Clinical Research Directory

AI-SUPPORTED FLIPPED LEARNING IN NURSING EDUCATION

The increasing complexity of healthcare services and the diversification of patient needs require nurses to be equipped not only with clinical knowledge and technical skills, but also with effective communication, critical thinking, and self-directed learning competencies. Nurses continuously interact with multidisciplinary teams throughout the processes of planning, implementing, and evaluating patient care. Therefore, communication skills are among the fundamental determinants of patient safety and quality of care. However, traditional educational methods are largely based on passive learning and may be insufficient in developing students' professional communication and self-directed learning skills. This limitation can reduce students' learning motivation and negatively affect their ability to make independent decisions and communicate effectively in clinical practice. Digital technologies and artificial intelligence (AI)-supported applications provide opportunities to strengthen student-centered approaches in education. AI-supported systems offer personalized feedback, enabling targeted support according to students' individual learning needs. The flipped learning approach, on the other hand, is based on acquiring theoretical knowledge before class, while class time is devoted to practice, discussion, and problem-solving activities. This approach enhances students' active participation and supports the development of critical thinking and communication skills. AI-supported flipped learning combines technological opportunities with pedagogical strategies to create a more interactive and personalized learning experience. This method encourages students to take responsibility for their own learning and strengthens their self-directed learning skills. Nevertheless, studies examining the effects of this approach on learning motivation and self-directed learning in nursing education remain limited. Therefore, this study aims to evaluate the effects of professional communication skills training based on an AI-supported flipped learning approach on nursing students' learning motivation and self-directed learning levels.

Effect of a Chatbot on Nursing Students' Self-Efficacy in Pediatric Medication Administration

This study looked at whether a chatbot can help nursing students feel more confident about giving medicines to children. Giving medicines to children is difficult because doses depend on the child's weight, and mistakes can be harmful. Third-year nursing students starting their pediatric clinical placement took part. They were divided by chance into two groups. Both groups received the usual training. One group also used a chatbot that helped with medicine dose calculations and answered questions about giving medicines to children, based on a trusted nursing textbook. The other group used only the usual references. Students' confidence in giving medicines to children was measured with a questionnaire before and after the placement. The study compared how much each group's confidence changed to see whether the chatbot added a benefit beyond the usual training.

Animation-Based Orotracheal Suction Training for Expert Nurses

This randomized controlled trial aimed to evaluate the effect of animation-based orotracheal suction training on the clinical reasoning competency and knowledge levels of expert pediatric nurses. Orotracheal suctioning is a complex and invasive nursing procedure requiring advanced clinical reasoning, rapid decision-making, and patient safety awareness. Although digital learning approaches are increasingly used in nursing education, evidence regarding their effectiveness among expert nurses remains limited. A total of 66 pediatric nurses with at least five years of clinical experience and classified as expert nurses according to Patricia Benner's Novice-to-Expert Model were randomly assigned to either an intervention group receiving animation-based mobile training or a control group receiving PowerPoint-supported traditional training. Clinical reasoning competency and knowledge regarding orotracheal suctioning were assessed before and after the educational intervention.

Gamified Learning Methods and HPV Knowledge in Nursing Students

This study is a randomized controlled trial (RCT) with a pretest-posttest-follow-up design that compares the effectiveness of gamified teaching methods (Gimkit and educational escape room) with traditional theoretical education in improving undergraduate nursing students' Human Papillomavirus (HPV) knowledge and HPV literacy. Both HPV knowledge and HPV literacy were prespecified primary outcome measures in the study protocol. These outcomes represent related but distinct educational constructs and are reported separately to allow independent interpretation of each outcome.

Comparing Digital and Collaborative Gamified Reinforcement Strategies for HPV Literacy and Retention Among Nursing Students

This randomized comparative study aims to evaluate the effectiveness of two gamified reinforcement strategies, Gimkit and Escape Room, on human papillomavirus (HPV) literacy, short-term retention, and gameful learning experiences among undergraduate nursing students. Following standardized theoretical instruction on HPV infection, participants will be randomly assigned to either a digital quiz-based gamification intervention (Gimkit) or a collaborative Escape Room activity. Outcomes will be assessed using the Human Papillomavirus Literacy Scale (HPV-LS) and the Gameful Experience Scale (GAMEX) at multiple time points, including baseline, post-theoretical instruction, post-intervention, and one-month follow-up.

