Practical Study of Specialized Alliance Nurses' Clinical Nursing Competency Enhancement Course Based on 5G Remote Realistic Teaching： study protocol for a clinical trial

Practical Study of Specialized Alliance Nurses' Clinical Nursing Competency Enhancement Course Based on 5G Remote Realistic Teaching： study protocol for a clinical trial | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Study protocol Practical Study of Specialized Alliance Nurses' Clinical Nursing Competency Enhancement Course Based on 5G Remote Realistic Teaching： study protocol for a clinical trial Yin Zhudan, Chen Huayu, Zhou Ruhua, Tong Zirong, You Yongping, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3989771/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background 5G remote realistic teaching technology can break through geographical, time and space restrictions. It makes online conference communication mode possible, and has great room for development in the field of nursing, which can greatly improve the quality of nursing training. Knowledge sharing can be realized through 5G platform, and homogenized management of neurosurgical nursing in primary units is expected to be formed.The purpose of this study is to investigate the effect of specialized alliance nurses' clinical nursing competency enhancement course based on 5G remote realistic teaching. Methods In this pre-post comparative trial,a total of seven nursing alliance units will participate in the two-year nursing training course based on 5G remote realistic teaching.The primary outcomes will evaluate the theoretical performance and clinical competence of the nurses before and after the training.Secondary outcomes include the incidence changes of nursing quality control indicators and teaching satisfaction. Discussion This study is expected to investigate the effectiveness of the clinical nursing ability improvement courses based on 5G remote realistic teaching in specialist alliances, in order to improve the practical ability and management level of neurosurgery nursing in primary units. 5G remote realistic teaching primary unit nurse study protocol Figures Figure 1 1. Introduction Amid the processes of population aging and urbanization, as well as other socio-economic transitions, a rapid surge in the fundamental health needs of residents has emerged, leading to a discrepancy between the comparatively lagging capabilities of primary healthcare institutions.Medical frontline personnel must confront the significant disparity in the distribution of high-quality medical resources. Addressing how to effectively channel these resources to county and municipal-level hospitals, which serve a broader audience, in order to elevate the standards of medical care and nursing, enhance healthcare skills at the grassroots level, and implement hierarchical medical diagnosis and treatment, poses a question worthy of careful consideration. The pertinent theoretical knowledge within the field of neurosurgery is intricate, encompassing a wide array of medical conditions [1]. The meticulous nature of nursing procedures in this field significantly impacts patients' quality of life. Neurosurgical healthcare professionals in primary hospitals face challenges in accessing ample learning and training opportunities, which are necessary to elevate their professional skills to a higher level.The primary factors affecting the standard of healthcare and nursing at the grassroots level are the demanding work conditions and the lack of expert guidance. This circumstance influences the healthcare-seeking choices of local patients, prompting them to seek treatment at urban hospitals, thereby impeding the effective implementation of tiered medical diagnosis and treatment [2]. To enhance the equity and accessibility of healthcare services, facilitate the equitable distribution of high-quality resources, and augment the capabilities of grassroots services, the government has successively introduced policies to vigorously promote the establishment of medical consortiums. These initiatives also encourage the integration of emerging technologies, such as 5G, to empower the intelligent transformation of medical consortiums [3].Characterized by its high bandwidth, low latency, high reliability, and broad connectivity, 5G technology offers the potential to establish a dedicated network for medical consortia. Constructing a 5G-based network for medical consortia not only facilitates the efficient utilization of existing information technology applications but also possesses the scalability required to support the deployment of future novel applications [4]. Traditional offline academic conference communication is constrained by limitations in time and location. However, 5G technology enables the implementation of online conference communication for remote realistic teaching to enhance nurses' clinical competencies, without being restricted by geographical, temporal, or spatial constraints. The application of 5G-enabled remote realistic teaching holds significant potential within the nursing field. It can shorten the repetitive training periods and waiting times for nursing personnel, while utilizing multimedia formats that incorporate visuals and real-life scenarios to stimulate nurses' enthusiasm for participating in training. This approach substantially elevates the quality of nursing education and training. This study aims to conduct 5G remote realistic teaching in the Neurosurgery Department of Jiangsu Provincial People's Hospital, investigating the effects of discipline alliance based on the 5G medical consortium network. The goal is to establish standardized management for neurosurgical nursing at grassroots units, enhance the professional skills of neurosurgical nursing personnel at these units, and elevate the nursing technical proficiency in local hospitals. This endeavor seeks to facilitate the distribution of high-quality resources, fostering the advancement of the discipline of neurosurgical nursing. 2. Methods 2.1 Study design A pre-post comparative trial will be conducted to assess the changes in nursing theory, skills, teaching satisfaction, and nursing quality control indicators among specialized alliance nurses and healthcare units at the grassroots level before and after the implementation of 5G remote realistic teaching.The study is expected to span two years. Flowchart and study design schedule are presented in Fig. 1 and Table 1 ,respectively. 2.2 Theoretical Model The ADDIE theoretical model is one of the most common approaches, comprising five stages: Analysis, Design, Development, Implementation, and Evaluation [5].The ADDIE theoretical model revolves around assessment in instructional design, with each phase building upon the research conducted in the preceding stage, constituting an iterative and feedback-driven system. The ADDIE theoretical model is primarily employed to create instructional courses or training programs that aim to achieve specific learning outcomes and behaviors. It offers a systematic approach for analyzing learning needs, curriculum design and development, as well as the implementation and initial evaluation of training plans. It is highly applicable in designing training programs aimed at changing learning behaviors and enhancing learning outcomes [6] .The ADDIE theoretical model is widely applied in the field of global nursing education and has demonstrated significant instructional effectiveness. 