AI-Supported E-Learning for Pressure Injury Prevention

June 16, 2026 updated by: İslam Elagöz, Kilis 7 Aralik University

The Effect of an AI-Supported Modular E-Learning Programme for Pressure Injury Prevention on Nursing Students' Knowledge, Attitudes and Self-Efficacy: A Randomised Controlled Trial

Brief Summary

Pressure injuries are damage to the skin and underlying tissue that may occur in patients who stay in bed for long periods, have limited mobility or use medical devices. These injuries are often preventable. They may cause pain, infection, longer hospital stays and increased care costs. For this reason, it is important that nurses and nursing students have accurate knowledge, confidence and positive attitudes about preventing pressure injuries.

The aim of this study is to compare two different methods of teaching pressure injury prevention to nursing students. One group of students received the education in a face-to-face classroom session. The other group completed the same topic through an artificial intelligence-supported modular e-learning programme. The e-learning programme included short videos, clinical examples, question-and-answer activities, short quizzes and feedback. The educational materials prepared with artificial intelligence support were checked by experts before being used with students.

Undergraduate nursing students took part in the study. The students were randomly assigned to one of two groups. In both groups, measurements were taken before the education, immediately after the education and four weeks later. The study assessed students' knowledge of pressure injury prevention, their confidence in managing pressure injury prevention and their attitudes towards prevention.

This study does not provide a treatment or direct intervention to patients. However, its findings may help improve how nursing students and future healthcare professionals are educated about pressure injury prevention. In the long term, better education may support safer patient care, help prevent pressure injuries and improve the quality of care.

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

Detailed Description

This study is a single-centre, two-arm, parallel-group randomised controlled educational trial comparing two different teaching methods for pressure injury prevention. The study was conducted with undergraduate nursing students in the nursing department of a faculty of health sciences.

Pressure injuries are an important patient safety problem, especially for patients with limited mobility, patients in intensive care, patients after surgery and patients using medical devices. Preventing pressure injuries requires regular risk assessment, skin inspection, appropriate positioning, pressure redistribution, nutritional assessment, monitoring of device-related pressure and continuity of care. Therefore, it is important that nursing students develop adequate knowledge, self-efficacy and positive attitudes before graduation.

In this study, students were randomly assigned to one of two groups. The first group received pressure injury prevention education through conventional face-to-face classroom instruction. The second group completed the same core content through an artificial intelligence-supported modular e-learning programme. Both educational methods covered key topics, including the causes of pressure injuries, classification, risk assessment, nutrition, preventive interventions, care for special patient groups and medical device-related pressure injuries.

The artificial intelligence-supported e-learning programme consisted of short video presentations, narration scripts, clinical examples, question-and-answer activities, short quizzes and feedback sections. The educational materials were prepared with the support of artificial intelligence, but they were not used directly. The materials were reviewed by experts in surgical nursing and related fields for clinical accuracy, consistency with current evidence, suitability for undergraduate nursing students and clarity of instruction. Necessary revisions were made according to expert feedback before the e-learning content was delivered.

Students' outcomes were assessed at three time points: before the education, immediately after the education and four weeks after the education. Knowledge of pressure injury prevention was measured using PUKAT 2.0-T. Self-efficacy in pressure injury management was measured using PUM-SES. Attitudes towards pressure injury prevention were measured using APuP. This allowed the study to examine not only immediate learning after the education but also whether learning was maintained after four weeks.

This study does not involve a direct clinical intervention with patients. The participants are nursing students. Therefore, the effect of the study on patient care is indirect. However, improving the way pressure injury prevention is taught may support future healthcare professionals' clinical decision-making and patient safety practices.

The study aims to show whether artificial intelligence-supported modular e-learning is a useful method for pressure injury prevention education, how it compares with face-to-face instruction and whether students retain what they have learned over a short follow-up period. The findings may contribute to the development of nursing education programmes, the standardisation of pressure injury prevention education and stronger patient safety-focused education strategies in tissue viability.

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.
162

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 Locations

  • Turkey (Türkiye)
    • Kilis
      • Kilis, Kilis, Turkey (Türkiye), 79000
        • Kilis 7 Aralık University, Yusuf Şerefoğlu Faculty of Health Sciences, Department of Nursing

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

  • Child
  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Being an undergraduate nursing student.
  • Being aged 18 years or older.
  • Voluntarily agreeing to participate in the study.
  • Providing written informed consent.
  • Being able to participate in the allocated educational intervention and scheduled outcome assessments.

