ChatGPT-Driven Blended Teaching for Pain Management in Nursing Students: A Randomized Controlled Trial

Effect of a ChatGPT-Driven Blended Teaching Model for Pain Management on Knowledge, Attitudes, Competence, and Self-Efficacy Among Nursing Students: A Two-Arm Parallel-Group Randomized Controlled Trial

Pain management is a core competency in nursing practice, yet nursing students consistently demonstrate insufficient knowledge, unfavorable attitudes, limited competence, and low self-efficacy in this area. Artificial intelligence (AI)-based educational tools, particularly ChatGPT, have emerged as promising resources in nursing education; however, rigorous experimental evidence on their effectiveness remains scarce.

This study is a two-arm, parallel-group randomized controlled trial (RCT) that aims to evaluate the effect of a ChatGPT-driven blended teaching model for pain management on nursing students' knowledge and attitudes toward pain, nursing competence, and learning self-efficacy.

Eligible nursing students at Shahid Beheshti University of Medical Sciences (Tehran, Iran) will be randomly assigned in a 1:1 ratio to either:

• Intervention group: ChatGPT-assisted blended clinical nursing rounds (8 sessions over 4 weeks, each 90 minutes, combining bedside rounds with AI-assisted pre- and post-round activities)
• Control group: Traditional clinical nursing rounds (same number and duration of sessions, without any AI tools)

Outcomes will be measured at baseline (1 week before intervention), immediate post-test (1 week after intervention), and 3-month follow-up using validated instruments: the Nurses' Knowledge and Attitudes Survey Regarding Pain (NKASRP), the Nursing Student Competence Scale (NSCS), and the Nursing Students' Learning Self-Efficacy instrument (NLSE).

Findings will provide empirical evidence to guide educational policy and curriculum design in nursing programs, with the goal of improving pain management education and patient care outcomes.

Inclusion Criteria:

1. Undergraduate nursing students in their fourth semester or higher, or master's or doctoral nursing students engaged in clinical training involving direct patient care
2. Provision of electronic informed consent
3. Access to the internet and a personal device (computer, tablet, or smartphone) for the asynchronous components of the blended teaching model
4. No participation in a formal comprehensive pain management course within the previous 12 months

Exclusion Criteria:

1. Inability to attend at least one face-to-face session or to complete online activities (e.g., due to repeated absences)
2. Any self-reported or university-documented cognitive or mental health condition that prevented completion of questionnaires or participation in training
3. Voluntary withdrawal at any stage of the study