VR Simulation-Based Implanted Port Catheter Training in Nursing Students

Implanted port catheter care is a critical clinical skill in oncology nursing, requiring accurate knowledge, aseptic technique, safe procedural practice, and early recognition of potential complications. This parallel group randomized controlled study aims to evaluate the effectiveness of virtual reality simulation-based implanted port catheter training in undergraduate nursing students. Eligible second-year nursing students will be randomly assigned to either an intervention group or a control group. All students will receive a two-hour traditional implanted port catheter training session in the classroom setting. In addition to traditional training, students in the intervention group will receive virtual reality simulation-based training consisting of two scenarios: safe implanted port catheter access and extravasation/complication management. The control group will receive only traditional training.

Impact of Climate Change Education on Nursing Students' Awareness

This study investigated the impact of peer-supported climate change education on the awareness levels of nursing students. While climate change poses a major threat to human health, nurses play a central role in reducing greenhouse gas emissions and ensuring adaptation within the healthcare sector. Raising awareness among nurses on this issue is possible through acquiring knowledge about eco-friendly practices and sustainable care strategies during their professional education. The study was conducted with students studying in the Department of Nursing at Istanbul Atlas University and lasted for 12 months. Utilizing the peer education method, students were provided with training on climate change, and the difference this education made in students' awareness levels was measured using a pre-test and post-test method. PDF The objective of the study was to evaluate the baseline awareness levels of nursing students regarding climate change and to examine how peer-supported education influenced these awareness level. Through peer education, it was aimed to encourage students to learn from one another, take a more active role in this regard, and promote climate-friendly healthcare delivery. Data were collected through face-to-face questionnaire forms and analyzed using SPSS software. The Climate Change Awareness Scale used in the study determined the changes in students' awareness levels before and after the training. The results are expected to contribute to integrating climate change and sustainability topics into the nursing education curriculum. This study aimed to enhance the capacity of future nurses to provide environmentally sensitive healthcare services.

Effects of NICU Scenario-Based Simulation on Nursing Students' Perceived Stress, Satisfaction, Self-Confidence, and Learning: A Mixed-Methods Study

This mixed-methods study examines the effects of neonatal intensive care unit (NICU) scenario-based simulation training on third-year nursing students' perceived stress, learning satisfaction, self-confidence, and simulation-based learning experiences. All eligible participants will receive a high-fidelity simulation session involving a NICU scenario that includes therapeutic communication with a postpartum mother, neonatal emergency intervention, and support for mother-infant interaction. The simulation protocol consists of prebriefing (3 minutes), environmental orientation (3 minutes), scenario-based simulation (10 minutes), and debriefing using the PEARLS model (30 minutes). Quantitative data will be collected before and after the simulation using validated scales. Qualitative data will be gathered through semi-structured focus group interviews following the simulation. The study aims to provide evidence on the effectiveness of NICU simulation-based education in nursing training.

Augmented Reality and 3D Model-Based Ventrogluteal Injection Training in Nursing Students (AR3D-VGI)

The aim of this study was to evaluate the impact of a skills training program-conducted using augmented reality (AR) and 3D model technologies-on first-year nursing students' knowledge, skills, anxiety, and satisfaction, as well as the retention of learning, regarding the correct identification of the injection site and the application of the correct technique for intramuscular (IM) injections in the deltoid (VG) region. The hypotheses of the study are as follows: H1: There is a difference in knowledge scores regarding the administration of intramuscular injections into the ventrogluteal region between the AR group and the control group. H2: There is a difference in skill scores regarding the administration of intramuscular injections into the ventrogluteal region between the AR and control groups. H3: There is a difference in state anxiety scores regarding the administration of intramuscular injections into the ventrogluteal region between the AR and control groups. H4: There is a difference in satisfaction scores regarding training methods for intramuscular injection into the ventrogluteal region between the AR and the control group. H5: There is a difference in knowledge scores regarding intramuscular injection into the ventrogluteal region between the 3D Model group and the control group. H6: There is a difference in skill scores regarding intramuscular injection into the ventrogluteal region between the 3D Model group and the control group. H7: There is a difference in state anxiety scores regarding intramuscular injection into the ventrogluteal region between the 3D Model group and the control group. H8: There is a difference in satisfaction scores regarding training methods for intramuscular injection into the ventrogluteal region between the 3D Model group and the control group. H9: There is a difference in retention scores regarding knowledge of intramuscular injection into the ventrogluteal region between the AR and control groups. H10: There is a difference in retention scores regarding knowledge of intramuscular injection into the ventrogluteal region between the 3D Model and control groups. H11: There is a difference in skill retention scores regarding the application of intramuscular injection into the ventrogluteal region between the AR and the control group. H12: There is a difference in skill retention scores regarding the application of intramuscular injection into the ventrogluteal region between the 3D Model and the control group. After providing theoretical training to the entire group, the researcher will randomly assign participants and have them practice using the AR, a 3D hip model, and a traditional model. After four weeks, the researcher will assess retention.

