant surgeons (86.39%), but mean score did not vary significantly between medical personnel (p = .091). In the hand scrubbing procedure, scrub the nail and palm using brush side and the skin of hand and arm using sponge side, in both hands had the lowest mean score (1.82 ± 1.152 of the maximum score of 4). While in the gowning procedure, taking and unfolding the sterile gown had the lowest mean score (1.97 ± .158 of the maximum score of 2). In the donning the glove procedure, grasping left glove with right hand and putting the glove over the left hand in opposite direction procedure had the lowest mean score (1.97 ± .158 of the maximum score of 2). CONCLUSIONS: The mean score of each group of health personnel in each section showed good results. Comparison of hand hygiene and gowning procedure performance between groups of health personnel did not show significant differences. However, larger scale research is needed after this pilot study.

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Epidural or spinal anesthesia-related infections cause serious and devastating morbidity and mortality. The possible infectious complications of neuraxial anesthesia have become better understood in the past 10 years. We assessed information from published case series, studies, randomized controlled trials, and retrospective cohort studies to determine the rate of neuraxial infection and to evaluate iatrogenic causes of infection. The use of sterile gowning appears to be a factor associated with the decreased infection rates noted in some studies. A review of the literature demonstrated that personnel in interdisciplinary specialties use gowns for invasive procedures to prevent infection, and national and international multidisciplinary health care professionals appear to be increasing their use of sterile gowning to prevent infections. We undertook this literature review to explore the incidence of neuraxial infection, provide additional insight into multidisciplinary standards, and evaluate whether the use of sterile gowns while performing neuraxial anesthesia decreases infection rates.

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BACKGROUND: Contact precautions (CPs) are recommended to prevent methicillin-resistant Staphylococcus aureus (MRSA) transmission in institutions. Rising doubts about CP effectiveness and recognition of unintended consequences for patients have raised questions about the benefit. The objective of this study was to evaluate the effectiveness and adverse outcomes associated with CPs for prevention of MRSA transmission. METHODS: We searched PubMed, Embase, and the Cochrane Library for articles related to effectiveness and adverse outcomes of CPs in patients with MRSA. Criteria for inclusion included the following: articles conducted in the United States, articles performed in an acute care setting, articles that were not a case series or review, and those with standardized collection of data or inclusion of case and control groups. Results were summarized and examined for potential limitations. Recommendations were based on our findings. RESULTS: CPs reduced MRSA transmission in epidemic settings and in instances with high compliance, but a decrease in infection rates was not shown. Unintended consequences of CPs include decreased health care provider (HCP) time spent with patients, low HCP compliance, decreased perceptions of comfort from patients, and greater likelihood of patient complaints and negative psychologic implications. CONCLUSION: In endemic settings, there are few data to support routine use of CPs to control the spread of MRSA. Education should be performed in hospitals to improve patients' perception of care and understanding of CPs when implemented and HCPs' adherence to good hand hygiene and standard precautions practices.

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