ArticleBMC medical education2026
Pre-post changes in operating room nurses' knowledge and attitudes toward medical device-related pressure injuries after a problem-based and simulation-based training program: a single-group pretest-posttest study.
Article in BMC medical education, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo examine within-participant pre–post changes in operating room (OR) nurses’ knowledge and attitudes toward medical device–related pressure injuries (MDRPIs) following a problem-based learning (PBL) and simulation-based training program.
methodsA prospective, single-group, pretest–posttest quasi-experimental study was conducted in the OR of a tertiary hospital from March to June 2025. A total of 80 OR nurses who met the inclusion criteria were enrolled. The intervention consisted of eight small-group training sessions integrating problem-based learning (PBL), case discussions, and scenario-based simulation. Each theoretical PBL/case session lasted 2 h and each simulation session 1 h. MDRPI-related knowledge and attitudes were assessed before and after the intervention using the validated Chinese versions of the Pieper–Zulkowski Pressure Ulcer Knowledge Test (PZ-PUKT) and the Attitude towards Pressure Ulcer Prevention instrument (APuP).
resultsThe mean total PZ-PUKT score significantly increased from 40.58 ± 9.00 to 53.23 ± 6.78 (P < 0.001), and the overall knowledge accuracy improved from 56.36% to 73.93%. Significant gains were observed in all subdomains, with accuracy increasing from 64.57% to 78.88% for risk factors/prevention, from 50.75% to 68.90% for staging, and from 51.46% to 72.33% for wound description. The total APuP score also significantly increased from 40.06 ± 3.33 to 44.60 ± 2.49 (P < 0.001), corresponding to an accuracy improvement from 77.04% to 85.77%. Significant improvements were found in personal prevention capability, prioritization of prevention, perceived impact of pressure injuries, and confidence in the effectiveness of prevention (all P < 0.05). No statistically significant change was observed in the responsibility dimension (P = 0.157).
conclusionParticipants’ knowledge and attitude scores were higher at post-test than at pretest. Statistical analysis indicated an association between the training intervention and improved MDRPI-related cognition and attitudes. These findings suggest potential benefits of this PBL-simulation hybrid training for operating room MDRPI prevention, though causal inference is limited by the single-group pretest-posttest design.
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