Problem-Based Learning to Improve Critical Thinking in Obstetric Nursing Students

NCT07373665 | Completed

• 1 other identifier: PBL-OBN-2025
• Study Type: interventional
• Target: 312
• Locations: 1 country
• Sites: 1

Brief Summary

This study examined the effect of a problem-based learning (PBL) instructional approach on undergraduate nursing students' learning outcomes in obstetrics health nursing. The intervention was implemented with nursing students at the Faculty of Nursing, Benha University, Egypt. Students participated in structured problem-based learning sessions designed to enhance critical thinking, clinical decision making, and knowledge retention related to maternal and newborn health topics. Learning outcomes were assessed before and after the intervention using validated assessment tools. The findings of this study aim to provide evidence on the effectiveness of problem-based learning as an educational strategy in nursing education and to inform curriculum development and teaching practices in obstetrics health nursing Course.

Conditions

Problem-based Learning in Nursing Education

Keywords

Problem-based learning; Nursing education; Obstetric nursing; Critical thinking; Clinical decision making; Knowledge retention; Undergraduate nursing students; Educational intervention; Cluster randomized trial

Outcome Measures

Primary Outcomes (3)

• Critical Thinking Skills

  Critical thinking skills were assessed using the Critical Thinking Questionnaire (CThQ), a validated 25-item self-administered instrument measuring six domains of critical thinking: remembering, understanding, applying, analyzing, evaluating, and creating. Items are rated on a 5-point Likert scale, with higher scores indicating stronger critical thinking ability.

  Baseline (pre-intervention), immediately post-intervention, and 4-week follow-up

• Clinical Decision-Making Ability

  Clinical decision-making ability was measured using the Clinical Decision Making in Nursing Scale (CDMNS), a validated 40-item self-report instrument assessing four dimensions of decision-making: search for alternatives, canvassing of objectives and values, evaluation of consequences, and information search. Higher total scores reflect more developed clinical decision-making abilities.

  Baseline (pre-intervention), immediately post-intervention, and 4-week follow-up

• Knowledge retention in obstetrics Health Nursing

  Knowledge acquisition and retention were assessed using a researcher-developed, case-based multiple-choice questionnaire covering normal labor, preeclampsia/eclampsia, and postpartum hemorrhage. The tool consists of 30 items, with higher scores indicating higher levels of knowledge acquisition and retention.

  Baseline (pre-intervention), immediately post-intervention, and 4-week follow-up

Study Arms (2)

Problem-Based Learning (PBL) Group

EXPERIMENTAL

Participants in this arm received a structured problem-based learning (PBL) instructional program covering normal labor, preeclampsia/eclampsia, and postpartum hemorrhage. The intervention was delivered in small-group sessions using standardized clinical case scenarios, guided facilitation, self-directed learning, and group discussion over a six-week period.

Behavioral: Problem-Based Learning (PBL)

Traditional Lecture-Based Instruction Group

ACTIVE COMPARATOR

Participants in this arm received traditional lecture-based instruction covering normal labor, preeclampsia/eclampsia, and postpartum hemorrhage, delivered through instructor-led lectures and PowerPoint presentations in accordance with the standard course syllabus.

Behavioral: Traditional Lecture-Based Instruction

Interventions

Problem-Based Learning (PBL) BEHAVIORAL

A structured problem-based learning instructional approach using standardized clinical case scenarios related to maternal and newborn health nursing. The intervention emphasized active learning, small-group discussion, self-directed learning, clinical reasoning, and facilitated synthesis of evidence-based nursing decisions. Arm Assigned:Problem-Based Learning (PBL) Group

Problem-Based Learning (PBL) Group

Traditional Lecture-Based Instruction BEHAVIORAL

Traditional lecture-based instruction delivered through instructor-led teaching and PowerPoint presentations, covering maternal and newborn health nursing topics according to the standard undergraduate nursing curriculum. Arm Assigned:Traditional Lecture-Based Instruction Group

Traditional Lecture-Based Instruction Group

Eligibility Criteria

• Age: 18 Years - 21 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Undergraduate nursing students enrolled in the third academic level of the Obstetrics and Gynecology Nursing course at the Faculty of Nursing, Benha University.
• Aged 18 to 21 years at the time of enrollment.
• Regular attendance in the course during the study period.
• Willingness to participate and provide written informed consent.
• No prior formal exposure to structured problem-based learning (PBL).
• Completion of baseline assessment prior to participation.

Sponsors & Collaborators

• Eman Atef Elsokary: lead
• Helwan University: collaborator

Study Sites (1)

Faculty of Nursing, Benha University

Banhā, Qalyubia Governorate, Egypt

Location

Study Officials

• Eman Atef Elsokary, PhD

  Faculty of Nursing, Helwan University, Egypt

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Masking Details: This was an open-label educational intervention. Due to the nature of the instructional methods, participants, instructors, and investigators were aware of group allocation.
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Lecturer of Maternal and Newborn Health Nursing

Model Details: Participants were assigned to intervention or control groups using cluster randomization at the academic-group level to minimize contamination. Academic clusters were allocated in parallel to either problem-based learning (PBL) or traditional lecture-based instruction. All clusters were followed concurrently, and outcomes were assessed at baseline, immediately post-intervention, and at four-week follow-up.

Study Record Dates

• First Submitted: January 21, 2026
• First Posted: January 28, 2026
• Study Start: September 20, 2025
• Primary Completion: December 25, 2025
• Study Completion: January 20, 2026
• Last Updated: January 28, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)