This study was conducted in a pretest-posttest parallel-group, randomized controlled design.The population of the study consisted of students (n=220) enrolled in the Fundamentals of Nursing course at the Faculty of Nursing of a public university in the 2022-2023 academic year.According to the exclusion criteria, 56 students were excluded from the study. One hundred sixty-four students who met the inclusion criteria were randomized to the intervention I (n = 82) and control groups (n = 82) by stratified block randomization after the completion of baseline measures. The study was completed with 164 students. The theoretical lecture was carried out by a researcher who was an expert faculty member in Fundamentals of Nursing. All students completed the pretest after attending the theoretical lecture. In the laboratory practice after the theoretical lecture, all students were divided into small groups and practiced parenteral medication administration skills one-to-one under the guidance of the instructor. Students in the intervention group received hard copies of the puzzles at the end of the laboratory practice. All students completed the posttest again at the end of the laboratory practice. Students were supervised during the tests and were not allowed to consult any books, the internet, or any other source of information.

Inclusion Criteria:

(1) Register for the Fundamentals of Nursing course for the first time.

Exclusion Criteria:

1. not communicate in Turkish
2. graduate from any health-related university in the past.