2.3 Recruitments A survey will be administered to nurses participating in the 5G remote realistic teaching project within the neurosurgery discipline alliance member units from May 2022 to May 2024. The core unit for this study is the Neurosurgery Department of Jiangsu Provincial People's Hospital, with clinical nurses in 7 domestic nursing alliance units. Inclusion criteria encompassed those who were informed about and consented to participation in this study, aged 18 to 60, holding valid nursing qualifications, and engaged in clinical nursing duties after completing hospital pre-employment training. Exclusion criteria involved accumulated training duration of less than 60 minutes, rotating nurses, rehired personnel, and those on extended medical or maternity leave for a month or more. 2.4 Team members The 5G remote medical project was led by the Director of the Neurosurgery Department, who assumed the role of the team leader. Additionally, one specialized neurosurgery head nurse, in conjunction with three ward head nurses, served as deputy team leaders to oversee the overall planning and delineate project responsibilities. The neurosurgery head nurses from alliance member units, alongside several core nurses, comprised the project team members. They collaboratively formulated the training program and conducted preliminary investigations. The training was facilitated by 15 medical and nursing professionals from the department, who held positions as trainers. These trainers held bachelor's degrees or higher, possessed intermediate-level titles or above, had accumulated at least 5 years of specialized work experience, and had at least 3 years of mentoring experience. They were selected through self-recommendation and endorsement, with a final evaluation conducted via trial lectures using prepared course materials. 2.5 Preliminary research analysis In January 2022, a questionnaire survey was conducted among nurses participating in the 5G remote realistic teaching project within the discipline alliance. The survey encompassed topics such as basic information, training needs, monitored indicators in the respective departments, pressing issues, and clinical competency assessment scores. Among the 59 questionnaires collected, 83.04% had bachelor's degree or above, 50.84% had intermediate title or above, and 55.26–78.95% believed that it was necessary to set the contents of neurosurgery target body temperature, BIS monitoring, restraint management, artificial airway nursing, nutritional support, drainage tube nursing, skin management, etc. 97.37% of the respondents considered it necessary to discuss neurosurgery scientific research knowledge and new techniques in this training course; Among the recommended nursing workshops, physical examination and evaluation nursing workshop for neurosurgery patients was in the highest demand (84.21%), followed by tube fixation workshop, acute and critical patient transport workshop, naso-intestinal tube placement workshop, and patient restraint experience workshop. 92.10% of the respondents suggested that 1–2 case nursing rounds should be carried out in this training course. The monitoring indicators mentioned in the survey are involved in various departments. 2.6 Teaching scheme design Based on the preliminary research results and in combination with literature studies and expert consultations, the instructional program was designed following the "5W1H" principle, namely Who, When, Where, What for, What, and How. Who : Nurses from seven grassroots units within the alliance. When : Every Wednesday from 16:00pm to 17:00pm, with two sessions per week, each lasting 2 class hours (1 class hour is 30 minutes). Where : Neurosurgery Ward 1 Classroom at Jiangsu Provincial People's Hospital, equipped with dedicated 5G devices. What for : Developed based on the training outline and the current work situation of nurses within the alliance. What : Four modules were preliminarily established for the 5G remote realistic teaching neurosurgery nursing training course—Introduction, Key Points of Neurosurgery Patient Assessment, Neurosurgical Specialized Nursing Skills, and Nursing for Common Neurosurgical Diseases. How : Utilizing the 5G platform, the main methods included PowerPoint (PPT) lectures and live demonstration of practical procedures to deliver course content. 2.7 Curriculum development During the course development phase, the key aspects of curriculum development were addressed. Considering the characteristics and training needs of nurses from grassroots units within the alliance, as well as the content of neurosurgery nursing training, training materials were compiled and integrated. Additionally, active communication and exchange with nurses within the alliance were enhanced to adjust course content appropriately based on feedback. 2.8 Project implementation Prior to the implementation of the training, efforts will be made to ensure the uniformity of knowledge and skill delivery by the training instructors, thereby ensuring overall training quality. The teaching team will undergo standardized training regarding training objectives, content, teaching requirements, and methods. The theoretical instructors will conduct trial lectures before actual teaching, while practical instructors will engage in bedside teaching rehearsals. To meet the needs of the nurses within the alliance and align with teaching content requirements, instructional materials such as lesson plans, presentation slides, and teaching aids will be prepared. This preparation will be reinforced through activities such as collective lesson planning, group discussions, simulated teaching trials, video recordings, and on-site assessments. Before each course, 1–2 people will be assigned to be responsible for 5G system debugging, teaching notification, training sign-up and assessment, and quality management and control of training implementation to ensure the homogeneity of training. Before the beginning of the course, the learning objectives and main learning contents of this section will be introduced to the research subjects. Course tasks include attending classes, completing in-class tests, and participating in brainstorming sessions. In practical teaching, live broadcast of 5G ultrasonic remote consultation system is carried out, and remote realistic demonstration and guidance is provided by the trainer, during which "face-to-face" interaction can be realized, and the trainer guides and operates in real time through the network platform. During the teaching process, network interaction should be carried out appropriately, and the methods of questioning and testing in class and stage testing should be used to understand students' grasp of the teaching content and the degree of realization of teaching objectives. After the course, in order to ensure the learning effect, it is necessary to follow up and supervise the nurses' learning every time, understand the nurses' opinions on the teachers, collect the nurses' feedback information, and constantly revise and improve the teaching design scheme. 2.9 Effect evaluation Since the beginning of the training, anonymous network test papers and questionnaires will be used at regular intervals to evaluate the training effect of 5G remote realistic teaching. The theoretical mastery level, clinical ability level and the incidence of nursing quality control indicators will be compared before and after the training of neurosurgical nurses in the alliances. 