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CompletedNCT07737002Updated Jul 31, 2026

Sequential Case Triangle-Based Learning and Psychosocial Care Competency in Nursing Students

An interventional study of Sequential Case Triangle Based Project in Psychosocial Care Competency in Nursing Students, sponsored by Medipol University. Completed at 1 site in Turkey (Türkiye). Per ClinicalTrials.gov, last updated 2026-07-31.

Sponsored by Medipol University · Not applicable, Interventional, and Other

From the registry’s dates

  • Registered 5 months after the study started (first participant enrolled Feb 2026, registered Jul 2026).
Phase
Not applicable
Study type
Interventional
Enrollment
179
Allocation
Not applicable
Sex
All
01

Study summary

This study will look at whether a teaching method called "Sequential Case Triangle-Based Project-Based Learning" helps nursing students learn psychosocial care skills better. The study will take place during a Psychosocial Nursing course for fourth-year nursing students. Students will be divided into groups. Each group will work on one part of a patient case (creating the case, assessing it, or planning nursing care) using short role-play videos, building on the work of the group before them. Before and after the course, students will complete surveys measuring their psychosocial care competency, teamwork (cooperative learning) skills, and clinical reasoning skills. The study will compare students' scores before and after the course to see if this teaching method improved these skills.

Read the detailed description

Background: Nursing education aims to develop critical thinking, problem-solving, and clinical reasoning skills, alongside the ability to provide holistic psychosocial care. Case-based and project-based learning are student-centered strategies shown to support these outcomes, but their combined application in a sequential, team-dependent format has not been widely studied in psychosocial nursing education.

Objective: To evaluate the effect of a Sequential Case Triangle-based project-based learning approach, applied within a Psychosocial Nursing course, on nursing students' self-assessed psychosocial care competency, cooperative learning, and clinical reasoning levels.

Hypotheses:

H1: Students' psychosocial care competency self-assessment scores will increase after the intervention.

H2: Students' cooperative learning scores will increase after the intervention. H3: Students' clinical reasoning levels will increase after the intervention.

Design: Single-group, pretest-posttest quasi-experimental design.

Setting: Fourth-year nursing students enrolled in the "Psychosocial Nursing" elective course (Turkish-medium and English-medium sections) at Istanbul Medipol University, Faculty of Health Sciences, Department of Nursing, during the 2025-2026 spring semester.

Intervention: Over the 15-week course, the class was divided into 20 main groups of 9 to 12 students each (179 participants in total), and every main group was split into three subgroups responsible for a sequential stage of the nursing process: case creation (depicting psychosocial responses to illness), psychosocial assessment, and planning/implementing psychosocial nursing interventions. Each subgroup prepared a short role-play video for its stage and submitted it to the course instructor, who forwarded it unedited to the next subgroup. Subgroups had no access to or prior knowledge of the case content created by the preceding subgroup; each stage was developed solely on the basis of the video received, without the ability to view or revise earlier work. In the final stage, the three videos were combined into one case narrative and discussed in class.

Outcomes were assessed using validated self-report instruments, administered face-to-face at baseline (course week 1) and post-intervention (course week 15).

Statistical Analysis: Data were analyzed using SPSS 22.0. Descriptive statistics (mean, SD, median, min-max for quantitative variables; frequency and percentage for categorical variables) were reported. Pretest-posttest comparisons used the paired-samples t-test; group comparisons used the Student's t-test (two groups) or one-way ANOVA with Bonferroni post-hoc test (three or more groups); associations between variables were assessed with Pearson correlation. Significance was set at p\<0.05, 95% confidence interval.

02

Conditions studied

  • Psychosocial Care Competency in Nursing Students

Keywords

  • Psychosocial Nursing
  • Nursing Education
  • Cooperative Learning
  • Clinical Reasoning
  • Project-Based Learning
  • Case-Based Learning
  • Case Triangle
03

In context

Lead sponsor

Medipol University is the lead sponsor of 311 studies on the registry; 86 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
Child (0–17), Adult (18–64), Older adult (65+)
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  • Enrolled in the "Psychosocial Nursing" elective course
  • Willing to voluntarily participate in the study and sign the Informed Consent Form

Exclusion criteria

Exclusion Criteria:

  • Unable to complete the course (e.g., more than five absences, failure to submit the project assignment, or withdrawal from the course)
05

Study design

Phase
Not applicable
Primary purpose
Other
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
179 participants (actual)