Effects of Simulation Fidelity on Patient-Centered Care Competency, Empathy, and Learning Outcomes in Nursing Students: A Randomized Controlled Trial

This randomized controlled trial examines the effects of simulation fidelity on nursing students' patient-centered care competency, empathy, learning self-confidence, and satisfaction. Participants will be randomly assigned to two groups: one group will practice with a standardized patient (actor) and the other with a manikin in a myocardial infarction scenario. All sessions will follow the same structured simulation protocol including briefing, simulation, and debriefing phases. The study aims to provide evidence on whether the type of simulated patient affects learning outcomes in nursing education.

The Effect of an Interactive Video on Nursing Students' Learning in the Care of Anti-Embolism Stockings

This study will be conducted as a randomized controlled trial with a parallel design to determine the impact of an interactive video developed for the care of surgical patients wearing anti-embolism stockings on nursing students' learning outcomes. The research hypotheses are as follows: H0a: There is no statistically significant difference in knowledge scores regarding anti-embolism stocking application between the intervention and control groups. H0b: There is no statistically significant difference in knowledge scores regarding anti-embolism stocking application over time. H0c: There is no statistically significant difference in skill scores regarding anti-embolism stocking application between the intervention and control groups. H0d: There is no statistically significant difference in skill scores regarding anti-embolism stocking application over time. H0e: There is no statistically significant difference in knowledge and skill scores regarding anti-embolism stocking application based on the interaction between group and time factors.

Simulator and Standardized Patient Training for Cardiopulmonary Examination Skills in Nursing Students

Cardiopulmonary physical examination is a fundamental nursing skill that is essential for the early recognition of patient problems and safe clinical decision-making. Nursing students often experience difficulties in developing competence and confidence in performing cardiac and pulmonary assessment skills during their early clinical education. This quasi-experimental study aims to compare the effects of simulation-based training and standardized patient-based training on first-year nursing students' cardiopulmonary physical examination outcomes. The study will evaluate knowledge, clinical skill performance, learning satisfaction, self-confidence, and anxiety levels before and after the educational interventions. Participants will be first-year nursing students enrolled in a health assessment course. Students will be assigned to either a simulation-based training group or a standardized patient-based training group. Data will be collected using knowledge tests, skill assessment checklists, satisfaction and self-confidence scales, and anxiety measures. The findings are expected to contribute to evidence-based nursing education by identifying effective teaching strategies for improving cardiopulmonary assessment competence among nursing students.

Digital Microlearning for Patient-Safety Readiness in Nursing Students

This randomized controlled trial evaluated the effect of a patient safety-focused digital microlearning program on nursing students before and during surgical clinical practice. Nursing students may face patient-safety and clinical decision-making challenges when moving from classroom learning to clinical settings. This study examined whether short, structured, scenario-based digital learning modules could improve patient-safety awareness, clinical error recognition, decision-making under stress, clinical practice readiness, and self-confidence. Second-year undergraduate nursing students were randomly assigned to either a digital microlearning plus standard education group or a standard education control group. Outcomes were measured at baseline before the program, immediately after the intervention, at the end of the first week of surgical clinical practice, and at the end of the seventh week of surgical clinical practice. Weekly ecological momentary assessment prompts were also used during clinical practice to examine safety-related behavioral transfer.