Exclusion Criteria:

  • Refusing to participate in the study.
  • Having previously received additional structured education on pressure ulcer or pressure injury prevention outside the standard curriculum.
  • Being unable to complete the educational intervention due to absence or withdrawal before intervention delivery.

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: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

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.
Active Comparator: Face-to-Face Instruction
Participants assigned to this arm received conventional face-to-face classroom instruction on pressure injury prevention. The session covered the causes of pressure injuries, classification and observation, risk assessment, nutrition, preventive interventions, care for special patient groups, and medical device-related pressure injuries. The education was delivered using standardised presentation materials.
Behavioral: Face-to-Face Pressure Injury Prevention Education
Participants received conventional face-to-face classroom instruction on pressure injury prevention. The session was delivered using standardised presentation materials and covered the causes of pressure injuries, classification and observation, risk assessment, nutrition, preventive interventions, care for special patient groups, and medical device-related pressure injuries.
Other Names:
  • Face-to-face instruction Conventional classroom instruction
Experimental: AI-Supported Modular E-Learning Programme
Participants assigned to this arm completed an artificial intelligence-supported modular e-learning programme on pressure injury prevention. The programme included short video presentations, clinical examples, question-and-answer activities, short quizzes and feedback sections. The content covered the same core pressure injury prevention topics as the face-to-face instruction and was reviewed by experts before implementation.
Behavioral: AI-Supported Modular E-Learning Programme
Participants completed an artificial intelligence-supported modular e-learning programme on pressure injury prevention. The programme included short video presentations, clinical examples, question-and-answer activities, short quizzes and feedback sections. The content covered the same core pressure injury prevention topics as the face-to-face instruction and was reviewed by experts before implementation.
Other Names:
  • AI-supported e-learning programme Modular e-learning programme

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
Change in Pressure Injury Prevention Knowledge Score
Time Frame: Baseline, immediately after the intervention, and 4 weeks after the intervention.

Outcome Measure Description:

Pressure injury prevention knowledge will be assessed using the Turkish version of the Pressure Injury Knowledge Assessment Tool 2.0 (PIKAT 2.0-Tr). The tool evaluates evidence-based knowledge of pressure injury prevention, including aetiology, classification and observation, risk assessment, nutrition, prevention, and care for special patient groups. The total score ranges from 0 to 24, with higher scores indicating higher levels of pressure injury prevention knowledge.
Baseline, immediately after the intervention, and 4 weeks after the intervention.

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
Change in Pressure Injury Prevention Self-Efficacy Score
Time Frame: Baseline, immediately after the intervention, and 4 weeks after the intervention.

Outcome Measure Description:

Pressure injury prevention self-efficacy will be assessed using the Pressure Ulcer Management Self-Efficacy Scale (PUM-SES). This scale measures students' perceived confidence in performing pressure injury prevention and management-related activities. The total score is standardised from 0 to 100, with higher scores indicating higher perceived self-efficacy.
Baseline, immediately after the intervention, and 4 weeks after the intervention.
Change in Attitudes Towards Pressure Injury Prevention Score
Time Frame: Baseline, immediately after the intervention, and 4 weeks after the intervention.

Outcome Measure Description:

Attitudes towards pressure injury prevention will be assessed using the Attitude towards Pressure Ulcer Prevention instrument (APuP). The scale evaluates students' attitudes towards the importance, responsibility, and effectiveness of pressure injury prevention. The total score ranges from 13 to 52, with higher scores indicating more positive attitudes towards pressure injury prevention.
Baseline, immediately after the intervention, and 4 weeks after the intervention.

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.
Kilis 7 Aralik University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Study Director: İSLAM ELAGÖZ, PhD, Kilis 7 Aralik 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

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.
May 30, 2025

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.
June 15, 2025

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.
June 20, 2025

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).
June 9, 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.
June 16, 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.
June 18, 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 18, 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 16, 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.
  • kilis22222

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

No individual participant data will be shared. The study was conducted with undergraduate nursing students at a single institution, and the dataset may include educational and demographic information that could increase the risk of indirect identification. De-identified aggregate results will be reported in publications and scientific presentations.

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.

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