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| ID | Type | Description | Link |
|---|---|---|---|
| 8306 | Other Identifier | Inonu University |
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This randomized controlled study will evaluate the effectiveness of an online Watch-Summarize-Question-Ask (WSQA) learning method on nursing students' knowledge, skills, attitudes, and behaviors related to patient fall prevention and management. Sixty-six nursing students will be randomly assigned to intervention and control groups. Both groups will receive standard patient safety education, while the intervention group will additionally participate in an online, evidence-based fall prevention training program structured according to the WSQA method, including video-based learning, summarization, question generation, and interactive discussions. Outcomes will be assessed using validated instruments measuring fall management knowledge, self-efficacy, attitudes toward fall prevention, care planning performance, and student satisfaction. The study aims to determine the effectiveness of an innovative educational approach to improve fall prevention competencies and enhance the quality and safety of nursing care.
Objective The aim of this study is to evaluate the effect of an online fall prevention training program, developed based on the Watch-Summarize-Question-Ask instructional strategy, on the knowledge, skills, attitudes, and behaviors of fourth-year undergraduate nursing students. This evaluation will be conducted using the four levels of the Kirkpatrick's Four-Level Evaluation Model, and it aims to comprehensively determine both the learning outcomes of the training and its reflection on clinical practice.
Type of Research This research will be conducted using a randomized controlled experimental design. Participants will be randomly assigned to two groups using the block randomization method.
Location and Time of the Study The study will be conducted at the Faculty of Nursing, İnönü University, between February and June 2026.
Participants/Sample The study population will consist of fourth-year undergraduate nursing participants enrolled in the Nursing Internship Course at the Faculty of Nursing, İnönü University, during the 2025-2026 academic year. Power analysis indicated a minimum sample size of 56 participants; however, considering potential attrition, a total of 66 participants will be recruited. Participants who meet the inclusion criteria will be assigned to the experimental and control groups using a block randomization method. Each group will include 33 participants (Experimental Group = 33; Control Group = 33).
Method / Intervention Participants in both groups will receive the standard patient safety education included in the undergraduate nursing curriculum. In addition, participants in the experimental group will receive an evidence-based fall prevention training delivered through an online learning model structured according to the Watch-Summarize-Question (WSQ) teaching strategy. The intervention will include video-based learning, structured summarization activities, question generation, and interactive online discussion sessions to reinforce learning and promote active participation. The control group will continue with the standard curriculum without receiving the WSQ-based training. Outcomes will be evaluated using validated measurement tools assessing knowledge, skills, attitudes, and behavioral outcomes related to fall management.
Data Collection Tools Participant Information Form: Participants' demographic characteristics, educational background, and access to technological resources required for participation in online learning platforms.
Satisfaction with E-Learning Scale (Turkish version: E-Derslere Yönelik Memnuniyet Ölçeği): The scale consists of 35 items and five subdimensions. The response options are designed as a five-point Likert-type scale scored between 1 and 5.
Falls Management Knowledge Test: This test will be developed by the researcher based on a literature review to assess participants' knowledge levels on falls management and to evaluate the effectiveness of the education on the patient safety knowledge subdimension Scales for Assessing Self-Efficacy: The scale consists of 11 items prepared in a 6-point Likert-type format.
Attitudes of Nurses Toward Falls Prevention Scale (Turkish version: Hemşirelerin Düşmelerin Önlenmesine Yönelik Tutumları Ölçeği): The scale consists of 19 items and 5 subdimensions. The response options are designed as a five-point Likert scale scored between 1 and 5.
Care Plan Evaluation Form: A structured seven-item assessment form developed by the researchers will be used to determine the extent to which students reflect their knowledge and awareness of fall management in their care plans.