2.9.1 Primary outcomes Theoretical results : The manager of the core unit will formulate a theoretical test questionnaire every three months according to the training content of the period, including 60 single choice questions, 10 multiple choice questions, 10 judgment questions and 5 question and answer questions. The exam will last 40 minutes and the total score of the test is 100 points. Each person has only one opportunity to take the test. Once submitted, the answer cannot be modified. The test interface cannot be switched during the test. Once the test interface is switched, the system will automatically submit the test results. Clinical ability results : Each nurse in the alliance will select a typical clinical case semiannually, and the two core unit managers will evaluate the nurse's nursing evaluation ability, clinical nursing ability, communication and cooperation ability, nursing records and other aspects by referring to the Assessment and Evaluation Table of Clinical Practical Work Ability of Nurses through the 5G platform. The exam will be limited to 40 minutes and the total score of each case is 100 points. 2.9.2 Secondary outcomes The core unit will select nursing managers and specialist nurses every year to control the nursing quality of the alliance units, and compare the incidence changes of nursing quality control indicators in the wards before and after the implementation of 5G real teaching in each primary unit. Nursing quality control indicators refer to the nursing quality monitoring indicators that can be retrieved in the nursing system of each hospital. This study aims to investigate the incidence of falling out of bed, unplanned extubation, urinary tract infections associated with indwelling catheters, venous thromboembolism (VTE), physical restraint of inpatients, pulmonary infection of stroke patients, no defecation for three consecutive days, hypoglycemia, hyperglycemia, incidence of new pressure injury of inpatients. At the end of the project, a teaching satisfaction survey will be conducted to understand the satisfaction of nurses in primary units participating in the survey with the content and development form of 5G remote real teaching project, which was divided into very satisfied, basically satisfied, general and dissatisfied. 2.10 Statistical analysis The network questionnaire and test results will be cross-checked and analyzed by two graduate students in the specialty. SPSS version 23.0 will be used for statistical analysis.The measurement data will be described by mean ± standard deviation (x¯±s), and the count data will be described by frequency and constituent ratio. Paired t test will be used for the data before and after training that met the normal distribution, and non-parametric rank sum test will be used for the data that does not meet the normal distribution. P < 0.05 will be considered statistically significant. 3. Discussion 3.1 Resource allocation in the health care system requires comprehensive policy and technical support. Uneven distribution of medical resources and learning resources can lead to equity and access issues. Inadequate medical and learning resources in primary hospitals can prevent those living in remote or low-resource areas from accessing quality medical care and education, which can exacerbate health inequalities.People in need of medical care are usually spread between urban and rural areas. Large first-class hospitals are mainly concentrated in cities, while grass-roots hospitals are more common in rural areas. Therefore, it is necessary to achieve a balanced allocation of resources between the two to meet the needs of different regions. Governments and health authorities should ensure a balanced allocation of medical and learning resources through rational planning, which may include providing financial incentives to attract health care professionals to work in primary hospitals and setting up special funds to support health care education in remote and remote areas. In addition, 5G technology and distance education can obtain learning and diagnosis resources through remote training of medical personnel, without the need to visit large top-three hospitals in person, which can help bridge the gap in resource allocation. 3.2 As a hot topic in distance education research, "5G" has been deeply discussed in its connotation, key features and propagation model. Under the influence of key features such as "ultra-wide connection" and "interconnection and collaboration" of 5G technology, open mobile learning will become a new way of learning, which also puts forward new requirements for teaching space. In order to ensure that learners can carry out learning activities anytime and anywhere, the separation between formal teaching space and daily teaching space must be broken down. In the traditional teaching ecosystem, teachers generally believe that knowledge is static and definite, and it is presented in the form of pictures and pictures in the textbook. The teaching process of teachers is the process of transmitting the knowledge in the textbook to all students in a straight line. In recent years, although the mobile communication technology including 4G technology has brought certain challenges to the linear knowledge transfer, due to the immaturity of the technology itself, it is easy to produce "delay, jam, low definition and other phenomena attached to the call from the server side of large video, high-definition image and cross-over mutual function" in the actual operation process. This makes the linear knowledge transfer still occupy the dominant position in the teaching process, and the static knowledge view is still deeply rooted in the existence. Now, the development of "5G" will provide new possibilities for changing the linear knowledge transmission, which can effectively overcome the technical barriers of slow speed, less connection, delay and high energy consumption according to its own characteristics of "ultra-fast access", "ultra-many connections" and "ultra-reliable". When 5G networks achieve full coverage and 5G terminals are gradually popularized, knowledge will no longer be static, but editable, connected, audiovisual, and mobile sharing. The intervention of 5G technology not only introduces interactive space into virtual time and space, but more importantly, intelligent technologies such as blockchain, big data, cloud computing, VR and AR are integrated in the 5G technology scene, so that in addition to teachers and students, students and human-computer interaction in the traditional network environment, interaction and learning between environment and environment, resources and resources are also carried out in a brain-like way. It forms an intelligent education ecosystem that includes the interaction and learning of multiple intelligent agents. 3.3 5G technology makes nursing distance teaching more interactive, real-time and efficient. 5G networks offer faster data transmission speeds and lower latency, which makes high-definition video communication in distance teaching smoother and clearer. Primary unit nurses can participate remotely in real-time teaching, simulated surgery, and actual nursing operations for a richer learning experience. 5G technology enables real-time interaction where information and questions can be quickly passed between teachers and students, and this interactivity helps increase the primary unit nurse's engagement and understanding of course content. 5G enables remote students to access virtual labs and simulated training environments without having to physically visit the actual lab. For primary unit nurse, this can provide more practical opportunities and improve her skill level. With the 5G network, teachers can monitor students' performance in real time, providing timely feedback and assessment. This helps the primary unit nurse improve quickly and better understand her weaknesses. 5G enables the accessibility and flexibility of online education, where primary unit nurses do not have to travel to physical classrooms and can participate in learning anywhere, which is particularly beneficial for grassroots units that are geographically remote or have other constraints. With the help of 5G technology, primary unit nurses can quickly connect to remote experts to consult on course content or actual cases, which helps improve the comprehensive medical knowledge of primary unit nurses. 