Investigating the Effect of Evaluation by Direct Observation of Procedural Skills Method on the Level of Anxiety and Clinical Performance of Nursing Students during Drug Injections

Abstract Introduction Junior nursing students frequently experience performance anxiety during clinical skills training, particularly with invasive procedures like injections, affecting the quality of their work. Direct Observation of Practical Skills (DOPS) constitutes a contemporary pedagogical and evaluative approach, affording constructive feedback and facilitating enhanced clinical proficiency. This study’s aim was to determine the effect of DOPS on the anxiety and performance of nursing students during injection procedures. Method This quasi-experimental study employed census to recruit 74 first-semester nursing students from Shahid Beheshti Nursing School. These students were randomly assigned to either a control group (n = 36) or an intervention group (n = 38). Both groups received equivalent training in injection techniques (intramuscular, intravenous, subcutaneous, and intradermal). Student anxiety levels and performance were assessed using the Spielberger’s State-Trait Anxiety Inventory and standardized checklists respectively on two occasions: once during the first week and again in the third week following injection training. Evaluations in the intervention group employed the DOPS method, while the control group underwent standard evaluation procedures. SPSS version 16 was utilized for data analysis, employing descriptive and analytical statistical methods with a significance level of 0.05. Results Pre-intervention, no significant differences in anxiety or performance were observed between groups (p < 0.05). Post-intervention, DOPS implementation resulted in a significant reduction in state and trait anxiety within the intervention group, as determined by the chi-square test and Wilcoxon tests(p < 0.001). Also, the results showed that, based on the independent and paired t-tests, their performance after the evaluation was better in the intervention group compared to the control group and to before the intervention. (p < 0.001). Conclusion Findings indicate that the DOPS method mitigates anxiety and enhances the injection skills of nursing students, suggesting its efficacy as a pedagogical tool in clinical training.