Puzzle-Based Learning on Nursing Students' Parenteral Medication Knowledge and Motivation

NCT07544810 | Not Yet Recruiting DMC

• 1 other identifier: GY-HM-FKE-01
• Study Type: interventional
• Target: 80
• Locations: 0 countries
• Sites: N/A

Brief Summary

This randomized, controlled, parallel-group, interventional study aims to evaluate the effects of Crossword-Based Learning for Parenteral Drug Administration on the knowledge level, self-efficacy perception, and learning motivation of Nursing Department students. It is considered original because it examines the effects of crossword-based learning on cognitive and psychosocial outcomes in parenteral drug administration, a skill with a high risk of error in the clinical field. The study will be conducted with 80 (40 Experimental, 40 Control) nursing students selected through a power analysis. Participants will be assigned to groups by random assignment, and the study will be conducted in accordance with the triple-blind principle (participant, data collector, statistician). The experimental group will receive Crossword Activities in four different phases (Initial, Theoretical, Laboratory, and Post-Clinical Practice) in addition to the standard educational content. The control group will only complete the standard education. The primary outcomes of the study are; At the end of the 4th stage, the Parenteral Drug Administration Knowledge Test will be evaluated based on the Safe Parenteral Drug Administration Self-Efficacy Scale (SES-SES) and the Higher Education Learning Motivation Scale (SLS-SES) scores.

Conditions

Nursing Students

Keywords

nursing student; Crossword puzzle; drug administration; motivation; self-sufficiency

Outcome Measures

Primary Outcomes (1)

• Change in Knowledge Level Related to Parenteral Medication Administration

  Parenteral medication knowledge will be assessed using the Parenteral Medication Knowledge Test developed by the researchers. The test consists of 20 multiple-choice questions covering medication preparation, aseptic technique, administration principles, and clinical decision-making. Each correct answer is scored as 1 point and incorrect answers as 0 points. Total scores range from 0 to 20, with higher scores indicating greater knowledge. The outcome will be evaluated as the change in total scores between measurement time points.

  Baseline (Week 0) and after intervention (Week 4)

Secondary Outcomes (2)

• Change in Learning Motivation (YÖMÖ-Ü)

  Baseline (Week 0), Post-Theoretical Training (Week 2), and Final Assessment (Week 10)

• Change in Self-Efficacy Related to Safe Parenteral Medication Administration

  Baseline (Week 0) and after clinical practice (Week 10)

Study Arms (2)

Intervention Group

EXPERIMENTAL

Students in the intervention group will receive the structured theoretical lesson content together with a puzzle-based learning activity (çengel bulmaca). The activity is designed to reinforce knowledge, promote active learning, and support concept integration.

Behavioral: Puzzle-Based Learning Activity

Control Group

NO INTERVENTION

Students in the control group will receive only the structured theoretical lesson content without any puzzle-based activity.

Interventions

Puzzle-Based Learning Activity BEHAVIORAL

A structured puzzle-based (crossword) learning activity developed to reinforce theoretical content on parenteral medication administration. The activity aims to enhance knowledge retention, strengthen concept integration, and promote active engagement among nursing students.

Intervention Group

Eligibility Criteria

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

You may qualify if:

• Being enrolled as a 2nd-year student in the Nursing Department of the Faculty of Health Sciences at Kütahya Health Sciences University.
• Being registered for the "Fundamental Principles and Practices in Nursing" course.

You may not qualify if:

• Not completing the pre-test or post-test data collection forms.
• Being on medical or academic leave during the study period.
• Having previously received structured training related to parenteral medication administration within the past 6 months.
• Participating in another educational intervention study at the same time.

Sponsors & Collaborators

• Gazi University: lead

Related Publications (1)

• Bahar, A., Arslan, M., Gokgoz, N., Ak, H., & Kaya, H. (2017). Do parenteral medication administration skills of nursing students increase with educational video materials? International Journal of Caring Sciences, 10(3), 1514-1525. Turkish Nursing Education Association. (2022). National Core Education Program in Nursing (HUÇEP 2022). https://www.hemed.org.tr/2022-hucep/ Karaahmetoğlu, G. U. (2019). Investigation of nursing students' knowledge levels regarding intramuscular injection practices. Abant Medical Journal, 8(3), 155-161. Foss, K., & Morandini, S. (2023). Using objective structured clinical examination to teach medication rights in undergraduate nursing education. Journal of Professional Nursing, 45, 89-93. https://doi.org/10.1016/j.profnurs.2023.01.007 Kırşan, M., Korhan, E. A., Şimşek, S., Özçiftçi, S., & Ceylan, B. (2019). Medication errors in nursing practices: A systematic review. Turkiye Klinikleri Journal of Nursing Sciences, 11(1). World Health Organization. (2024). Medication without harm: Policy brief. Geneva, Switzerland: WHO. Kelly, S. H., Koharchik, L., Henry, R., Cippel, M., Hardner, S., Kolesar, A., & Clark, B. (2018). An advanced medication administration experience to promote students' knowledge acquisition. Teaching and Learning in Nursing, 13(2), 104-107. Hewitt, J., Tower, M., & Latimer, S. (2015). An education intervention to improve nursing students' understanding of medication safety. Nurse Education in Practice, 15(1), 17-21. Zaybak, A., Taşkıran, N., Telli, S., Ergin, E. Y., & Şahin, M. (2017). Nursing students' opinions regarding sufficiency of their drug administration knowledge. Journal of Education and Research in Nursing, 14(1), 6-14. Doğan, S. E., & Aslan, H. (2024). Current teaching methods and techniques used in nursing education. Bingöl University Journal of Health, 5(1), 224-235. Alcindor, M. L. (2022). Application of a crossword puzzle tournament to prepare nursing students for examinations. Nurse Educator, 47(6), E152-E1

  BACKGROUND

Central Study Contacts

FERZAN KALAYCI EMEK, RESEARCH Asistan

CONTACT

+905436540498; ferzan.kalayciemek@ksbu.edu.tr

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Masking Details: This study will employ a triple-blind method to minimize bias. In the first-level blinding, participants will not know which group (intervention or control) they have been assigned to; data collection times and debriefing procedures will be conducted equally in both groups. In the second-level blinding, data collection and research personnel will be blinded to the groups and will not have access to the randomization list. In the third-level blinding, the analyst performing the statistical analyses will see the dataset only coded as "Group A" and "Group B" and will not know which group corresponds to the intervention or control group until the analysis is completed. The randomization codes will be stored in a locked digital file and will not be accessible by any researcher until the analysis is complete. This will ensure blindness at the participant, practitioner, and analyst levels, strengthening the internal validity of the study and minimizing potential sources of bias.
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: RESEARCH ASSISTANT

Model Details: Single-center, two-arm, parallel-group, triple-blind, randomized controlled, repeated-measures experimental study

Study Record Dates

• First Submitted: November 21, 2025
• First Posted: April 22, 2026
• Study Start: April 28, 2026
• Primary Completion (Estimated): July 15, 2026
• Study Completion (Estimated): September 15, 2026
• Last Updated: April 22, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share