4 Conclusion The development of telemedicine has opened up a new field of distance education and training for primary hospitals. And the use of modern network and digital media technology to carry out online teaching method have gradually become an important way of specialist nursing continuing education [7]. While 5G offers faster data transfer speeds and lower latency, to achieve 5G distance learning requires appropriate hardware and network infrastructure support. Not all regions have this infrastructure in place, so huge investments may be needed to expand and improve the network. Medical care is a highly practical field that requires hands-on and face-to-face instruction. Although some knowledge can be transferred through 5G distance teaching, some aspects, such as actual clinical skills training, may require face-to-face interaction. Manpower and material resources should be invested in the development of neurosurgery technical training courseware and the construction of network education website. The online training form based on 5G remote realistic teaching can effectively overcome the influence of time and space on offline training work, help improve the specialized ability and level of neurosurgery nurses in primary units, and 5G remote realistic teaching will be more oriented to the primary level, and ultimately promote the homogenization of domestic neurosurgery nursing management. Declarations Ethics approval and consent to participate Not applicable. Consent for publication Not applicable. Availability of data and materials The data as well as detailed descriptions of the intention survey and course arrangement are available from the corresponding author upon request. Competing Interests The authors declare that there are no competing interests. Funding This study received no specific funding from any funder. Open access funding provided by Jiangsu Province Hospital. Authors' contributions Yin Zhudan directly involved in the preparation and design of experiments, experiment implementation, draft and write papers.Chen Huayu directly involved in the experiment implementation, collect and analyze the data.Zhou Ruhua directly involved in the experiment implementation, and interpret data.Tong Zirong provided job supports involving project guidance and the article review.You Yongping provided job supports involving project guidance , researching fundings and other administrative, technical or material support.Xu Bin directly involved in the preparation and design of experiments,and review the article. Acknowledgements Thanks to the guidance and help of the researchers in this study design.Thanks to the grass-roots units for their active cooperation and participation in this study.Thanks to all the organizations and individuals who facilitated this research. References Weiqing,W., Yue J., Chunyou Q.,2017.Discussion on the solution to improve the clinical ability of neurosurgeons in primary hospitals.Chinese Medical Equipment.02,115-118. Yadu, Z.,2015.A brief history of neurosurgery in China.Chinese Journal of Surgery.53(1), 33-41. Xinlong, W., Lijie, Z.,2023.Research on the application of smart medical combination based on 5G.Data Communication.2, 6-8. Tao,H., Yeye, L.,2020.Application and development of 5G in smart medical field.Information and Communication Technology and Policy.318(12), 19-24. Reinbold,S.,2013. Using the ADDIE model in designing library instruction. Medical reference services quarterly.32(3),244-256. Patel, S.R., et al.,2018. Using Instructional Design, Analyze, Design, Develop, Implement, and Evaluate, to Develop e-Learning Modules to Disseminate Supported Employment for Community Behavioral Health Treatment Programs in New York State. Front Public Health. 6,113. Yue, Z., Jianqiang, Q.,2016.The model and thinking of continuing education of neurosurgery based on network platform.Northwest Medical Education.24(3),478-479. Table 1 Table 1 is available in the Supplementary Files section. Additional Declarations No competing interests reported. Supplementary Files Table1.doc Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3989771","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Study protocol","associatedPublications":[],"authors":[{"id":275316538,"identity":"de1ea5f6-85fd-49a1-979f-10a9751befc0","order_by":0,"name":"Yin Zhudan","email":"","orcid":"","institution":"Jiangsu Province Hospital","correspondingAuthor":false,"prefix":"","firstName":"Yin","middleName":"","lastName":"Zhudan","suffix":""},{"id":275316539,"identity":"cb958714-965e-435a-90ef-f780449cac9e","order_by":1,"name":"Chen Huayu","email":"","orcid":"","institution":"Jiangsu Province Hospital","correspondingAuthor":false,"prefix":"","firstName":"Chen","middleName":"","lastName":"Huayu","suffix":""},{"id":275316540,"identity":"666b9427-657d-4240-9dd8-613687cfe6b9","order_by":2,"name":"Zhou Ruhua","email":"","orcid":"","institution":"Jiangsu Province Hospital","correspondingAuthor":false,"prefix":"","firstName":"Zhou","middleName":"","lastName":"Ruhua","suffix":""},{"id":275316541,"identity":"944b37bb-fda7-4db8-9164-f182732ee8c3","order_by":3,"name":"Tong Zirong","email":"","orcid":"","institution":"Jiangsu Province Hospital","correspondingAuthor":false,"prefix":"","firstName":"Tong","middleName":"","lastName":"Zirong","suffix":""},{"id":275316542,"identity":"474dd545-fe54-4624-866b-f889bb65e2b3","order_by":4,"name":"You Yongping","email":"","orcid":"","institution":"Jiangsu Province Hospital","correspondingAuthor":false,"prefix":"","firstName":"You","middleName":"","lastName":"Yongping","suffix":""},{"id":275316543,"identity":"33777b8e-fa81-4452-8ebe-341ae61592c2","order_by":5,"name":"Xu Bin","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA1UlEQVRIiWNgGAWjYBACeWb+5x8+GEjUtzEzHyBOi2E7DxvjjAoLxn72tgQirTnPw8bMc6aCcWbPGQPidDA28x57wNsmwWxwI+fjjTcMdnK6DQS0sDPzpRtItkmwGdzI3Ww5hyHZ2OwAQVsYDCQM2yR4gFq2SfMwHEjcRkgLw2GglsQ2CQmgw54Rq4XHTOLAGQkDyZ4zbMRpMWxmSzZsqJBI4GdvM7acY0CEX+T5Dx98/MegLoGNmfnhjTcVdnIEtaAAYCCQohyihVQdo2AUjIJRMCIAAOjdP57EhB+yAAAAAElFTkSuQmCC","orcid":"","institution":"Jiangsu Province Hospital","correspondingAuthor":true,"prefix":"","firstName":"Xu","middleName":"","lastName":"Bin","suffix":""}],"badges":[],"createdAt":"2024-02-26 03:49:25","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3989771/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3989771/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":51809202,"identity":"8dd26801-42a5-4b74-8a92-4eeb0ff1e94f","added_by":"auto","created_at":"2024-02-29 11:49:36","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":149461,"visible":true,"origin":"","legend":"\u003cp\u003eTrial flow chart\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-3989771/v1/0eef14fb60d53c3ffd64dbbb.png"},{"id":52757087,"identity":"92ae4ad0-0072-4ef1-a2cc-6069b4e47983","added_by":"auto","created_at":"2024-03-15 11:53:11","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":536310,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3989771/v1/aa903212-22fe-4e28-af69-abc945acdd81.pdf"},{"id":51809465,"identity":"0593646e-58e5-46cc-bfba-507c796ddea6","added_by":"auto","created_at":"2024-02-29 11:57:36","extension":"doc","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":159232,"visible":true,"origin":"","legend":"","description":"","filename":"Table1.doc","url":"https://assets-eu.researchsquare.com/files/rs-3989771/v1/58004c7c8e658f19e8f5ccce.doc"}],"financialInterests":"No competing interests reported.","formattedTitle":"Practical Study of Specialized Alliance Nurses' Clinical Nursing Competency Enhancement Course Based on 5G Remote Realistic Teaching： study protocol for a clinical trial","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eAmid the processes of population aging and urbanization, as well as other socio-economic transitions, a rapid surge in the fundamental health needs of residents has emerged, leading to a discrepancy between the comparatively lagging capabilities of primary healthcare institutions.Medical frontline personnel must confront the significant disparity in the distribution of high-quality medical resources. Addressing how to effectively channel these resources to county and municipal-level hospitals, which serve a broader audience, in order to elevate the standards of medical care and nursing, enhance healthcare skills at the grassroots level, and implement hierarchical medical diagnosis and treatment, poses a question worthy of careful consideration.