Factors Associated With Pain Perception and Management Among Paediatric Nurses and Nursing Students Using Virtual Children: A Comparative Study.
Hyejung Lee, Hyeryeong Lee, Sumi Oh and 1 others
PMID 39258842WHAT IT FOUND
Nurses and students underrated pain in virtual children who smiled rather than grimaced, even when self-reporting high scores.
Nurses scored pain higher than students, but both groups let facial expressions override the patient's reported intensity.
Key findings
01Both nurses and students significantly underrated the pain of virtual children displaying a smiling facial expression compared to those grimacing, despite identical self-reported pain scores.
02Paediatric nurses assigned higher overall pain scores and administered higher morphine doses than nursing students, though both groups still underrated pain relative to the self-report.
03Pain knowledge scores (PNKAS) did not differ significantly between nurses and students, suggesting experience alone did not improve knowledge, though it correlated with higher pain ratings.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was recruited from a single tertiary hospital and one nursing school in South Korea, limiting generalisability. Participants responded to virtual vignettes rather than real patients, so they could not interact with or assess the child's full clinical context. The study used only quantitative methods, so it cannot explain why participants chose specific pain scores or doses. The reliability of the PNKAS in this study (Cronbach's alpha 0.68) was lower than the original instrument's reported range (0.72–0.77).
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not assume nurses manage pain better than students simply because they gave higher scores. Both groups underrated pain in smiling children, and the difference in scores may reflect risk aversion or protocol differences rather than superior clinical judgment. The study shows a shared bias, not a clear advantage for experienced staff.