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The study aims to evaluate the effectiveness of chatbot-facilitated education (CFE) in assisting nursing personnel to prevent child and adolescent abuse and neglect (CAN). The main questions it aims to answer are:
Researchers will compare CFE to lecture-based teaching to verify if CFE can improve the nurses' competency of CAN.
Participants will:
Based on the rigor of the study and the anticipated benefits to the participants, we will:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Chatbot-facilitated education Group | Experimental | The participants will receive a lecture on the CAN course with assistance from a chatbot. The instructor will pose questions to the participants, who will respond using the chatbot. |
|
| Lecture-based teaching Group | Active Comparator | The participants will only receive a lecture on the CAN course. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| chatbot facilitated teaching | Other | The experimental group will use "chatbot" to facilitate teaching. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Intention to Report Child and Adolescent Abuse and Neglect | This subscale is part of the Child and Adolescent Abuse and Neglect (CAN) Competency Assessment. It comprises eight simulated child abuse scenarios, with participants rating their intention to report each case on an 11-point scale ranging from 0 (no intention to report) to 10 (definite intention to report). The total possible score is 80, with higher scores indicating a stronger and more consistent intention to report suspected CAN cases. | Pre-test (before the course), Post-test 1 (one week after), Post-test 2(four weeks after). |
| Attitude Toward Reporting Child and Adolescent Abuse and Neglect | This subscale is part of the Child and Adolescent Abuse and Neglect (CAN) Competency Assessment and consists of three sections: five items on attitudes toward child discipline, six items on perceptions of abusive parents, and seven items on professional responsibility in reporting child abuse, totaling 18 items. Participants rate each item on a 7-point Likert scale ranging from 0 (strongly disagree) to 6 (strongly agree). The maximum possible score is 108. Higher scores reflect more negative attitudes toward physical discipline, lower tolerance for abusive behavior by parents, and stronger endorsement of professional responsibility in reporting suspected child abuse. | Pre-test (before the course), Post-test 1 (one week after), Post-test 2(four weeks after). |
| Knowledge About Child and Adolescent Abuse and Neglect | This subscale is part of the Child and Adolescent Abuse and Neglect (CAN) Competency Assessment and includes 13 true-false items. Participants are instructed to respond with "true," "false," or "don't know" for each statement. Correct responses receive one point, while incorrect or "don't know" responses receive zero. The total possible score is 13, with higher scores indicating greater knowledge of CAN and its relevant legal framework. | Pre-test (before the course), Post-test 1 (one week after), Post-test 2(four weeks after). |
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Inclusion Criteria:
Nurses who
Exclusion Criteria:
The nurses will be excluded if they are in an administrative position or withdraw the protocol for any reason.
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| Name | Affiliation | Role |
|---|---|---|
| Mei-Lin Hsieh | Tzu Chi University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Tzu Chi University | Hualien City | Hualien County | 970374 | Taiwan |
Our study won't share the IPD with others. It has been written on the participants' consent.
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Course promotion commenced in July 2023. The first participant was not enrolled until the inaugural course launched on January 10, 2024. During the six-month preparatory period, we engaged in iterative planning, instructional design, and repeated testing of both the course delivery system and the integrated chatbot functionality.
We enrolled the participants for a year from July 2023 at a tertiary hospital in eastern Taiwan.
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| ID | Title | Description |
|---|---|---|
| FG000 | Chatbot-facilitated Education Group | Chatbot facilitated teaching: The experimental group will use "chatbot" to facilitate lecture-based teaching. |
| FG001 | Lecture-based Teaching Group | Lecture-based teaching: The control group only receives lecture-based teaching. |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
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|
Five participants in the experimental group and one in the control group didn't finish either post-test one or two. So they couldn't be included in the analysis.