Study arms

  • Experimental
    Experimental Group

    Behavioral: Sequential Case Triangle Based Project

Interventions

  • BehavioralSequential Case Triangle Based Project

    Intervention: Over the 15-week course, the class was divided into 20 main groups of 9 to 12 students each and every main group was split into three subgroups responsible for a sequential stage of the nursing process: case creation (depicting psychosocial responses to illness), psychosocial assessment, and planning/implementing psychosocial nursing interventions. Each subgroup prepared a short role-play video for its stage and submitted it to the course instructor, who forwarded it unedited to the next subgroup. Subgroups had no access to or prior knowledge of the case content created by the preceding subgroup; each stage was developed solely on the basis of the video received, without the ability to view or revise earlier work. In the final stage, the three videos were combined into one case narrative and discussed in class.

    Also known as: Sequential Case Triangle-Based Project-Based Learning Approach

06

What researchers measure

Primary outcomes

  1. Psychosocial Care Competency Self-Assessment

    The Psychosocial Care Competency Self-Assessment Scale is an 18-item, 5-point Likert-type self-report scale with four subscales (symptom identification, use of knowledge, intervention, and diagnosis). Total scores range from 18 (minimum) to 90 (maximum), with higher scores indicating better self-assessed psychosocial care competency.

    Time frame: Baseline (course week 1) and post-intervention (course week 15)

  2. Clinical Reasoning

    The Clinical Reasoning Scale for Nursing Students is a 16-item, 5-point Likert-type self-report scale with four subscales (awareness of clinical clues, verification of clinical problems, action determination and implementation, and evaluation and reflection). Total scores range from 16 (minimum) to 80 (maximum), with higher scores indicating a higher level of clinical reasoning.

    Time frame: Baseline (course week 1) and post-intervention (course week 15)

Secondary outcomes

  1. Cooperative Learning

    The Cooperative Learning Scale is a 15-item, 5-point Likert-type self-report scale with five factors (interpersonal skills, group processing, positive interdependence, supportive interaction, and individual accountability), with no reverse-scored items. Total scores range from 15 (minimum) to 75 (maximum), with higher scores indicating higher cooperative learning skills.

    Time frame: Baseline (course week 1) and post-intervention (course week 15)

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Study locations

1 site
  • Istanbul Medipol University
    Istanbul, Kavacık 34810, Turkey (Türkiye)
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References and documents

Publications

  • Thought process Thought process 2,000 karakter sınırına uyacak şekilde sadece ölçeklerin geçerlik/uyarlama kaynaklarını seçtim (arka plan/literatür atıflarını çıkardım): Karataş, H., Kelleci, M.; Psikososyal Bakım Yetkinliği Öz Değerlendirme Ölçeği'nin geliştirilmesi geçerlik ve güvenirlik çalışması; Psikiyatri Hemşireliği Dergisi; 2021; 12(3); 263-271. Fernandez-Rio, J., Cecchini, J. A., Morgan, K., Mendez-Gimenez, A., Lloyd, R.; Validation of the cooperative learning scale and cooperation global factor using bifactor structural equation modelling; Psicología Educativa; 2022; 28(2); 91-97. Güngör, P., Kaya Uyanık, G., Yeşil, R.; İşbirlikli Öğrenme Ölçeği: Türkçeye Uyarlama Çalışması; MANAS Sosyal Araştırmalar Dergisi; 2025; 14(Eğitim Bilimleri Ek Sayısı); 31-49. Huang, H. M., Huang, C. Y., Lin, K. C., Yu, C. H., Cheng, S. F.; Development and psychometric testing of the clinical reasoning scale among nursing students enrolled in three types of programs in Taiwan; Journal of Nursing Research; 2023; 31(2); e263. Bal, B., Kaba, N. K., Öztürk, H.; Hemşirelik Öğrencileri için Klinik Muhakeme Ölçeğinin Türkçe Geçerliği ve Güvenirliği: Bir Metodolojik Çalışma; Journal of Nursology; 2024; 27(2); 129-135.

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 31, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT07737002
Lead sponsor
Medipol University
Responsible party
Seda Er (Assist. Prof., Medipol University) — Principal investigator
First posted
Jul 30, 2026
Start date
Feb 9, 2026
Primary completion
May 18, 2026
Completion
May 18, 2026
Last update
Jul 31, 2026

Study contacts

Seda Er
study chair · Medipol University

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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