\u003c/p\u003e \u003cp\u003eThe pertinent theoretical knowledge within the field of neurosurgery is intricate, encompassing a wide array of medical conditions [1]. The meticulous nature of nursing procedures in this field significantly impacts patients' quality of life. Neurosurgical healthcare professionals in primary hospitals face challenges in accessing ample learning and training opportunities, which are necessary to elevate their professional skills to a higher level.The primary factors affecting the standard of healthcare and nursing at the grassroots level are the demanding work conditions and the lack of expert guidance. This circumstance influences the healthcare-seeking choices of local patients, prompting them to seek treatment at urban hospitals, thereby impeding the effective implementation of tiered medical diagnosis and treatment [2].\u003c/p\u003e \u003cp\u003eTo enhance the equity and accessibility of healthcare services, facilitate the equitable distribution of high-quality resources, and augment the capabilities of grassroots services, the government has successively introduced policies to vigorously promote the establishment of medical consortiums. These initiatives also encourage the integration of emerging technologies, such as 5G, to empower the intelligent transformation of medical consortiums [3].Characterized by its high bandwidth, low latency, high reliability, and broad connectivity, 5G technology offers the potential to establish a dedicated network for medical consortia. Constructing a 5G-based network for medical consortia not only facilitates the efficient utilization of existing information technology applications but also possesses the scalability required to support the deployment of future novel applications [4].\u003c/p\u003e \u003cp\u003eTraditional offline academic conference communication is constrained by limitations in time and location. However, 5G technology enables the implementation of online conference communication for remote realistic teaching to enhance nurses' clinical competencies, without being restricted by geographical, temporal, or spatial constraints. The application of 5G-enabled remote realistic teaching holds significant potential within the nursing field. It can shorten the repetitive training periods and waiting times for nursing personnel, while utilizing multimedia formats that incorporate visuals and real-life scenarios to stimulate nurses' enthusiasm for participating in training. This approach substantially elevates the quality of nursing education and training.\u003c/p\u003e \u003cp\u003eThis study aims to conduct 5G remote realistic teaching in the Neurosurgery Department of Jiangsu Provincial People's Hospital, investigating the effects of discipline alliance based on the 5G medical consortium network. The goal is to establish standardized management for neurosurgical nursing at grassroots units, enhance the professional skills of neurosurgical nursing personnel at these units, and elevate the nursing technical proficiency in local hospitals. This endeavor seeks to facilitate the distribution of high-quality resources, fostering the advancement of the discipline of neurosurgical nursing.\u003c/p\u003e"},{"header":"2. Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\n \u003ch2\u003e2.1 Study design\u003c/h2\u003eA pre-post comparative trial will be conducted to assess the changes in nursing theory, skills, teaching satisfaction, and nursing quality control indicators among specialized alliance nurses and healthcare units at the grassroots level before and after the implementation of 5G remote realistic teaching.The study is expected to span two years. Flowchart and study design schedule are presented in Fig. \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e and Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e,respectively.\n\u003c/div\u003e\n\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\n \u003ch2\u003e2.2 Theoretical Model\u003c/h2\u003e\n \u003cp\u003eThe ADDIE theoretical model is one of the most common approaches, comprising five stages: Analysis, Design, Development, Implementation, and Evaluation [5].The ADDIE theoretical model revolves around assessment in instructional design, with each phase building upon the research conducted in the preceding stage, constituting an iterative and feedback-driven system. The ADDIE theoretical model is primarily employed to create instructional courses or training programs that aim to achieve specific learning outcomes and behaviors. It offers a systematic approach for analyzing learning needs, curriculum design and development, as well as the implementation and initial evaluation of training plans. It is highly applicable in designing training programs aimed at changing learning behaviors and enhancing learning outcomes [6] .The ADDIE theoretical model is widely applied in the field of global nursing education and has demonstrated significant instructional effectiveness.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\n \u003ch2\u003e2.3 Recruitments\u003c/h2\u003e\n \u003cp\u003eA survey will be administered to nurses participating in the 5G remote realistic teaching project within the neurosurgery discipline alliance member units from May 2022 to May 2024. The core unit for this study is the Neurosurgery Department of Jiangsu Provincial People\u0026apos;s Hospital, with clinical nurses in 7 domestic nursing alliance units. Inclusion criteria encompassed those who were informed about and consented to participation in this study, aged 18 to 60, holding valid nursing qualifications, and engaged in clinical nursing duties after completing hospital pre-employment training. Exclusion criteria involved accumulated training duration of less than 60 minutes, rotating nurses, rehired personnel, and those on extended medical or maternity leave for a month or more.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\n \u003ch2\u003e2.4 Team members\u003c/h2\u003e\n \u003cp\u003eThe 5G remote medical project was led by the Director of the Neurosurgery Department, who assumed the role of the team leader. Additionally, one specialized neurosurgery head nurse, in conjunction with three ward head nurses, served as deputy team leaders to oversee the overall planning and delineate project responsibilities. The neurosurgery head nurses from alliance member units, alongside several core nurses, comprised the project team members. They collaboratively formulated the training program and conducted preliminary investigations. The training was facilitated by 15 medical and nursing professionals from the department, who held positions as trainers. These trainers held bachelor\u0026apos;s degrees or higher, possessed intermediate-level titles or above, had accumulated at least 5 years of specialized work experience, and had at least 3 years of mentoring experience. They were selected through self-recommendation and endorsement, with a final evaluation conducted via trial lectures using prepared course materials.