Examining the Effects of ARCS-Based Education on Cardiovascular System Physical Examination Skills, Motivation, and Self-Efficacy Levels in Nursing Students

July 23, 2026 updated by: Şeyda KAZANÇ, Cumhuriyet University

Examining the Effects of ARCS-Based Education on Cardiovascular System Physical Examination Skills, Motivation, and Self-Efficacy Levels in Nursing Students: A Randomized Controlled Experimental Study

Objective: The purpose of this study is to determine the effect of ARCS-based nursing education on skill levels, motivation, and self-efficacy in the physical examination of the cardiovascular system.

Background: In nursing education, it is crucial for students to acquire skills in comprehensive patient assessment and physical examination. Motivation and academic self-efficacy are key factors in education and academic success.

Methods: This study was conducted during the Spring Semester of 2025-2026 with 100 second-year students enrolled in the Department of Nursing at Tokat Gaziosmanpaşa University's Faculty of Health Sciences, as part of the Health Assessment course. Students who received cardiovascular system education using traditional methods were assigned to experimental and control groups. The experimental group also received training based on the ARCS motivation model. Data were collected using a Personal Information Form, a Cardiovascular System Examination Skills Assessment Form, the "Motivation Scale for Instructional Material," and the "Academic Self-Efficacy Scale." This randomized controlled experimental study was conducted and reported in accordance with the CONSORT guidelines

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.

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.
100

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

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
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Being a second-year nursing student (18-25 years old),
  • Taking the physical examination course for the first time
  • Voluntarily agreeing to participate in the study

Exclusion Criteria:

  • Being a student transferring from another program,
  • Having difficulty understanding and speaking Turkish
  • Having graduated from a Health Vocational High School
  • Currently participating in any training related to physical examination in nursing; Not having taken courses related to physical examination of the cardiovascular system Withdrawing from the study or revoking consent during the research,

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: Other
  • 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: ARCS Experimental Group
ARCS Model Training The experimental group received a total of two hours (120 minutes) of supplementary training, structured by the same instructor based on the ARCS (Attention, Relevance, Confidence, Satisfaction) Motivation Model. This training was conducted in accordance with the model's four components, using the following activities in sequence: Attention Component , Relevance Component , Confidence Component , Satisfaction Component
Other: ARCS Model Education
The experimental group received a total of two hours (120 minutes) of supplementary training, structured by the same instructor based on the ARCS (Attention, Relevance, Confidence, Satisfaction) Motivation Model. This training was conducted in accordance with the model's four components, using the following activities in sequence:
Other: Structured Supplementary Training Based on the ARCS Motivation Model
The experimental group received a total of two hours (120 minutes) of supplementary training, structured by the same instructor based on the ARCS (Attention, Relevance, Confidence, Satisfaction) Motivation Model. This training was conducted in accordance with the model's four components, using the following activities in sequence:
No Intervention: Control Group: Traditional Reinforcement Training
The control group received reinforcement training using the traditional question-and-answer method, conducted by the same instructor during the same time period (one week later). During this process, the instructor summarized and reviewed the topics covered in the four-hour basic training on cardiovascular system examination (history-taking, inspection, palpation, percussion, auscultation, heart sounds, peripheral pulse, and circulation assessment); the instructor verbally assessed the students' level of understanding by asking them questions in sequence. Based on the students' responses, any gaps or misunderstandings were verbally corrected; however, motivational and interactive activities-such as scenario-based exercises, role-playing, station-based activities, immediate feedback, or rewards-which were implemented in the experimental group, were not included. The control group's training was completed in the same amount of time (two hours) as the experimental group's but was conduct

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
Motivation Scale for Instructional Material
Time Frame: The assessment will be conducted in two separate time periods. The first assessment will be immediately before the training, and the second assessment will be two weeks after the training (post-training test).
It is assessed using a 5-point Likert-type scale, and the total score range is between 33 and 165 point; an increase in score is interpreted as an increase in motivation. an increase in score is interpreted as an increase in motivation. The lower and upper score ranges are categorized as very low (33-37) and very high (161-165), respectively.
The assessment will be conducted in two separate time periods. The first assessment will be immediately before the training, and the second assessment will be two weeks after the training (post-training test).
Academic Self-Efficacy Scale:
Time Frame: The assessment will be conducted in two separate time periods. The first assessment will be immediately before the training, and the second assessment will be two weeks after the training (post-training test).
To assess academic self-efficacy, the "Academic Self-Efficacy Scale"-developed by Owen and Froman (1988) and adapted into Turkish by Ekici (2012) was used. It is noted that the scale consists of a total of 33 items and 3 dimensions, and that it can be used as a single-dimension scale. The scale is scored on a five-point Likert scale. The total score ranges from 33 to 165. The scale's subdimensions are listed as social status, cognitive applications, and technical skills. In the validity and reliability study of the Turkish version of the scale, the Cronbach's Alpha value was found to be 0.86 (Ekici, 2012). In this study, Cronbach's Alpha values were found to be 0.904 for the pretest and 0.963 for the posttest.
The assessment will be conducted in two separate time periods. The first assessment will be immediately before the training, and the second assessment will be two weeks after the training (post-training test).
Cardiac and Circulatory System Examination Skills Assessment Form:
Time Frame: The assessment will be conducted by OSCE two weeks after the training, during the students' practical applications.
A 54-item form covering the cardiovascular system examination-including taking a medical history, identifying key areas when auscultating heart sounds, and using inspection, palpation, and auscultation methods, as well as assessing the jugular vein, carotid artery, and capillary refill-has been developed in accordance with the literature (Özden, 2024; Yava and Koyuncu, 2017). This form was used as part of a post-education structured clinical examination (OSCE) to assess students' skills. Three categories were established for student evaluations, and the ability to perform the task described in the relevant item was scored as follows: Performed: 2 points; Incomplete/Incorrect: 1 point; Did Not Perform: 0 points. A maximum score of 0-108 points can be achieved on the skills form. A high score indicates good skill development.
The assessment will be conducted by OSCE two weeks after the training, during the students' practical applications.

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.
Cumhuriyet 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 7, 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.
May 15, 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.
June 15, 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).
July 7, 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.
July 23, 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.
July 29, 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.
July 29, 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.
July 23, 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.
July 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

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.
  • TOGU SBF

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

In order to protect personal data, the data is not available for sharing.

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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