Expected Results/Significance The study is expected to determine the effectiveness of the online fall prevention education developed based on the WSQ learning strategy in improving nursing students' knowledge, skills, attitudes, and behaviors regarding fall management. The findings are anticipated to support the integration of structured, evidence-based online teaching methods into nursing education, enhance patient safety awareness, strengthen clinical decision-making skills, and contribute to the quality of nursing care
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Experimental Group | Experimental | Participants in the experimental arm will receive the standard patient safety education included in the undergraduate nursing curriculum through face-to-face instruction. In addition, they will participate in the Watch-Summarize-Question (WSQ)-based online fall prevention education. The WSQ program will include watching educational videos, summarizing course content, generating questions, participating in interactive online discussion sessions, and engaging in peer interaction through an online discussion forum. |
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| Control Group | No Intervention | Participants in the control arm will receive only the standard patient safety education included in the undergraduate nursing curriculum through face-to-face instruction and will not receive any additional educational intervention during the study period. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Online Watch Summarize Question Learning Model | Behavioral | The intervention consists of a structured online fall prevention education program based on the WSQ instructional strategy. Unlike traditional lecture-based education, this intervention integrates active learning components including video-based instruction, structured summarization tasks, student-generated question development, synchronous interactive discussion sessions, and peer-supported learning through an online discussion forum. The program is delivered through a distance education platform and is designed to promote reflective learning, cognitive engagement, and collaborative knowledge construction. The WSQ model ensures that participants actively process educational content rather than passively receiving information. The intervention is implemented in addition to the standard undergraduate patient safety curriculum and is specifically tailored to improve nursing students' competencies in fall risk assessment and fall prevention management. |
| Measure | Description | Time Frame |
|---|---|---|
| Participant Information Form | Participants' demographic characteristics, educational background, and access to technological resources required for participation in online learning platforms. | at baseline |
| Satisfaction with E-Learning Scale (Turkish version: E-Derslere Yönelik Memnuniyet Ölçeği) | The scale developed by Kolburan Geçer and Deveci Topal aims to determine university students' satisfaction levels with the online courses they attend. The Cronbach's alpha reliability coefficient of the scale was calculated as 0.97. The scale consists of 35 items and 5 subdimensions. The response options are designed as a five-point Likert-type scale scored between 1 and 5. | Immediately after completion of the intervention |
| Falls Management Knowledge Test | This test will be developed by the researcher based on a literature review to assess participants' knowledge levels on falls management and to evaluate the effectiveness of the education on the patient safety knowledge subdimension | At baseline and immediately after completion of the education program and at least 3 weeks after the training |
| Scales for Assessing Self-Efficacy | The Cronbach's Alpha value of the scale developed by Dykes and colleagues and validated in Turkish by Ekin and Uğur was found to be 0.97, and it has no subscales. The scale consists of 11 items prepared on a 6-point Likert scale. In the evaluation of the scale, the item mean of the scores obtained from all items is used, and as the scores increase, the level of self-efficacy also increases. | At baseline and immediately after completion of the education program and at least 3 weeks after the training |
| Attitudes of Nurses Toward Falls Prevention Scale (Turkish version: Hemşirelerin Düşmelerin Önlenmesine Yönelik Tutumları Ölçeği) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Zeliha Cengiz, Associate Professor | Contact | +905433277494 | +9(422)3413825 | zeliha.cengiz@inonu.edu.tr |
| Gözde Küçükkarakurt, Phd student | Contact | +905355272070 | +9(422)3413825 | gozde_sayar@hotmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Zeliha Cengiz, Associate Professor | Inonu University Faculty of Nursing | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Inonu University Faculty of Nursing | Malatya | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29588829 | Background | Maddineshat M, Hashemi M, Besharati R, Gholami S, Ghavidel F. The effectiveness of clinical teaching of mental health courses in nursing using clinical supervision and Kirkpatrick's model. Electron Physician. 2018 Jan 25;10(1):6265-6272. doi: 10.19082/6265. eCollection 2018 Jan. | |
| 40334548 | Background | Elias S, Taylor K, Jenkins E, Robinson K, Tesfai Y, Han HR. Strategies to improve student engagement in online nursing education: A systematic review. Nurse Educ Today. 2025 Sep;152:106762. doi: 10.1016/j.nedt.2025.106762. Epub 2025 Apr 29. |
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This research is a doctoral thesis study. The research is expected to be completed
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Participants will be randomly assigned to two parallel groups (experimental and control) using block randomization. All participants will receive standard patient safety education included in the undergraduate nursing curriculum through face-to-face instruction. After this stage, only the experimental group will receive WSQ-based online fall prevention education.