\u003c/p\u003e\n \u003ch2\u003e2.5 Preliminary research analysis\u003c/h2\u003e\n \u003cp\u003eIn January 2022, a questionnaire survey was conducted among nurses participating in the 5G remote realistic teaching project within the discipline alliance. The survey encompassed topics such as basic information, training needs, monitored indicators in the respective departments, pressing issues, and clinical competency assessment scores.\u003c/p\u003e\n \u003cp\u003eAmong the 59 questionnaires collected, 83.04% had bachelor\u0026apos;s degree or above, 50.84% had intermediate title or above, and 55.26\u0026ndash;78.95% believed that it was necessary to set the contents of neurosurgery target body temperature, BIS monitoring, restraint management, artificial airway nursing, nutritional support, drainage tube nursing, skin management, etc. 97.37% of the respondents considered it necessary to discuss neurosurgery scientific research knowledge and new techniques in this training course; Among the recommended nursing workshops, physical examination and evaluation nursing workshop for neurosurgery patients was in the highest demand (84.21%), followed by tube fixation workshop, acute and critical patient transport workshop, naso-intestinal tube placement workshop, and patient restraint experience workshop. 92.10% of the respondents suggested that 1\u0026ndash;2 case nursing rounds should be carried out in this training course. The monitoring indicators mentioned in the survey are involved in various departments.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\n \u003ch2\u003e2.6 Teaching scheme design\u003c/h2\u003e\n \u003cp\u003eBased on the preliminary research results and in combination with literature studies and expert consultations, the instructional program was designed following the \u0026quot;5W1H\u0026quot; principle, namely Who, When, Where, What for, What, and How.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eWho\u003c/em\u003e: Nurses from seven grassroots units within the alliance.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eWhen\u003c/em\u003e: Every Wednesday from 16:00pm to 17:00pm, with two sessions per week, each lasting 2 class hours (1 class hour is 30 minutes).\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eWhere\u003c/em\u003e: Neurosurgery Ward 1 Classroom at Jiangsu Provincial People\u0026apos;s Hospital, equipped with dedicated 5G devices.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eWhat for\u003c/em\u003e: Developed based on the training outline and the current work situation of nurses within the alliance.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eWhat\u003c/em\u003e: Four modules were preliminarily established for the 5G remote realistic teaching neurosurgery nursing training course\u0026mdash;Introduction, Key Points of Neurosurgery Patient Assessment, Neurosurgical Specialized Nursing Skills, and Nursing for Common Neurosurgical Diseases.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eHow\u003c/em\u003e: Utilizing the 5G platform, the main methods included PowerPoint (PPT) lectures and live demonstration of practical procedures to deliver course content.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\n \u003ch2\u003e2.7 Curriculum development\u003c/h2\u003e\n \u003cp\u003eDuring the course development phase, the key aspects of curriculum development were addressed. Considering the characteristics and training needs of nurses from grassroots units within the alliance, as well as the content of neurosurgery nursing training, training materials were compiled and integrated. Additionally, active communication and exchange with nurses within the alliance were enhanced to adjust course content appropriately based on feedback.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\n \u003ch2\u003e2.8 Project implementation\u003c/h2\u003e\n \u003cp\u003ePrior to the implementation of the training, efforts will be made to ensure the uniformity of knowledge and skill delivery by the training instructors, thereby ensuring overall training quality. The teaching team will undergo standardized training regarding training objectives, content, teaching requirements, and methods. The theoretical instructors will conduct trial lectures before actual teaching, while practical instructors will engage in bedside teaching rehearsals. To meet the needs of the nurses within the alliance and align with teaching content requirements, instructional materials such as lesson plans, presentation slides, and teaching aids will be prepared. This preparation will be reinforced through activities such as collective lesson planning, group discussions, simulated teaching trials, video recordings, and on-site assessments.\u003c/p\u003e\n \u003cp\u003eBefore each course, 1\u0026ndash;2 people will be assigned to be responsible for 5G system debugging, teaching notification, training sign-up and assessment, and quality management and control of training implementation to ensure the homogeneity of training.\u003c/p\u003e\n \u003cp\u003eBefore the beginning of the course, the learning objectives and main learning contents of this section will be introduced to the research subjects. Course tasks include attending classes, completing in-class tests, and participating in brainstorming sessions. In practical teaching, live broadcast of 5G ultrasonic remote consultation system is carried out, and remote realistic demonstration and guidance is provided by the trainer, during which \u0026quot;face-to-face\u0026quot; interaction can be realized, and the trainer guides and operates in real time through the network platform. During the teaching process, network interaction should be carried out appropriately, and the methods of questioning and testing in class and stage testing should be used to understand students\u0026apos; grasp of the teaching content and the degree of realization of teaching objectives.\u003c/p\u003e\n \u003cp\u003eAfter the course, in order to ensure the learning effect, it is necessary to follow up and supervise the nurses\u0026apos; learning every time, understand the nurses\u0026apos; opinions on the teachers, collect the nurses\u0026apos; feedback information, and constantly revise and improve the teaching design scheme.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\n \u003ch2\u003e2.9 Effect evaluation\u003c/h2\u003e\n \u003cp\u003eSince the beginning of the training, anonymous network test papers and questionnaires will be used at regular intervals to evaluate the training effect of 5G remote realistic teaching. The theoretical mastery level, clinical ability level and the incidence of nursing quality control indicators will be compared before and after the training of neurosurgical nurses in the alliances.\u003c/p\u003e\n \u003cdiv id=\"Sec12\" class=\"Section3\"\u003e\n \u003ch2\u003e2.9.1 Primary outcomes\u003c/h2\u003e\n \u003cp\u003e\u003cstrong\u003eTheoretical results\u003c/strong\u003e: The manager of the core unit will formulate a theoretical test questionnaire every three months according to the training content of the period, including 60 single choice questions, 10 multiple choice questions, 10 judgment questions and 5 question and answer questions. The exam will last 40 minutes and the total score of the test is 100 points. Each person has only one opportunity to take the test. Once submitted, the answer cannot be modified. The test interface cannot be switched during the test. Once the test interface is switched, the system will automatically submit the test results.