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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:
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ChatGPT-Driven Blended Teaching Group | Experimental | Participants receive a blended teaching intervention integrating ChatGPT-assisted instruction with traditional in-person clinical nursing rounds focused on pain management. The intervention consists of 8 sessions over 4 weeks (2 sessions per week), each approximately 90 minutes, comprising three phases: pre-round preparation (30 min) using standardized ChatGPT prompts and case-based learning; bedside nursing round (30 min) with patient assessment and instructor feedback; and post-round activities (30 min) using ChatGPT to resolve uncertainties and complete case reports. Students are organized in groups of 4-6 and rotate through medical, surgical, and chronic pain clinical departments. |
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| Traditional Clinical Nursing Rounds Group | Active Comparator | Participants receive traditional clinical nursing rounds without any ChatGPT or AI components. The instructor selects and introduces clinical cases; students review resources and prepare reports. During rounds, the instructor directs all activities, including case presentation, assessment, nursing diagnosis, intervention, and outcome evaluation. The control group receives an identical number and duration of sessions (8 sessions over 4 weeks, each approximately 90 minutes) in the same clinical departments to ensure exposure consistency. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ChatGPT-Driven Blended Teaching Model for Pain Management | Behavioral | A blended teaching model integrating ChatGPT with in-person clinical nursing rounds for pain management education. Delivered over 4 weeks (8 sessions × 90 minutes). Each session includes: (1) pre-round preparation using standardized ChatGPT prompts for case analysis and evidence retrieval; (2) bedside nursing rounds with pain assessment, patient education, and instructor feedback; and (3) post-round activities using ChatGPT to resolve clinical uncertainties and complete case reports. All ChatGPT outputs were reviewed by supervising faculty for accuracy. Students used pre-designed, standardized prompts based on the WHO analgesic ladder and national clinical protocols. |
| Measure | Description | Time Frame |
|---|---|---|
| Knowledge and Attitudes Toward Pain | Measured using the Nurses' Knowledge and Attitudes Survey Regarding Pain (NKASRP), a 39-item instrument comprising 22 true/false questions, 13 multiple-choice questions, and 2 case studies. Each correct answer scores 1 point (range: 0-39); results expressed as percentage of correct responses. Higher scores indicate better knowledge and attitudes toward pain management. A Persian forward-backward translation was performed, with face and content validity confirmed by a nursing faculty panel. | Baseline (1 week before intervention), immediate post-test (1 week after intervention), and 3-month follow-up |
| Measure | Description | Time Frame |
|---|---|---|
| Nursing Competence | Measured using the Persian version of the Nursing Student Competence Scale (NSCS), a 28-item instrument across 6 subscales: medical-related knowledge, basic nursing skills, communication and cooperation, lifelong learning, global perspective, and critical thinking. Items rated on a 5-point Likert scale (range: 28-140). Higher scores indicate greater competence. The Persian version demonstrated Cronbach's α = 0.90 and ICC = 0.88. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Sogand Sarmadi | Contact | +989198599908 | sogand.sarmadi@ymail.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences | Tehran | Tehran Province | Iran |
Due to privacy considerations, a final decision has not been made at this time.
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Two-arm parallel-group design with 1:1 allocation ratio. Participants are randomly assigned to either a ChatGPT-driven blended teaching group or a traditional clinical nursing rounds group. Both groups receive the same number and duration of sessions (8 sessions over 4 weeks, each approximately 90 minutes) in the same clinical departments.
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Due to the nature of the educational intervention, blinding of participants and instructors was not feasible. Outcome assessors responsible for administering and scoring questionnaires, and the data analyst, remained blinded to group allocation throughout the study. All questionnaires were distributed using participant identification codes rather than names.
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| Traditional Clinical Nursing Rounds | Behavioral | Standard clinical nursing rounds without AI tools. The instructor directs all activities including case introduction, bedside assessment, nursing diagnosis, intervention planning, and outcome evaluation. Students primarily observe and respond to instructor questions. Sessions match the intervention group in number, duration, and clinical setting (8 sessions × 90 minutes over 4 weeks). |
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| Baseline (1 week before intervention), immediate post-test (1 week after intervention), and 3-month follow-up |
| Learning Self-Efficacy | Measured using the Persian version of the Nursing Students' Learning Self-Efficacy instrument (NLSE), a 21-item instrument across 5 dimensions: conceptual understanding, higher-order cognitive skills, practical work, everyday application, and nursing communication. Items rated on a 5-point Likert scale (range: 21-105). Higher scores indicate greater self-efficacy. The Persian version demonstrated Cronbach's α = 0.93 and ICC = 0.89. | Baseline (1 week before intervention), immediate post-test (1 week after intervention), and 3-month follow-up |
| ID | Term |
|---|---|
| D000377 | Agnosia |
| D001519 | Behavior |
| ID | Term |
|---|---|
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D059408 | Pain Management |
| ID | Term |
|---|---|
| D013812 | Therapeutics |
| D019468 | Disease Management |
| D010346 | Patient Care Management |
| D006298 | Health Services Administration |
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