An interventional study of Intervention Description - Digital Storytelling Group and Control Group (Traditional Case-Based Education) in Education, Nursing, Students, Nursing and Clinical Competence, sponsored by Sakarya University. Not yet recruiting at 1 site in Turkey (Türkiye). Open to participants aged 18 Years to 45 Years. Per ClinicalTrials.gov, last updated 2026-03-25.
Sponsored by Sakarya University · Not applicable, Interventional, and Basic science
Study Type: Randomized Controlled Experimental Study
Purpose:
This study aims to evaluate the effects of digital storytelling-enhanced nursing process education on nursing students' knowledge, nursing process competency, and clinical reasoning skills. The nursing process, which includes assessment, diagnosis, planning, implementation, and evaluation, forms the foundation of evidence-based and holistic care. However, the literature indicates that nursing students often face difficulties in assessment, prioritization, and individualization of care interventions and frequently apply the process mechanically.
The study addresses the following primary questions:
Does digital storytelling improve nursing students' knowledge of the nursing process?
Does digital storytelling enhance students' nursing process competency and clinical reasoning skills?
Study Design and Comparison:
Participants will be assigned to either the intervention or control group based on their Nursing Process knowledge scores. Groups will be stratified by gender and knowledge test scores using a stratified randomization method to ensure balanced distribution and group homogeneity. Researchers will compare outcomes between groups to evaluate the effectiveness of the educational approach.
Participants' Key Activities:
Participants must be first-time enrollees in the Fundamentals of Nursing I course, have completed all course content, and have voluntarily agreed to attend.
Complete pre- and post-intervention assessments, including the Nursing Process Knowledge Test, Nursing Process Competency Scale, Clinical Reasoning Assessment Rubric, and Instructional Material Motivation Scales.
Engage in follow-up evaluations immediately after the intervention and three months later to assess the retention and sustainability of learning outcomes.
Additional Notes:
Digital storytelling materials will be validated through expert review and pilot testing. The Clinical Reasoning Assessment Rubric will undergo Turkish-language validity and reliability evaluation. Findings are expected to provide evidence on the effectiveness of digital storytelling in nursing process education, support curriculum development at the undergraduate level, and guide the broader implementation of technology-enhanced, reflective learning approaches in nursing education.
Sakarya University is the lead sponsor of 178 studies on the registry; 48 are open to participants now.
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Exclusion Criteria:
Participants in the intervention group will receive nursing process education supported by digital storytelling within the Nursing Fundamentals I course. A digital story developed by the research team will present a single clinical scenario illustrating the stages of the nursing process, including assessment, diagnosis, planning, implementation, and evaluation. Students will watch the digital story and participate in guided discussions to analyze the presented clinical situation and apply the nursing process in a structured manner. The digital storytelling approach is intended to promote reflective learning, contextual understanding of the patient situation, and the development of clinical reasoning skills. Assessments will be conducted before the intervention, immediately after the educational sessions, and three months later to evaluate nursing process knowledge, competency, and clinical reasoning outcomes.
Other: Intervention Description - Digital Storytelling Group · Other: Control Group (Traditional Case-Based Education)
Participants assigned to the intervention group will receive nursing process education supported by digital storytelling within the Nursing Fundamentals I course. A digital story developed by the research team will present a single clinical scenario illustrating the stages of the nursing process, including assessment, diagnosis, planning, implementation, and evaluation. Students will watch the digital story, participate in guided discussions, and analyze the presented scenario to apply the nursing process in a structured manner. This approach aims to promote reflective learning, contextual understanding of the patient situation, and the development of clinical reasoning skills. Educational activities will be conducted during scheduled course sessions as part of the nursing process training.
Participants in the control group will receive traditional nursing process education within the Nursing Fundamentals I course. Teaching will be conducted using a written clinical case representing the same patient situation used in the intervention group. Students will analyze the case and apply the steps of the nursing process, including assessment, diagnosis, planning, implementation, and evaluation, through instructor-led explanations and classroom discussion. This approach reflects the conventional educational method used in the course. Outcome assessments will be conducted at the same time points as the intervention group, including before the intervention, immediately after the educational sessions, and three months later, in order to evaluate nursing process knowledge, competency, and clinical reasoning skills.
Nursing Process Knowledge
Change in nursing students' knowledge of the nursing process measured using the Nursing Process Knowledge Test.The student knowledge test consists of 25 multiple-choice questions designed to assess knowledge related to the nursing process. Each correct answer is scored as 4 points and incorrect answers receive 0 points, resulting in a total possible score ranging from 0 to 100. Higher scores indicate a higher level of knowledge. It is expected that students who participate in the digital storytelling-based educational intervention will demonstrate an increase in knowledge scores compared with their baseline scores.
Time frame: Baseline pre-intervention, immediately after the educational intervention, and 3 months after the intervention.
Nursing Process Competency Scale
The Nursing Process Competency Scale (NPCS) is a 24-item instrument comprising five subscales: Data Collection (items 1-4), Patient Problem/Nursing Diagnosis (items 5-9), Planning (items 10-14), Implementation (items 15-21), and Evaluation (items 22-24). Responses are recorded on a five-point Likert scale (1 = I do not trust myself at all, 2 = I do not trust myself, 3 = I feel I need more practice, 4 = I trust myself, 5 = I feel competent in this skill), with no cut-off points or reverse-scored items. Subscale scores are calculated by dividing the total score by the number of items, resulting in mean scores ranging from 1 to 5, where higher scores indicate greater competency in the nursing process.
Time frame: Baseline pre-intervention, immediately after the educational intervention, and 3 months after the intervention.
Clinical Reasoning Skills
Change in students' clinical reasoning skills evaluated using the Clinical Reasoning Assessment Rubric applied to the nursing process case analysis. The Clinical Reasoning Rubric is an assessment tool developed to evaluate students' clinical reasoning skills. The rubric is structured into eight categories based on the five stages of the nursing process. Content and face validity of the rubric were established qualitatively, resulting in a clear and practical set of criteria for evaluating clinical reasoning performance. The rubric is used to systematically assess students' clinical reasoning during the nursing process.
Time frame: Baseline pre-intervention, immediately after the educational intervention, and 3 months after the intervention.
Instructional Material Motivation
Students' motivation regarding the instructional material will be evaluated using the Instructional Materials Motivation Scale (IMMS). This scale is a unidimensional 14-item instrument with no reverse-scored items and is specifically designed to measure users' motivation in relation to a single instructional material or application. Higher total or mean scores reflect a greater degree of positive motivation toward the evaluated material.
Time frame: Immediately after completion of the educational intervention.
Plan to share: Undecided — The decision regarding sharing individual participant data has not yet been made. This study involves undergraduate nursing students, and the collected data include personal academic information and responses to educational assessments. Data sharing considerations will take into account participant confidentiality, ethical approvals, and institutional policies. A final plan for data sharing may be developed upon completion of the study and in accordance with applicable regulations and guidelines.
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Sakarya University