Validation of virtual simulation content for prevention of unplanned extubation in intensive care

Carvalho, Cinthya Helena dos Anjos; Barra, Daniela Couto Carvalho; Alvarez, Ana Graziela; Knihs, Neide da Silva; Sasso, Grace Teresinha Marcon Dal; Cruz-Correia, Ricardo João; Sardo, Pedro Miguel Garcez

doi:10.1590/1980-220X-REEUSP-2024-0443en

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ORIGINAL ARTICLE • Rev. esc. enferm. USP 59 • 2025 • https://doi.org/10.1590/1980-220X-REEUSP-2024-0443en linkcopy

Validation of virtual simulation content for prevention of unplanned extubation in intensive care^*

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective: To develop and validate the content of an interactive virtual simulation based on a branching scenario for the prevention of unplanned extubation in adult Intensive Care Units.

Method: Technological production developed through the stages of Contextualized Instructional Design and methodological study of content validation. Content validation (objectives, structure and presentation, relevance, general aspects) was carried out by five judges, with the Content Validity Index, Content Validity Ratio, and Content Validity Coefficient being calculated.

Results: The virtual simulation contains five branched scenes, structured and implemented on a free virtual platform. The judges’ average score was 4.3 and the agreement >0.8 in all metrics for validation.

Conclusion: The virtual simulation was developed and validated in terms of content, and is recommended as an educational strategy for nurses. Digital educational technology can support nurses to promote patient safety by preventing the occurrence of unplanned extubation in the intensive care unit.

DESCRIPTORS
High Fidelity Simulation Training; Airway Extubation; Patient Safety; Intensive Care Units; Educational Technology.

Domains/Questions		CVI	CVC	CVR	Mean	SD
1. Objectives:	1.1 The contents are consistent with the objective of the clinical simulation scenario	1	0.92	1	4.6	0.89
	1.2 Learning objectives are clear and concise	1	0.84	1	4.2	0.84
	1.3 Scenario content facilitates critical thinking	1	0.84	1	4.2	0.84
	1.4 The information presented is scientifically correct	1	0.88	1	4.4	0.89
	1.5 There is a logical sequence of proposed content	1	0.92	1	4.6	0.55
	1.6 The information presented in the scenario covers the content on prevention of accidental endotracheal extubation in the ICU well.	0.8	0.8	0.6	4	1.22
	1.7 Information/content is important for the quality of care provided	1	0.96	1	4.8	0.45
	1.8 The objective of the scenario invites/instigates changes in participants’ behavior and attitude	0.8	0.76	0.6	3.8	1.30
2. Structure and presentation	2.1 The scenario script is appropriate for the participants	1	0.84	1	4.2	0.84
	2.2 The language used is easy to understand by participants	1	0.92	1	4.6	0.55
	2.3 The scenario has an attractive appearance that keeps the participant’s attention	1	0.84	1	4.2	0.84
	2.4 The data is presented in a structured and objective manner	1	0.88	1	4.4	0.55
	2.5 The way the scenario is presented contributes to the participants’ learning	1	0.84	1	4.2	0.84
	2.6 Contextual details provide clues based on desired outcomes	0.8	0.76	0.6	3.8	1.30
	2.7 The patient profile provides sufficient data to make a clinical judgment	1	0.92	1	4.6	0.55
	2.8 The visual composition of the virtual simulations structured on the online platform is attractive and seems organized	0.8	0.72	0.6	3.6	1.14
3. Relevance	3.1 The scenario allows knowledge transfer regarding the prevention of accidental endotracheal extubation	1	0.80	1	4	0.71
	3.2 The topic shows key aspects that must be reinforced.	1	0.92	1	4.6	0.55
	3.3 The model allows the transfer and generalization of learning to different contexts	1	0.84	1	4.2	0.84
	3.4 The simulation scenario script proposes the construction of knowledge	1	0.80	1	4	0.71
	3.5 Can be used by healthcare professionals/or educators	0.80	0.84	0.6	4.2	1.30
	3.6 The simulation scenario on prevention of accidental endotracheal extubation in the ICU is of sufficient quality to circulate in scientific circles	1	0.84	1	4.2	0.84
4. General aspects	4.1 Simulation can be used as a continuing education strategy to raise awareness about patient safety culture among nurses.	1	0.88	1	4.4	0.89
4. General aspects	4.2 The developed interactive virtual simulation has the potential to promote the strengthening of patient safety culture in care scenarios	1	0.96	1	4.8	0.45
Domain 1		0.95	0.86	0.90	4.3
Domain 2		0.95	0.84	0.90	4.2
Domain 3		0.97	0.84	0.93	4.2
Domain 4		1	0.92	1	4.6
Averages		0.96	0.85	0.92	4.3

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Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[T1FN1] Legend: CVI – Content Validity Index; CVC – Content Validity Coefficient; CVR – Content Validity Ratio; SD – standard deviation.

Validation of virtual simulation content for prevention of unplanned extubation in intensive care*

ABSTRACT

Validation of virtual simulation content for prevention of unplanned extubation in intensive care^*