\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eClinical ability results\u003c/strong\u003e: Each nurse in the alliance will select a typical clinical case semiannually, and the two core unit managers will evaluate the nurse\u0026apos;s nursing evaluation ability, clinical nursing ability, communication and cooperation ability, nursing records and other aspects by referring to the Assessment and Evaluation Table of Clinical Practical Work Ability of Nurses through the 5G platform. The exam will be limited to 40 minutes and the total score of each case is 100 points.\u003c/p\u003e\n \u003c/div\u003e\n \u003cdiv id=\"Sec13\" class=\"Section3\"\u003e\n \u003ch2\u003e2.9.2 Secondary outcomes\u003c/h2\u003e\n \u003cp\u003eThe core unit will select nursing managers and specialist nurses every year to control the nursing quality of the alliance units, and compare the incidence changes of nursing quality control indicators in the wards before and after the implementation of 5G real teaching in each primary unit. Nursing quality control indicators refer to the nursing quality monitoring indicators that can be retrieved in the nursing system of each hospital. This study aims to investigate the incidence of falling out of bed, unplanned extubation, urinary tract infections associated with indwelling catheters, venous thromboembolism (VTE), physical restraint of inpatients, pulmonary infection of stroke patients, no defecation for three consecutive days, hypoglycemia, hyperglycemia, incidence of new pressure injury of inpatients.\u003c/p\u003e\n \u003cp\u003eAt the end of the project, a teaching satisfaction survey will be conducted to understand the satisfaction of nurses in primary units participating in the survey with the content and development form of 5G remote real teaching project, which was divided into very satisfied, basically satisfied, general and dissatisfied.\u003c/p\u003e\n \u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\n \u003ch2\u003e2.10 Statistical analysis\u003c/h2\u003eThe network questionnaire and test results will be cross-checked and analyzed by two graduate students in the specialty.\u003cp\u003eSPSS version 23.0 will be used for statistical analysis.The measurement data will be described by mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation (x\u0026macr;\u0026plusmn;s), and the count data will be described by frequency and constituent ratio. Paired t test will be used for the data before and after training that met the normal distribution, and non-parametric rank sum test will be used for the data that does not meet the normal distribution. P\u0026thinsp;\u0026lt;\u0026thinsp;0.05 will be considered statistically significant.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"3. Discussion","content":"\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e\n \u003ch2\u003e3.1 Resource allocation in the health care system requires comprehensive policy and technical support.\u003c/h2\u003eUneven distribution of medical resources and learning resources can lead to equity and access issues. Inadequate medical and learning resources in primary hospitals can prevent those living in remote or low-resource areas from accessing quality medical care and education, which can exacerbate health inequalities.People in need of medical care are usually spread between urban and rural areas. Large first-class hospitals are mainly concentrated in cities, while grass-roots hospitals are more common in rural areas. Therefore, it is necessary to achieve a balanced allocation of resources between the two to meet the needs of different regions.\u003cp\u003eGovernments and health authorities should ensure a balanced allocation of medical and learning resources through rational planning, which may include providing financial incentives to attract health care professionals to work in primary hospitals and setting up special funds to support health care education in remote and remote areas. In addition, 5G technology and distance education can obtain learning and diagnosis resources through remote training of medical personnel, without the need to visit large top-three hospitals in person, which can help bridge the gap in resource allocation.\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e3.2 As a hot topic in distance education research, \u0026quot;5G\u0026quot; has been deeply discussed in its connotation, key features and propagation model.\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eUnder the influence of key features such as \u0026quot;ultra-wide connection\u0026quot; and \u0026quot;interconnection and collaboration\u0026quot; of 5G technology, open mobile learning will become a new way of learning, which also puts forward new requirements for teaching space. In order to ensure that learners can carry out learning activities anytime and anywhere, the separation between formal teaching space and daily teaching space must be broken down. In the traditional teaching ecosystem, teachers generally believe that knowledge is static and definite, and it is presented in the form of pictures and pictures in the textbook. The teaching process of teachers is the process of transmitting the knowledge in the textbook to all students in a straight line. In recent years, although the mobile communication technology including 4G technology has brought certain challenges to the linear knowledge transfer, due to the immaturity of the technology itself, it is easy to produce \u0026quot;delay, jam, low definition and other phenomena attached to the call from the server side of large video, high-definition image and cross-over mutual function\u0026quot; in the actual operation process. This makes the linear knowledge transfer still occupy the dominant position in the teaching process, and the static knowledge view is still deeply rooted in the existence. Now, the development of \u0026quot;5G\u0026quot; will provide new possibilities for changing the linear knowledge transmission, which can effectively overcome the technical barriers of slow speed, less connection, delay and high energy consumption according to its own characteristics of \u0026quot;ultra-fast access\u0026quot;, \u0026quot;ultra-many connections\u0026quot; and \u0026quot;ultra-reliable\u0026quot;.\u003c/p\u003e\n \u003cp\u003eWhen 5G networks achieve full coverage and 5G terminals are gradually popularized, knowledge will no longer be static, but editable, connected, audiovisual, and mobile sharing. The intervention of 5G technology not only introduces interactive space into virtual time and space, but more importantly, intelligent technologies such as blockchain, big data, cloud computing, VR and AR are integrated in the 5G technology scene, so that in addition to teachers and students, students and human-computer interaction in the traditional network environment, interaction and learning between environment and environment, resources and resources are also carried out in a brain-like way. It forms an intelligent education ecosystem that includes the interaction and learning of multiple intelligent agents.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec17\" class=\"Section2\"\u003e\n \u003ch2\u003e3.3 5G technology makes nursing distance teaching more interactive, real-time and efficient.\u003c/h2\u003e\n \u003cp\u003e5G networks offer faster data transmission speeds and lower latency, which makes high-definition video communication in distance teaching smoother and clearer. Primary unit nurses can participate remotely in real-time teaching, simulated surgery, and actual nursing operations for a richer learning experience. 5G technology enables real-time interaction where information and questions can be quickly passed between teachers and students, and this interactivity helps increase the primary unit nurse\u0026apos;s engagement and understanding of course content. 