Digital Microlearning for Patient-Safety Readiness in Nursing Students (DigiM-2026)

June 2, 2026 updated by: Volkan Gokmen, Agri Ibrahim Cecen University

Digital Microlearning for Patient-Safety Readiness Before Surgical Clinical Practice: A Randomized Controlled Trial With Ecological Momentary Assessment and Mixed-Methods Integration

This randomized controlled trial evaluated the effect of a patient safety-focused digital microlearning program on nursing students before and during surgical clinical practice.

Nursing students may face patient-safety and clinical decision-making challenges when moving from classroom learning to clinical settings. This study examined whether short, structured, scenario-based digital learning modules could improve patient-safety awareness, clinical error recognition, decision-making under stress, clinical practice readiness, and self-confidence.

Second-year undergraduate nursing students were randomly assigned to either a digital microlearning plus standard education group or a standard education control group. Outcomes were measured at baseline before the program, immediately after the intervention, at the end of the first week of surgical clinical practice, and at the end of the seventh week of surgical clinical practice. Weekly ecological momentary assessment prompts were also used during clinical practice to examine safety-related behavioral transfer.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

The transition from classroom-based nursing education to surgical clinical practice is a critical period for patient safety. During this phase, limited clinical experience, increased responsibility, unfamiliar ward routines, and supervisory dynamics may affect students' ability to recognize patient-safety risks, identify clinical errors, prioritize action, and communicate concerns appropriately.

This study was designed as a single-center, parallel-group randomized controlled trial with an explanatory mixed-methods extension. It was conducted at the Faculty of Health Sciences, Department of Nursing, Agri Ibrahim Cecen University. The recruitment frame consisted of second-year undergraduate nursing students registered for the relevant surgical nursing course and preparing to begin surgical clinical practice. Of 111 students registered on the course, 21 were excluded before randomization because of previous course failure or repetition, absenteeism, or other ineligibility. Ninety students were randomized in a 1:1 ratio and analyzed according to the intention-to-treat principle.

Participants were assigned to either a digital microlearning intervention group or a standard education control group. The intervention group received a patient safety-focused digital microlearning program delivered online for seven consecutive days in addition to standard education. The program consisted of short, scenario-based modules lasting approximately 3-5 minutes each. Module content addressed patient identification, medication safety, patient-safety risk recognition, clinical error recognition, prioritization, escalation, and decision-making under stress. The control group received standard patient-safety education as part of the undergraduate nursing curriculum without additional digital microlearning.

Outcome measures were collected at four time points: baseline before the program (T0), immediately after completion of the intervention (T1), at the end of the first week of surgical clinical practice (T2), and at the end of the seventh week of surgical clinical practice (T3). Primary outcomes were patient-safety awareness and clinical error recognition performance. Secondary outcomes included clinical decision-making under stress, clinical practice readiness, clinical self-confidence, behavioral transfer during clinical practice, and acceptability of the digital microlearning program.

During the seven weeks of surgical clinical practice, students also completed weekly ecological momentary assessment prompts on their clinical practice day. These prompts captured patient-safety risk noticing, appropriate response, escalation or supervisor discussion, perceived confidence, stress, and reflective depth. In addition, an explanatory qualitative component was conducted with selected intervention participants to explore how digital microlearning supported clinical readiness and safety-oriented behavior. The qualitative component focused on mechanisms such as scenario recall, cognitive load reduction, confidence to speak up, and implementation conditions.

This study involved an educational intervention only and did not include invasive procedures, drugs, or medical devices. Participation was voluntary, and written informed consent was obtained from all participants. The study was approved by the Agri Ibrahim Cecen University Scientific Research Ethics Committee and was conducted in accordance with ethical principles for research involving human participants.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
90

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.
  • Name: VOLKAN GOKMEN, Assistant Professor
  • Phone Number: +905327390938
  • Email: vgokmen@agri.edu.tr

Study Locations

  • Turkey (Türkiye)
    • Merkez
      • AĞRI, Merkez, Turkey (Türkiye), 04100
        • Agri Ibrahim Cecen University Faculty of Health Sciences

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Second-year undergraduate nursing students
  • Enrolled in the Faculty of Health Sciences, Department of Nursing
  • Preparing to begin surgical clinical practice for the first time
  • Aged 18 years or older
  • Willing to participate and able to provide written informed consent

Exclusion Criteria:

  • Previous surgical clinical practice experience
  • Previous professional nursing or healthcare work experience
  • Incomplete baseline assessment
  • Declining to participate or withdrawal of consent

