The Effect of the Fishbowl Method on Nursing Students

NCT07441577 | Completed

• 1 other identifier: Melekada
• Study Type: interventional
• Target: 63
• Locations: 1 country
• Sites: 1

Brief Summary

Background: Breathing and coughing exercises are fundamental components of nursing care in the management of chronic respiratory diseases, and the way students learn these skills is closely related to their clinical skill development. Active learning approaches that combine observation and participation may support skill acquisition more effectively than passive instruction. The Fishbowl teaching method is an interactive approach that allows students to learn through structured observation, discussion, and practice. However, its use in teaching breathing and coughing exercises in nursing education has not yet been examined. This study aims to evaluate the effect of the Fishbowl teaching method on nursing students' learning experience in the instruction of breathing and coughing exercises. Methods: This study is designed as a randomized controlled pretest-posttest experimental study. A total of 63 first-year nursing students will be randomly assigned to either an intervention group or a control group. The intervention group will receive instruction using the Fishbowl teaching method, while the control group will be taught using traditional demonstration-based instruction. Data will be collected using the Knowledge Test, Academic Self-Efficacy Scale, and Instructional Materials Motivation Scale at pretest and posttest time points.

Conditions

Educational Problems

Keywords

Breathing exercises; Cough exercises; Nursing education; Nursing students; Fishbowl method; Self efficacy; Motivation

Outcome Measures

Primary Outcomes (3)

• Knowledge Test

  The Knowledge Test was developed by the researchers to assess students' knowledge of diaphragmatic breathing and effective coughing exercises. Test items were prepared in line with the literature by three researchers who are experts in the Fundamentals of Nursing discipline. The development of the items was informed by core Fundamentals of Nursing textbooks and up-to-date nursing education literature, resulting in a 15-item multiple-choice test with four response options for each item. The test consisted of two main content domains: diaphragmatic breathing (Items 1-8) and effective coughing exercises (Items 9-15). Each item had a single correct answer. The internal consistency reliability (Cronbach's alpha) of the Knowledge Test was 0.70 for the pretest and 0.78 for the posttest.

  1 week

• The Academic Self-Efficacy Scale (ASES)

  The Academic Self-Efficacy Scale (ASES) was originally adapted into Turkish by Yılmaz et al.. The scale is unidimensional and consists of seven items assessing perceived academic self-efficacy. Responses are rated on a four-point Likert scale ranging from 1 ("Does not apply to me at all") to 4 ("Applies to me completely"), with total scores ranging from 7 to 28. Higher scores indicate higher levels of perceived academic self-efficacy. The Cronbach's alpha coefficient of the Turkish version of the scale was reported as 0.79. In the present study, Cronbach's alpha values were 0.85 for the pretest and 0.89 for the posttest.

  1 week

• The Instructional Materials Motivation Survey (IMMS)

  The Instructional Materials Motivation Survey (IMMS) was developed by Keller and adapted into Turkish by Dinçer and Doğanay. The IMMS consists of 33 items across four subdimensions: attention, relevance, confidence, and satisfaction. Items are rated on a five-point Likert scale ranging from 1 ("Not true") to 5 ("Very true"), yielding total scores between 33 and 165. Higher scores indicate higher levels of motivation toward instructional materials. The Cronbach's alpha reliability coefficient of the Turkish version of the IMMS was reported as 0.96. In this study, the overall Cronbach's alpha values were 0.98 for the pretest and 0.99 for the posttest.

  1 week

Study Arms (2)

Fishbowl Group

EXPERIMENTAL

The intervention group received instruction using the Fishbowl method.

Other: Fishbowl Teaching Method

Control group

NO INTERVENTION

In the control group, the implementation was conducted using the traditional laboratory demonstration method.

Interventions

Fishbowl Teaching Method OTHER

Students in the intervention group (n = 33) were divided into subgroups of 5-6 students to facilitate effective implementation of the Fishbowl method. Six separate sessions were conducted using the same scenario ensuring content standardization. Before the sessions, students received a briefing from the faculty member responsible for the Fundamentals of Nursing laboratory course. The scenario was distributed in print, roles (student nurse, patient, observer) were explained, and students were given 10-15 minutes to review the case and voluntarily select roles; the researcher acted only as a facilitator. During the session, inner-circle students performed the application while outer-circle students evaluated performance using the Fishbowl Observation Form. After each session, structured feedback was provided by the observers and faculty member, and strengths and areas for improvement were discussed. Each session lasted approximately 25-30 minutes.

Fishbowl Group

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Fundamentals of Nursing course
• Voluntarily agreed

You may not qualify if:

• Previous clinical training on breathing and coughing exercises
• Withdrawal from the study at any stage

Sponsors & Collaborators

• Zeynep Yılmaz: lead

Study Sites (1)

Atatürk University

Erzurum, Turkey (Türkiye)

Location

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Research Asisstant Doctor

Study Record Dates

• First Submitted: February 23, 2026
• First Posted: March 2, 2026
• Study Start: April 28, 2025
• Primary Completion: May 23, 2025
• Study Completion: August 29, 2025
• Last Updated: March 2, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)