5G enables remote students to access virtual labs and simulated training environments without having to physically visit the actual lab. For primary unit nurse, this can provide more practical opportunities and improve her skill level. With the 5G network, teachers can monitor students\u0026apos; performance in real time, providing timely feedback and assessment. This helps the primary unit nurse improve quickly and better understand her weaknesses. 5G enables the accessibility and flexibility of online education, where primary unit nurses do not have to travel to physical classrooms and can participate in learning anywhere, which is particularly beneficial for grassroots units that are geographically remote or have other constraints. With the help of 5G technology, primary unit nurses can quickly connect to remote experts to consult on course content or actual cases, which helps improve the comprehensive medical knowledge of primary unit nurses.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"4 Conclusion","content":"\u003cp\u003eThe development of telemedicine has opened up a new field of distance education and training for primary hospitals. And the use of modern network and digital media technology to carry out online teaching method have gradually become an important way of specialist nursing continuing education [7]. While 5G offers faster data transfer speeds and lower latency, to achieve 5G distance learning requires appropriate hardware and network infrastructure support. Not all regions have this infrastructure in place, so huge investments may be needed to expand and improve the network. Medical care is a highly practical field that requires hands-on and face-to-face instruction. Although some knowledge can be transferred through 5G distance teaching, some aspects, such as actual clinical skills training, may require face-to-face interaction. Manpower and material resources should be invested in the development of neurosurgery technical training courseware and the construction of network education website. The online training form based on 5G remote realistic teaching can effectively overcome the influence of time and space on offline training work, help improve the specialized ability and level of neurosurgery nurses in primary units, and 5G remote realistic teaching will be more oriented to the primary level, and ultimately promote the homogenization of domestic neurosurgery nursing management.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data as well as detailed descriptions of the intention survey and course arrangement are available from the corresponding author upon request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that there are no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study received no specific funding from any funder. Open access funding provided by Jiangsu Province Hospital.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eYin Zhudan directly involved in the preparation and design of experiments, experiment implementation, draft and write papers.Chen Huayu directly involved in the experiment implementation, collect and analyze the data.Zhou Ruhua directly involved in the experiment implementation, and interpret data.Tong Zirong provided job supports involving project guidance and the article review.You Yongping provided job supports involving project guidance , researching fundings and other administrative, technical or material support.Xu Bin directly involved in the preparation and design of experiments,and review the article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThanks to the guidance and help of the researchers in this study design.Thanks to the grass-roots units for their active cooperation and participation in this study.Thanks to all the organizations and individuals who facilitated this research.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eWeiqing,W., Yue J., Chunyou Q.,2017.Discussion on the solution to improve the clinical ability of neurosurgeons in primary hospitals.Chinese Medical Equipment.02,115-118.\u003c/li\u003e\n\u003cli\u003eYadu, Z.,2015.A brief history of neurosurgery in China.Chinese Journal of Surgery.53(1), 33-41.\u003c/li\u003e\n\u003cli\u003eXinlong, W., Lijie, Z.,2023.Research on the application of smart medical combination based on 5G.Data Communication.2, 6-8.\u003c/li\u003e\n\u003cli\u003eTao,H., Yeye, L.,2020.Application and development of 5G in smart medical field.Information and Communication Technology and Policy.318(12), 19-24.\u003c/li\u003e\n\u003cli\u003eReinbold,S.,2013. Using the ADDIE model in designing library instruction. Medical reference services quarterly.32(3),244-256.\u003c/li\u003e\n\u003cli\u003ePatel, S.R., et al.,2018. Using Instructional Design, Analyze, Design, Develop, Implement, and Evaluate, to Develop e-Learning Modules to Disseminate Supported Employment for Community Behavioral Health Treatment Programs in New York State. Front Public Health. 6,113.\u003c/li\u003e\n\u003cli\u003eYue, Z., Jianqiang, Q.,2016.The model and thinking of continuing education of neurosurgery based on network platform.Northwest Medical Education.24(3),478-479.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Table 1","content":"\u003cp\u003eTable 1 is available in the Supplementary Files section.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"5G, remote realistic teaching, primary unit nurse, study protocol","lastPublishedDoi":"10.21203/rs.3.rs-3989771/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3989771/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003e5G remote realistic teaching technology can break through geographical, time and space restrictions. It makes online conference communication mode possible, and has great room for development in the field of nursing, which can greatly improve the quality of nursing training. Knowledge sharing can be realized through 5G platform, and homogenized management of neurosurgical nursing in primary units is expected to be formed.The purpose of this study is to investigate the effect of specialized alliance nurses' clinical nursing competency enhancement course based on 5G remote realistic teaching.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eIn this pre-post comparative trial,a total of seven nursing alliance units will participate in the two-year nursing training course based on 5G remote realistic teaching.The primary outcomes will evaluate the theoretical performance and clinical competence of the nurses before and after the training.Secondary outcomes include the incidence changes of nursing quality control indicators and teaching satisfaction.\u003c/p\u003e\u003ch2\u003eDiscussion\u003c/h2\u003e \u003cp\u003eThis study is expected to investigate the effectiveness of the clinical nursing ability improvement courses based on 5G remote realistic teaching in specialist alliances, in order to improve the practical ability and management level of neurosurgery nursing in primary units.\u003c/p\u003e","manuscriptTitle":"Practical Study of Specialized Alliance Nurses' Clinical Nursing Competency Enhancement Course Based on 5G Remote Realistic Teaching： study protocol for a clinical trial","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-02-29 11:49:31","doi":"10.21203/rs.3.rs-3989771/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"70760fda-3be8-4dc4-b446-bd85c1484745","owner":[],"postedDate":"February 29th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-03-15T11:45:04+00:00","versionOfRecord":[],"versionCreatedAt":"2024-02-29 11:49:31","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3989771","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3989771","identity":"rs-3989771","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}