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IRCT20251224068434N1 IRCT 2026-01-04 Tehran University of Medical Sciences Comparing the Effectiveness of an Intelligent Interactive Chatbot and Virtual Training on Emergency Nurses’ Triage Knowledge and Performance Comparing the Effectiveness of an Intelligent Interactive Chatbot and Virtual Training on Emergency Nurses’ Triage Knowledge and Performance 2026-01-21 anticipated 132 Recruiting https://irct.ir/trial/88420 interventional Randomization: Not randomized, Blinding: Not blinded, Placebo: Not used, Assignment: Parallel, Purpose: Education/Guidance. N/A ESI Triage training. Intervention 1: Intervention group 1: The first intervention group: includes triage training in the form of three interactive online sessions over two weeks, each session lasting 45 to 60 minutes and the time is determined based on the nurses' opinions. The trainings are held via Skyroom or Meet and with content based on the latest version of ESI triage, and a question and answer period is considered at the end of each session. The training content will be presented after approval by emergency medicine and emergency nursing specialists. Intervention 2: Intervention group 2: The educational content will be prepared in the form of short text files, simple audio files, infographics, short videos, and educational scenarios based on the latest version of the ESI triage system, and then uploaded to the chatbot's internal database. The chatbot design includes the compilation of scientific content based on reliable triage sources, simulated clinical scenarios, multiple-choice questions, and nursing decision-making situations, and the intervention period will be two weeks. The chatbot used in this study is an automated interactive response system based on generative artificial intelligence, whose processing infrastructure is based on GPT version 40 of OpenAI, and will be designed to provide training and support in the field of hospital triage to nurses. The chatbot will be trained through a fine-tuning process to answer questions accurately and effectively and will interact with users continuously. Based on the official ESI guide, a set of clinical scenarios will be designed to cover the full range of ESI levels, and the scenarios will be reviewed by the research team. For each scenario, the correct answer and ESI decision logic will be provided, and after the user selects the triage level, the system will provide feedback on the correct answer, decision logic, and key training points. All interactions will be stored and reviewed by the research team. In order to ensure the technical performance of the system, an initial pilot study will be conducted on 10 nurses, and the resulting data will be used solely to address technical and content deficiencies. To increase participation, the chatbot will automatically send daily reminder messages. Sustained non-interaction is defined as complete cessation of chatbot use for 4 consecutive days, and “low adherence” will be considered as an average use of less than three times a week. The effect of the intervention will be analyzed separately in the subgroup that meets this adherence criterion. In this study, the chatbot will be developed and evaluated based on the CONSORT Guidelines for Clinical Trials of Artificial Intelligence Interventions, version 2025, to ensure the quality of reporting and transparency of the process. Intervention 3: Control group: In the control group, the current status of the ward regarding triage will be considered, and after the end of the study, the prepared educational content will be made available to them in order to comply with ethical considerations. Yes - There is a plan to make this available What will be shared: Yes - There is a plan to make this available When: The access period is 12 months after the publication of the article. To whom: Researchers employed at reputable institutions with a motivation for improvement. Conditions: The data from this study can be used for research and scientific purposes. The use of the data is subject to the submission of a formal request, stating the purpose of the research, and approval by the responsible researcher. The data will be provided to the applicant anonymously, and compliance with the principles of research ethics is mandatory. Where to obtain: They should be in contact with the corresponding author at the email address. How to obtain: After the process of eligibility researcher and verification, the request recipient's information will be shared with study collaborators, and the publishable data will be made available. Comments:
public Mahdieh Khadem
Amirabad, above the 16th, Medical Sciences Dormitory, Girls' Quarter0
Tehran Iran (Islamic Republic of) 1439955975 +98 21 8801 6071 mahdieh2001.khadem@gmail.com Tehran University of Medical Sciences scientific parvaneh asgari
Dr. Mirkhani Street (East Nusrat), Towhid Square
Tehran Iran (Islamic Republic of) 1419733171 +98 21 6692 7171 p-asgari@sina.tums.ac.ir Tehran University of Medical Sciences Iran (Islamic Republic of) Iran (Islamic Republic of) Iran (Islamic Republic of) Having a bachelor's degree in nursing Failure to participate in triage training in the past three months Smartphone access no limit no limit Both Other Other Other Intervention group 1: The first intervention group: includes triage training in the form of three interactive online sessions over two weeks, each session lasting 45 to 60 minutes and the time is determined based on the nurses' opinions. The trainings are held via Skyroom or Meet and with content based on the latest version of ESI triage, and a question and answer period is considered at the end of each session. The training content will be presented after approval by emergency medicine and emergency nursing specialists. Intervention group 2: The educational content will be prepared in the form of short text files, simple audio files, infographics, short videos, and educational scenarios based on the latest version of the ESI triage system, and then uploaded to the chatbot's internal database. The chatbot design includes the compilation of scientific content based on reliable triage sources, simulated clinical scenarios, multiple-choice questions, and nursing decision-making situations, and the intervention period will be two weeks. The chatbot used in this study is an automated interactive response system based on generative artificial intelligence, whose processing infrastructure is based on GPT version 40 of OpenAI, and will be designed to provide training and support in the field of hospital triage to nurses. The chatbot will be trained through a fine-tuning process to answer questions accurately and effectively and will interact with users continuously. Based on the official ESI guide, a set of clinical scenarios will be designed to cover the full range of ESI levels, and the scenarios will be reviewed by the research team. For each scenario, the correct answer and ESI decision logic will be provided, and after the user selects the triage level, the system will provide feedback on the correct answer, decision logic, and key training points. All interactions will be stored and reviewed by the research team. In order to ensure the technical performance of the system, an initial pilot study will be conducted on 10 nurses, and the resulting data will be used solely to address technical and content deficiencies. To increase participation, the chatbot will automatically send daily reminder messages. Sustained non-interaction is defined as complete cessation of chatbot use for 4 consecutive days, and “low adherence” will be considered as an average use of less than three times a week. The effect of the intervention will be analyzed separately in the subgroup that meets this adherence criterion. In this study, the chatbot will be developed and evaluated based on the CONSORT Guidelines for Clinical Trials of Artificial Intelligence Interventions, version 2025, to ensure the quality of reporting and transparency of the process. Control group: In the control group, the current status of the ward regarding triage will be considered, and after the end of the study, the prepared educational content will be made available to them in order to comply with ethical considerations. Triage knowledge score of emergency nurses in the triage knowledge assessment questionnaire. Timepoint: Before the intervention and one month after the intervention. Method of measurement: Triage Knowledge Assessment Questionnaire. Triage performance score of emergency nurses in the triage performance assessment questionnaire. Timepoint: Before the intervention and one month after the intervention. Method of measurement: Triage Performance Measurement Questionnaire. Satisfaction score with the educational method in the satisfaction questionnaire. Timepoint: One month after the intervention. Method of measurement: acceptance and satisfaction questionnaire. Tehran University of Medical Sciences Approved 2025-12-10 Research Ethics Committee of School of Nursing and midwifery And Rehabilitation- Tehran University 6th floor. Central Headquarters of Tehran University of Medical Sciences, at the corner of Ghods Street, Keshavarz Boulevard Tehran Tehran Iran (Islamic Republic of)