The effect of educational intervention using surgery preference cards on anxiety and clinical competence among operating room nursing students in general surgeries: a randomized controlled trial study

Learning skills in a clinical setting is one of the most desirable methods of education in medical sciences. Using a surgical preference card is an effective method in the clinical education of operating room nursing students. The aim of this study was to determine the effect of an educational intervention using a surgical preference card on anxiety and clinical competence of operating room nursing students. This randomized and parallel-group clinical trial was conducted on 60 operating room nursing students between 2023 and 2024 in Iran. Participants were selected using the available (consecutive) method and were allocated to two groups: preference card training (n = 30) and control (n = 30) using a four-block method. The intervention involved using preference cards to teach care before, during, and after common general surgeries, and it was conducted in two one-hour sessions. The primary outcome was clinical competence, and the secondary outcome was anxiety. The Spielberger State-Trait Anxiety Inventory (STAI) and the Perceived Perioperative Clinical Competence Scale (PPCS-R) were used to collect data at two stages: before and two weeks after the intervention. Data were analyzed using descriptive and inferential statistics through SPSS software, version 20. Multiple linear regression, paired t-tests, and independent t-tests were used to analyze the data. At baseline, there were no significant differences between the two groups in terms of mean scores of state and trait anxiety and clinical competence (p > 0.05). The results of the multiple linear regression, which took into account the anxiety scores before the intervention and adjusted for their effects, showed a significant difference between the scores of state anxiety (p = 0.019) and trait anxiety (p = 0.005) in the intervention and control groups. Additionally, the mean clinical competence score after the intervention was 12.83 units higher in the intervention group than in the control group, which was significant compared to the pre-intervention score (p < 0.001). According to the findings of the present study, educational centers and universities can use the surgical preference card as a valuable educational tool to manage students’ anxiety and enhance their proficiency in performing clinical skills in the operating room.