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Digital Microlearning Intervention Group
Participants in this group received a patient safety-focused digital microlearning program in addition to standard education before surgical clinical practice.
Behavioral: Digital Microlearning Program on Patient Safety
A structured digital microlearning program consisting of short, scenario-based online modules lasting approximately 3-5 minutes each. The program was delivered over seven consecutive days and focused on surgical patient-safety readiness, including patient identification, medication safety, patient-safety risk recognition, clinical error recognition, prioritization, escalation, and clinical decision-making under stress.
No Intervention: Control Group Standard Education
Participants in this group received standard patient-safety education as part of the undergraduate nursing curriculum without additional digital microlearning.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Patient Safety Awareness
Time Frame: Baseline before the program (T0), immediately after completion of the intervention (T1), end of the first week of surgical clinical practice (T2), and end of the seventh week of surgical clinical practice (T3).
Change in patient-safety awareness assessed using the Patient Safety Awareness Questionnaire. The questionnaire evaluates students' understanding of patient-safety principles, patient-safety risk recognition, and safe clinical practices in surgical care. Total scores are converted to a 0-100 scale, with higher scores indicating greater patient-safety awareness.
Baseline before the program (T0), immediately after completion of the intervention (T1), end of the first week of surgical clinical practice (T2), and end of the seventh week of surgical clinical practice (T3).
Clinical Error Recognition Performance
Time Frame: Baseline before the program (T0), immediately after completion of the intervention (T1), end of the first week of surgical clinical practice (T2), and end of the seventh week of surgical clinical practice (T3).
Change in clinical error recognition performance assessed using a scenario-based Clinical Error Recognition Test. The test evaluates students' ability to identify patient-safety risks and potential clinical errors in surgical clinical scenarios. Total scores range from 0 to 100, with higher scores indicating better clinical error recognition performance.
Baseline before the program (T0), immediately after completion of the intervention (T1), end of the first week of surgical clinical practice (T2), and end of the seventh week of surgical clinical practice (T3).

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Clinical Decision-Making Under Stress
Time Frame: Baseline before the program (T0), immediately after completion of the intervention (T1), end of the first week of surgical clinical practice (T2), and end of the seventh week of surgical clinical practice (T3).
Change in clinical decision-making performance under stress assessed using scenario-based decision-making evaluations simulating stressful surgical clinical situations. Total scores range from 0 to 100, with higher scores indicating better clinical decision-making performance under stress.
Baseline before the program (T0), immediately after completion of the intervention (T1), end of the first week of surgical clinical practice (T2), and end of the seventh week of surgical clinical practice (T3).
Clinical Practice Readiness
Time Frame: Baseline before the program (T0), immediately after completion of the intervention (T1), end of the first week of surgical clinical practice (T2), and end of the seventh week of surgical clinical practice (T3).
Change in perceived readiness for surgical clinical practice assessed using the Clinical Practice Readiness Scale. Scores are converted to a 0-100 scale for comparability, with higher scores indicating greater perceived readiness for clinical practice.
Baseline before the program (T0), immediately after completion of the intervention (T1), end of the first week of surgical clinical practice (T2), and end of the seventh week of surgical clinical practice (T3).
Clinical Self-Confidence
Time Frame: Baseline before the program (T0), immediately after completion of the intervention (T1), end of the first week of surgical clinical practice (T2), and end of the seventh week of surgical clinical practice (T3).
Change in clinical self-confidence for surgical clinical practice assessed using a self-confidence scale related to clinical preparedness and supervised patient-safety practice. Scores are converted to a 0-100 scale for comparability, with higher scores indicating greater clinical self-confidence.
Baseline before the program (T0), immediately after completion of the intervention (T1), end of the first week of surgical clinical practice (T2), and end of the seventh week of surgical clinical practice (T3).
EMA Behavioral Transfer Index
Time Frame: Weekly during surgical clinical practice weeks 1 through 7.
Behavioral transfer during surgical clinical practice assessed using weekly ecological momentary assessment prompts. The index captures patient-safety risk noticing, appropriate response, escalation or supervisor discussion, perceived confidence, stress, and reflective depth during clinical practice. Scores are converted to a 0-100 index, with higher scores indicating stronger safety-oriented behavioral transfer.
Weekly during surgical clinical practice weeks 1 through 7.
Acceptability of the Digital Microlearning Program
Time Frame: Immediately after completion of the intervention (T1).
Participant satisfaction, perceived usefulness, usability, and perceived relevance of the digital microlearning program assessed using a post-intervention program acceptability questionnaire in the intervention group. Total scores range from 1 to 5, with higher scores indicating greater acceptability and perceived usefulness.
Immediately after completion of the intervention (T1).

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Agri Ibrahim Cecen University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
February 10, 2026

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
April 30, 2026

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
April 30, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
January 13, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
January 20, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
January 26, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
June 4, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
June 2, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
June 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • Digital Microlearning-2026

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data will not be shared because the study involves undergraduate student participants and includes questionnaire responses, scenario-based educational performance scores, ecological momentary assessment data, and qualitative information. Sharing individual-level data could compromise participant confidentiality and privacy, particularly within a single-institution educational setting. Study findings will be reported in aggregate form only.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Clinical Trials on Medical Education

Clinical Trials on Digital Microlearning Program on Patient Safety

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

Cookie Settings

We use cookies to ensure that we give you the best experience on our website. For more details carefully read our Privacy and Cookies Policy. ...>>>You can change your preferences or withdraw your consent at any time by deleting the cookies from your website or computer as described in the policy. Please accept it and choose your preferences by ticking the corresponding boxes in the "Manage Settings" section below. Please carefully read our Terms of Service before you proceed with using any part of this website.
«Manage Settings