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| ID | Title | Description |
|---|---|---|
| BG000 | Chatbot-facilitated Education Group | Chatbot facilitated teaching: The experimental group will use "chatbot" to facilitate teaching. |
| BG001 | Lecture-based Teaching Group | Lecture-based teaching: The control group only receives lecture-based teaching. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Intention to Report Child and Adolescent Abuse and Neglect | This subscale is part of the Child and Adolescent Abuse and Neglect (CAN) Competency Assessment. It comprises eight simulated child abuse scenarios, with participants rating their intention to report each case on an 11-point scale ranging from 0 (no intention to report) to 10 (definite intention to report). The total possible score is 80, with higher scores indicating a stronger and more consistent intention to report suspected CAN cases. | Posted | Mean | Standard Deviation | score on a scale | Pre-test (before the course), Post-test 1 (one week after), Post-test 2(four weeks after). |
|
3 months
Participants were instructed to report any adverse events during the study. However, the intervention involved only a didactic course and access to a chatbot delivered via participants' personal mobile phones. No adverse events were reported throughout the study period.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Chatbot-facilitated Education Group | Chatbot facilitated teaching: The experimental group will use "chatbot" to facilitate lecture-based teaching. |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Associate professer Mei-Lin Hsieh | Tzu Chi University | 886933513291 | shaer@gms.tcu.edu.tw |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Jul 18, 2023 | Aug 14, 2025 | Prot_SAP_000.pdf |
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| lecture-based teaching | Other | The control group only receives lecture-based teaching. |
|
| BG002 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race and Ethnicity Not Collected | Race and Ethnicity were not collected from any participant. | Count of Participants | Participants |
|
| Job tenure | Mean | Standard Deviation | years |
|
| Units | Count of Participants | Participants |
|
| Level of nursing | According to the Taiwan Nurses Association, clinical nurses are classified into five levels: N - Less than 1 year of experience; N1 - At least 1 year of experience and able to provide basic patient care; N2 - 2 years of experience and competent in caring for critically ill patients; N3 - 3 years of experience with the ability to deliver holistic critical care, teach, and support quality improvement; N4 - 4 years of experience, responsible for advanced critical care, teaching, administration, and unit-based quality initiatives. | Count of Participants | Participants |
|
| Education | Count of Participants | Participants |
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| The experience of dealing with child and adolescent abuse and neglect | Count of Participants | Participants |
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| The experience of receiving training in child and adolescent abuse and neglect | Count of Participants | Participants |
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| The experience of receiving education by using a chatbot | Count of Participants | Participants |
|
| The motives for participating | Count of Participants | Participants |
|
| Lecture-based Teaching Group |
Lecture-based teaching: The control group only receives lecture-based teaching. |
|
|
| Primary | Attitude Toward Reporting Child and Adolescent Abuse and Neglect | This subscale is part of the Child and Adolescent Abuse and Neglect (CAN) Competency Assessment and consists of three sections: five items on attitudes toward child discipline, six items on perceptions of abusive parents, and seven items on professional responsibility in reporting child abuse, totaling 18 items. Participants rate each item on a 7-point Likert scale ranging from 0 (strongly disagree) to 6 (strongly agree). The maximum possible score is 108. Higher scores reflect more negative attitudes toward physical discipline, lower tolerance for abusive behavior by parents, and stronger endorsement of professional responsibility in reporting suspected child abuse. | Posted | Mean | Standard Deviation | score on a scale | Pre-test (before the course), Post-test 1 (one week after), Post-test 2(four weeks after). |
|
|
|
| Primary | Knowledge About Child and Adolescent Abuse and Neglect | This subscale is part of the Child and Adolescent Abuse and Neglect (CAN) Competency Assessment and includes 13 true-false items. Participants are instructed to respond with "true," "false," or "don't know" for each statement. Correct responses receive one point, while incorrect or "don't know" responses receive zero. The total possible score is 13, with higher scores indicating greater knowledge of CAN and its relevant legal framework. | Posted | Mean | Standard Deviation | score on a scale | Pre-test (before the course), Post-test 1 (one week after), Post-test 2(four weeks after). |
|
|
|
| 0 |
| 49 |
| 0 |
| 49 |
| 0 |
| 49 |
| EG001 | Lecture-based Teaching Group | Lecture-based teaching: The control group only receives lecture-based teaching. | 0 | 49 | 0 | 49 | 0 | 49 |
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| Medical Surgical Unit |
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| Adult intensive care units |
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| N2 |
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| N3 |
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| N4 |
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| Master's Degree |
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| Doctorate (Ph.D.) |
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| Assignment of workplace |
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| Requirement of nursing credits |
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| Post-test 2 |
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| Post-test 2 |
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