Three Teaching Strategies in Nursing Education: Effects on Learning and Knowledge Retention

The goal of this clinical trial is to learn whether three different instructional strategies improve learning outcomes and knowledge retention in nursing students receiving education on peritoneal dialysis catheter care. The main questions it aims to answer are: Does Pecha Kucha-based education improve students' knowledge of peritoneal dialysis catheter care compared with concept map-based education and traditional education? Do the three instructional strategies differ in terms of knowledge retention, learning satisfaction, learning experience, and perceived cognitive load? Researchers will compare Pecha Kucha-based education, concept map-based education, and traditional education to see which instructional strategy is more effective in improving students' knowledge, supporting knowledge retention, and providing a positive learning experience. Participants will: Complete a pre-test before the education. Receive one of three educational interventions on peritoneal dialysis catheter care: Pecha Kucha-based education, concept map-based education, or traditional education. Complete a post-test after the education. Complete forms evaluating learning satisfaction, learning experience, and perceived cognitive load. Complete a follow-up knowledge test to assess knowledge retention.

Efficacy of TPACK-Based Instruction in an Information Resources Course for Nursing Students

Study Purpose The purpose of this study is to evaluate the effectiveness of a blended teaching approach based on the TPACK framework in improving the skills of master\'s degree nursing students in retrieving and using network information resources. The TPACK framework integrates Technology, Pedagogy, and Content Knowledge to enhance teaching and learning experiences. Study Content and Implementation Plan This study involves a combination of online and offline teaching methods to help nursing students better understand and utilize various information resources. The main components of the study include: 1. Knowledge Mastery Survey: Students will be assessed on their understanding of the course content using a specially designed survey. 2. Resource Effectiveness Evaluation: The study will measure how helpful students find the different resources used in the course, such as videos, PPTs, and assignments. 3. Skill Improvement Assessment: The study will evaluate the extent to which the course helps improve students\' abilities in areas like literature search, document management, and academic writing. 4. Student Satisfaction Survey: Students will provide feedback on their satisfaction with the course through a comprehensive survey. By implementing these measures, the study aims to minimize any negative effects on students and maximize their learning outcomes in a safe and supportive environment.

Gamified Learning and Medication Error Prevention

This study aims to evaluate the effectiveness of gamification (using interactive tools like Kahoot!) on nursing students' awareness and knowledge levels regarding medication safety. Medication errors are a significant concern in healthcare, and innovative educational methods are needed to improve patient safety. The research will compare the traditional teaching methods with a game-based learning approach to determine which is more effective in enhancing students' clinical skills and attention to safety protocols.

Oral Health Education in Nursing Training Programs in Germany

This study aims to assess the current state of oral health education in nursing training programs in Germany. Good oral health is an important component of general health, yet it is often insufficiently addressed in nursing practice and education. This cross-sectional study uses self-developed standardized online questionnaires to collect data from educational leaders (such as school directors and program coordinators) as well as nursing trainees and students. The survey examines how oral health topics are integrated into curricula, which content is taught, how teaching is delivered, and how learners assess their own competence and educational needs in this area. The results of this study will provide a comprehensive overview of current practices and help identify gaps and opportunities to improve oral health education in nursing programs.

AI-SUPPORTED FLIPPED LEARNING IN BREAST SELF-EXAMINATION TRAINING

The global increase in cancer cases has made breast cancer the second most common cancer after lung cancer and a primary health problem among women. Early diagnosis is the most critical factor in improving survival rates and quality of life in breast cancer. Breast self-examination (BSE), which enables individuals to notice changes in their own breast tissue during the early diagnosis process, is a low-cost and effective awareness method. It is essential that nurses, who play a key role in raising public awareness on this issue, and nursing students, who are the future healthcare professionals, have sufficient knowledge and practical skills in BSE. However, the literature shows that even if students have theoretical knowledge, their application rates are low. In this context, the "AI-Supported Flipped Learning" model, which goes beyond traditional methods and supports active learning, personalized feedback, and digital literacy, has the potential to be an innovative solution in nursing education. Objective: This study aims to evaluate the effect of AI-supported flipped learning model and traditional education on the knowledge levels and performance skills of nursing students regarding BSE knowledge and skills.