The WSQ education will include watching educational videos via an online platform, summarizing course content using researcher-provided materials, generating questions based on the learning content, and participating in an interactive online session where student-generated questions will be discussed to reinforce learning. Additionally, a forum integrated into the distance education system will support peer interaction, question-answer exchange, and collaborative learning. The control group will receive no additional intervention during the study period.
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The Cronbach's Alpha reliability coefficient of the scale developed by Özbudak and Koç in 2023 was found to be 0.84. The scale consists of 19 items and 5 sub-dimensions. The scale's response options are designed as a five-point Likert scale scored on a 1-5 point range. The scale is evaluated based on the mean score.
| At baseline and immediately after completion of the education program and at least 3 weeks after the training. |
| Care Plan Evaluation Form | A structured seven-item assessment form developed by the researchers will be used to determine the extent to which students reflect their knowledge and awareness of fall management in their care plans. | At baseline and at least 3 weeks after the training |
| 34968932 | Background | Chang CY, Chung MH, Yang JC. Facilitating nursing students' skill training in distance education via online game-based learning with the watch-summarize-question approach during the COVID-19 pandemic: A quasi-experimental study. Nurse Educ Today. 2022 Feb;109:105256. doi: 10.1016/j.nedt.2021.105256. Epub 2021 Dec 24. |
| 40222324 | Background | De Gagne JC, Randall PS, Koppel PD, Cho E, Blackwood ER, Kang HS. Online learning in nursing education: A 21st century bibliometric analysis. Nurse Educ Today. 2025 Aug;151:106740. doi: 10.1016/j.nedt.2025.106740. Epub 2025 Apr 8. |
| 31756625 | Background | Taskiran G, Eskin Bacaksiz F, Harmanci Seren AK. Psychometric testing of the Turkish version of the Health Professional Education in Patient Safety Survey: H-PEPSSTR. Nurse Educ Pract. 2020 Jan;42:102640. doi: 10.1016/j.nepr.2019.102640. Epub 2019 Nov 1. |
| 31153088 | Background | Kim YM, Yoon YS, Hong HC, Min A. Effects of a patient safety course using a flipped classroom approach among undergraduate nursing students: A quasi-experimental study. Nurse Educ Today. 2019 Aug;79:180-187. doi: 10.1016/j.nedt.2019.05.033. Epub 2019 May 23. |
| 34673387 | Background | Eskici GT, Kanig M, Ugur E, Seren AKH. The Turkish version of the Patient Safety Competency Self-Evaluation Tool: A validity and reliability study. Nurse Educ Pract. 2021 Nov;57:103229. doi: 10.1016/j.nepr.2021.103229. Epub 2021 Oct 13. |
| 30877869 | Background | Fisher M, Kiernan M. Student nurses' lived experience of patient safety and raising concerns. Nurse Educ Today. 2019 Jun;77:1-5. doi: 10.1016/j.nedt.2019.02.015. Epub 2019 Feb 27. |
| 32143174 | Background | Levett-Jones T, Andersen P, Bogossian F, Cooper S, Guinea S, Hopmans R, McKenna L, Pich J, Reid-Searl K, Seaton P. A cross-sectional survey of nursing students' patient safety knowledge. Nurse Educ Today. 2020 May;88:104372. doi: 10.1016/j.nedt.2020.104372. Epub 2020 Feb 19. |