Accepted for/Published in: JMIR Formative Research
Date Submitted: Mar 17, 2026
Date Accepted: Jul 23, 2026
Feasibility of self-directed learning of Cardiopulmonary Resuscitation skills using interactive video in SimZone 0: A pilot randomized educational trial
ABSTRACT
Background:
The SimZones model proposes SimZone 0 as a preparatory, self-directed phase supported by automated feedback; however, empirical evidence on its impact on procedural skill acquisition and retention remains limited. We evaluated the feasibility and preliminary effectiveness of adding a SimZone 0 interactive-video phase before instructor-led cardiopulmonary resuscitation (CPR) training (SimZone 1) in undergraduate nursing students.
Objective:
The primary aim of this pilot randomized educational trial was to evaluate the feasibility and preliminary effectiveness of incorporating self-directed learning with interactive video in SimZone 0 as a preparatory phase before instructor-led CPR training in SimZone 1 among undergraduate nursing students.
Methods:
In this pilot randomized educational trial, fifty-two nursing students from San Pablo CEU University (Madrid, Spain) were randomly assigned to an experimental group (interactive video, IV) or a control group (traditional seminar). The experimental group completed a self-directed learning session using an interactive video in SimZone 0 before the instructor-led CPR seminar in SimZone 1, whereas the control group attended only the instructor-led seminar. Feasibility, competence acquisition, and retention were assessed immediately and at 3 and 6 months.
Results:
The experimental group achieved 72.7% competency in the self-learning phase and 100% after the seminar, compared with 84.2% in the control group. At 3 and 6 months, competence remained high in the experimental group and declined in the control group. CPR quality scores were consistently higher in the experimental group. The intervention was feasible, well accepted, and free of adverse events or technical issues.
Conclusions:
Self-directed interactive video learning as a preparatory phase before instructor-led training is feasible, acceptable, and shows promising potential to enhance CPR skill acquisition and retention among nursing students. Clinical Trial: This randomized educational trial was registered on 26 June 2025, at the ISRCTN registry with the study registration number ISRCTN16191678. Registered retrospectively.
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