Escape Room in Pressure Ulcer Education

This randomized controlled trial (RCT) with a pretest-posttest design aimed to determine the effect of a game-based escape room teaching method on intern nursing students' knowledge levels regarding pressure ulcers. The study was conducted at the Faculty of Nursing, Aydın Adnan Menderes University between March and December 2025. A total of 56 senior nursing students were randomly assigned to either the intervention group (n = 28) or the control group (n = 28). The intervention group received both theoretical instruction and escape room-based learning activities, while the control group received only traditional lecture-based theoretical instruction. Data were collected using the Student Information Form, the Pressure Ulcer Knowledge Assessment Tool 2.0 (PUKAT 2.0-T), and the Gameful Experience Scale (GAMEX). The primary outcome was the change in pressure ulcer knowledge levels measured using the Pressure Ulcer Knowledge Assessment Tool 2.0 (PUKAT 2.0-T) across three time points: baseline, immediately after theoretical instruction, and 1 month after the intervention.

The Effect of Gamified Metaverse-Based Training on Nursing Students' Self-Efficacy and Metaverse Perception Regarding Pressure Injury Management

Introduction: Pressure ulcers are a largely preventable clinical problem that negatively impacts the quality of patient care and constitutes a significant economic burden for healthcare systems. The prevention and effective management of these ulcers are closely related to nurses' knowledge, skills, and self-efficacy levels. However, current nursing education programs show a limited number of practice-based and interactive training approaches for the prevention and management of pressure ulcers. In recent years, innovative and technology-supported training methods such as gamification and metaverse have emerged as promising approaches for improving students' knowledge and self-efficacy levels by increasing their active participation in learning processes. Aim: The aim of this research is to evaluate the effect of gamified metaverse-based training developed for nursing students on their knowledge level, academic self-efficacy, and metaverse perception regarding pressure ulcer management. Method: The research was planned as a randomized controlled experimental design. The population of the study will consist of students studying in the nursing department. The sample size was calculated using G\*Power based on PUKAT 2.0-T scores; Assuming a two-way α=0.05 and power=0.80, at least 26 participants were selected for each group, and the total sample size was planned as 60 students, taking into account possible losses. Participants will be administered a Demographic Information Form, the Pressure Ulcer Knowledge Level Assessment Tool 2.0-Updated Version (PUKAT 2.0-T), and the Nursing Students Academic Self-Efficacy Scale. Participants will be randomly assigned to intervention and control groups based on their pre-test scores. The intervention group will receive traditional classroom theoretical training and gamified metaverse-based training for two weeks, while the control group will receive traditional classroom theoretical training. Post-tests will be administered immediately after the intervention and one month later. In addition, the Metaverse Perception Scale will be administered to the intervention group. Data will be collected using the Pressure Ulcer Knowledge Assessment Tool 2.0-Updated Version (PUKAT 2.0-T), the Nursing Students Academic Self-Efficacy Scale, and the Metaverse Perception Scale for Nursing Students. Results: The obtained data will be analyzed using appropriate statistical methods. Conclusion: This research is expected to provide evidence regarding the effectiveness of innovative digital education models in nursing education and contribute to the development of educational strategies for the prevention of pressure ulcers.

The Effectiveness of Gamified Metaverse-Based Training on Patient Safety for Nursing Students

