The Effects of Combining Electronic Picture Books With RPG-Based Gamified Learning on Nursing Students' Motivation and Learning Outcomes in Breastfeeding Education

NCT07525700 | Not Yet Recruiting

• 1 other identifier: CMUH115-REC1-069
• Study Type: interventional
• Target: 100
• Locations: 0 countries
• Sites: N/A

Brief Summary

This study aimed to explore the impact of electronic picture books combined with RPG on breastfeeding learning outcomes among nursing students. The study participants were third-year nursing students from a university in central Taiwan. A randomized controlled design was used, with the experimental group receiving electronic picture books combined with RPG, while the control group received traditional face-to-face instruction. Changes in students' breastfeeding knowledge, learning motivation, self-efficacy, and cognitive load were assessed. The expected results can provide a reference for innovative teaching models in nursing education and promote the future clinical application of breastfeeding.

Conditions

Nursing Education Research; Breastfeeding Education; Nursing Students

Keywords

nursing education; learning motivation; Breastfeeding Education; Nursing Students; electronic picture books; RPG

Outcome Measures

Primary Outcomes (4)

• Breastfeeding Knowledge Questionnaire

  This questionnaire consists of 10 multiple-choice questions. Each correct answer is scored 10 points, and each incorrect answer is scored 0 points, yielding a total score range of 0-100. The questions were self-developed in the form of clinical scenario-based multiple-choice items, focusing on the benefits of breastfeeding, breastfeeding positions, breast milk storage methods, breast milk expression (hand expression), and nursing interventions to maintain milk supply.

  The experimental group and the control group will Baseline (prior to intervention), immediately after intervention, and 4 weeks after intervention

• Breastfeeding Self-Efficacy Scale

  Breastfeeding self-efficacy was evaluated using a 10-item Breastfeeding Self-Efficacy Scale. Each item is rated on a 4-point Likert scale, where 1 = not at all capable and 4 = expert level. The total score ranges from 10 to 40, with higher scores indicating greater self-efficacy in performing breastfeeding self-efficacy .

  The experimental group and the control group will Baseline (prior to intervention), immediately after intervention, and 4 weeks after intervention

• ARCS-Based Learning Motivation Scale

  The scale assesses learners' motivation toward the educational materials across four dimensions: Attention (12 items), Relevance (9 items), Confidence (9 items), and Satisfaction (6 items), for a total of 36 items. Responses are rated on a 5-point Likert scale, ranging from 5 ("Strongly Agree") to 1 ("Strongly Disagree"). The total score ranges from 36 to 180 points, with higher scores indicating stronger learning motivation.

  The experimental group and the control group will Baseline (prior to intervention), immediately after intervention, and 4 weeks after intervention

• Cognitive Load Scale

  The cognitive load of learners taking electronic picture books and RPGs or face-to-face courses was assessed using an 8-item cognitive load scale. All items were rated on a 1-point Likert scale, ranging from 5 ("strongly agree") to 1 ("strongly disagree"). The total score ranged from 8 to 40, with higher scores indicating stronger cognitive load.

  The experimental group and the control group will Baseline (prior to intervention), immediately after intervention, and 4 weeks after intervention

Study Arms (2)

face-to-face teaching

ACTIVE COMPARATOR

face-to-face teaching of breastfeeding

Behavioral: face-to-face teaching

Electronic picture books and Online RPG interactive adventure game

EXPERIMENTAL

Integration of online RPG interactive adventure games with an electronic picture books learning mode for the instruction of breastfeeding.

Behavioral: Electronic picture books and Online RPG interactive adventure game

Interventions

face-to-face teaching BEHAVIORAL

face-to-face teaching of breastfeeding

face-to-face teaching

Electronic picture books and Online RPG interactive adventure game BEHAVIORAL

Integration of online RPG interactive adventure games with an electronic picture books learning mode for the instruction of breastfeeding.

Electronic picture books and Online RPG interactive adventure game

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• It is expected to include 100 people.
• A third-year nursing student.
• Studying obstetrics and gynecology nursing this semester.
• Agree to participate in this study and sign the research consent form.

You may not qualify if:

• Students who are planning to take a leave of absence at the time of data collection.
• Students who have not taken obstetrics and gynecology nursing this semester or have taken it in the past.
• Students who are unable to use 3C products.

Sponsors & Collaborators

• China Medical University, Taiwan: collaborator
• China Medical University Hospital: lead

Central Study Contacts

Ting-Shan Chang

CONTACT

+886422053366; tingshan@mail.cmu.edu.tw

Ya-Ling Tzeng

CONTACT

+886422053366; tyaling@mail.cmu.edu.tw

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Model Details: The study design will adopt a randomized controlled trial with repeated measures. A 60-minute intervention has been developed.Block randomization stratified by gender will be used, and eligible participants will be randomly assigned to either the experimental or control group in a 1:1 ratio using Random Allocation Software.Research assistants will code group assignments ("Group 1" and "Group 2") according to the randomization list, place the assignments into opaque sealed envelopes, and arrange them sequentially.On the day of the study, envelopes will be distributed in the order participants submit their consent forms. Participants will open the envelope themselves to learn their group assignment.

Study Record Dates

• First Submitted: April 7, 2026
• First Posted: April 13, 2026
• Study Start (Estimated): September 30, 2026
• Primary Completion (Estimated): December 1, 2026
• Study Completion (Estimated): December 31, 2026
• Last Updated: April 13, 2026

Record last verified: 2026-04