Introduction: Patient safety issues, such as medication errors, healthcare-associated infections, unsafe surgical procedures, and diagnostic errors, can negatively impact the quality of healthcare and patient outcomes due to preventable risks. There is a need for innovative, interactive educational approaches to ensure the lasting acquisition of patient safety competencies in nursing students and to strengthen their transfer to the clinical environment. Aim: This study aims to evaluate the effect of gamified metaverse-based training on patient safety competencies in nursing students and to assess student opinions regarding metaverse-based training. Method: The research will be conducted using a mixed-methods design. The quantitative phase will be an experimental design including intervention and control groups, pre-test-post-test, and a one-month follow-up (retention test). The research will be conducted between February 2026 and May 2026 with second-year students studying in the Spring semester of 2025-2026 at Başkent University Nursing Department in Ankara. According to G\*Power calculations, a minimum sample size of 52 was found; considering a possible 10% loss, the total sample size was planned as 60 students (intervention=30, control=30). All participants will take the Patient Safety Knowledge Level Test (pre-test) and the Patient Safety Competency Self-Assessment Tool before the training. This will be followed by 2 hours of traditional theoretical training on patient safety; the intervention group will also receive gamified metaverse-based training via Spatial.io for two weeks. Post-tests will be administered after the training and one month later. Data collection tools include the Demographic Information Form, the Patient Safety Knowledge Level Test, the Patient Safety Competency Self-Assessment Tool (PSCS), and focus group interviews to be conducted in the intervention group. Quantitative data will be analyzed through within-group and between-group comparisons; qualitative data will be analyzed using thematic analysis, and the findings will be interpreted holistically. Findings (Expected): Gamified metaverse-based training is expected to provide a greater increase in mean scores on the Patient Safety Knowledge Level Test (PSL) and total and sub-dimension scores (knowledge-skills-attitudes) of nursing students compared to the control group, and to support the retention of these results. Conclusion: This study is expected to generate evidence regarding the effectiveness of gamified metaverse-based training in improving patient safety competencies in nursing education and to contribute to the structuring of patient safety training in a more integrated, student-centered, and sustainable manner.

ADDIE-Based Training Program for Nurses on Medical Device-Related Pressure Injuries

Medical device-related pressure injuries (MDRPIs) are a significant and increasing problem in clinical settings, particularly in intensive care units, adversely affecting patient outcomes and increasing healthcare costs. Nurses play a critical role in the prevention and management of MDRPIs; however, previous studies have shown that their knowledge and practices in this area are often insufficient. This study aims to develop an ADDIE (Analysis, Design, Development, Implementation, Evaluation) model-based training program for nurses and to evaluate its effect on their knowledge and care practices related to MDRPIs. The study is designed as a single-group pretest-posttest pre-experimental study and will be conducted with nurses working in intensive care units. Data will be collected at three time points: before the training (pretest), immediately after the training (posttest), and one month after the training (follow-up). The training program will be delivered face-to-face using structured educational materials. Outcomes will include changes in nurses' knowledge levels and their evaluations of the training program. The findings are expected to contribute to improving nursing care practices and enhancing patient safety by supporting effective prevention and management of MDRPIs.

Blockchain-Enabled E-Portfolios for Competency Tracking in Undergraduate Nursing Education: A Randomized Controlled Trial

This study evaluates whether a blockchain-enabled electronic portfolio can improve competency tracking and lifelong learning in undergraduate nursing education. Conventional electronic portfolios are often fragmented across courses and clinical rotations, difficult to verify across institutions, and limited in supporting learner ownership of records. To address these challenges, this study compares a blockchain-enabled e-portfolio system with a conventional Moodle-based e-portfolio during a medical-surgical clinical rotation. Third-year undergraduate nursing students at Jouf University, Saudi Arabia, were randomly assigned to use either the blockchain-enabled e-portfolio intervention or the conventional e-portfolio control. The intervention was designed to support cryptographically verifiable competency records, structured reflective evidence, and personalized competency feedback through dashboard analytics. The main outcomes include clinical competence assessed by an Objective Structured Clinical Examination (OSCE), lifelong learning orientation, portfolio quality, and trust in the credibility and portability of competency records. After the quantitative phase, focus group interviews were conducted with students in the intervention group to explore their experiences with the system and the mechanisms through which it may influence learning. The study aims to determine whether blockchain-enabled e-portfolios offer educational advantages over conventional portfolio systems in competency-based nursing education and to identify implementation factors that may support or hinder adoption.

Building Sustainability Competencies in Future Nurses

Global warming and social justice issues are increasing the complexity of global healthcare delivery. Health systems significantly contribute to environmental harm through carbon emissions, medical waste, and resource overuse. Nurses, as the largest group in healthcare, face workplace hazards and environmental challenges, highlighting the need for institutions to promote sustainable practices and workplace safety. The United Nations' Sustainable Development Goals (SDGs) emphasize integrated social, economic, and environmental sustainability, with health and universal health coverage as key themes. The International Council of Nurses (ICN) underscores nurses' vital role in achieving these goals by linking nursing care to public health, sustainability, climate action, and education. Developing sustainability competencies in nursing education requires practical training in environmentally responsible behaviors within healthcare settings, beyond theoretical knowledge.