The Effect of Puzzle Activity on Nursing Students' Willingness to Work With Older Adults and Gerontological Nursing Competence (Puzzle)

September 16, 2025 updated by: Zühal Erdoğan, Gazi University
The study will be conducted using a parallel-group randomized controlled experimental design to determine the effect of a puzzle activity on nursing students' willingness to work with older adults and their competence in gerontological nursing. The study population will consist of second-year students (N=243) enrolled in the Faculty of Nursing at a university. The sample of the study will include at least 86 nursing students, with 43 students in the puzzle group and 43 students in the control group. The research will be carried out between March 2025 and June 2025. In this study, data will be collected using the "Descriptive Information Form," the "Willingness to Work with Older People Scale," and the "Gerontological Nursing Competence Scale."

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

The study will be conducted using a parallel-group randomized controlled experimental design to determine the effect of a puzzle activity on nursing students' willingness to work with older adults and their gerontological nursing competence. The study group will consist of second-year students (N=243) enrolled in the Faculty of Nursing at a university. The G*Power program was used to calculate the sample size. In the reference study (Kaynak, S., Ergün, S., & Karadaş, A. (2023). The effect of crossword puzzle activity used in distance education on nursing students' problem-solving and clinical decision-making skills: A comparative study. Nurse Education in Practice, 69, 103618), it was determined that at least 86 students (43+43) were needed, with α = 0.05, 80% power, and an effect size of 0.615.

After assigning the students to the intervention and control groups, a puzzle activity will be conducted with the intervention group following a lecture. In preparing the puzzles, the researchers will use free online puzzle-making tools (e.g., https://crosswordlabs.com/). The puzzles will include questions related to basic knowledge and concepts concerning gerontological nursing competence. During the puzzle-solving process, the researcher will be present in the classroom and provide guidance to students when needed. After students complete the puzzles, the researcher will project the puzzle on the presentation screen and evaluate the answers through interactive discussion with the students. Upon completion of each puzzle, the researcher will collect the puzzles from the students to prevent contamination between the intervention and control groups. A post-test will be administered to students at the end of the puzzle activity.

Study Type

Interventional

Enrollment (Actual)

102

Phase

  • 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

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • • Being a second-year nursing student

    • Volunteering to participate in the study

Exclusion Criteria:

Not taking the Geriatric Health Nursing course

  • Having difficulty in understanding and speaking Turkish
  • Incomplete or incorrectly answered data collection tools
  • Willingness to withdraw from the study voluntarily

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
Intervention / Treatment
Experimental: Puzzle Activity Group
The puzzles, which include questions related to basic knowledge and concepts of gerontological nursing competence, are required to be solved over a period of three weeks.
Other: Puzzle Activity
After assigning the students to the intervention and control groups, a puzzle activity will be conducted with the intervention group following a lecture. In preparing the puzzles, the researchers will use free online puzzle-making tools (e.g., https://crosswordlabs.com/). The puzzles will include questions related to basic knowledge and concepts concerning gerontological nursing competence. During the puzzle-solving process, the researcher will be present in the classroom and provide guidance to students when needed. After students complete the puzzles, the researcher will project the puzzle on the presentation screen and evaluate the answers through interactive discussion with the students. Upon completion of each puzzle, the researcher will collect the puzzles from the students to prevent contamination between the intervention and control groups. A post-test will be administered to students at the end of the puzzle activity.
No Intervention: Control group
After explaining the purpose and implementation of the study to the nursing students in the control group, the "Descriptive Information Form," the "Willingness to Work with Older People Scale," and the "Gerontological Nursing Competence Scale" will be administered. No intervention will be applied to the control group. At the end of the third week, the "Willingness to Work with Older People Scale" and the "Gerontological Nursing Competence Scale" will be re-administered.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Willingness to Work with Older People Scale
Time Frame: Baseline
The scale was developed by Fadayevatan and colleagues (2018) to determine medical students' willingness to work with older adults. The Turkish validity and reliability of the scale were conducted by Akpınar Söylemez and colleagues (2022) with nursing and medical students The scale consists of 4 sub-dimensions and 20 items. The scale is a six-point Likert-type scale, where items are scored from 1 = strongly disagree to 6 = strongly agree. The minimum score that can be obtained from the scale is 20, and the maximum score is 120. Scores for each sub-dimension and a total score are calculated. Higher scores indicate a greater willingness to work with older adults
Baseline
Willingness to Work with Older People Scale
Time Frame: At the end of the third week,
The scale was developed by Fadayevatan and colleagues (2018) to determine medical students' willingness to work with older adults. The Turkish validity and reliability of the scale were conducted by Akpınar Söylemez and colleagues (2022) with nursing and medical students The scale consists of 4 sub-dimensions and 20 items. The scale is a six-point Likert-type scale, where items are scored from 1 = strongly disagree to 6 = strongly agree. The minimum score that can be obtained from the scale is 20, and the maximum score is 120. Scores for each sub-dimension and a total score are calculated. Higher scores indicate a greater willingness to work with older adults
At the end of the third week,
Gerontological Nursing Competence Scale
Time Frame: Baseline
The scale was developed by Tohmola et al. (2021) to measure nursing students' competencies in geriatric care. The Turkish validity and reliability study was conducted by Aslan et al. (2024). The scale consists of 53 items and 11 subdimensions. The scale is a 4-point Likert-type scale and is rated as follows:1 = Strongly Disagree, 2 = Partially Disagree, 3 = Partially Agree, 4 = Strongly Agree. The minimum score that can be obtained from the scale is 53, and the maximum score is 212. As the level of competence increases, the score obtained from the scale also increases
Baseline
Gerontological Nursing Competence Scale
Time Frame: At the end of the third week,
The scale was developed by Tohmola et al. (2021) to measure nursing students' competencies in geriatric care. The Turkish validity and reliability study was conducted by Aslan et al. (2024). The scale consists of 53 items and 11 subdimensions. The scale is a 4-point Likert-type scale and is rated as follows:1 = Strongly Disagree, 2 = Partially Disagree, 3 = Partially Agree, 4 = Strongly Agree. The minimum score that can be obtained from the scale is 53, and the maximum score is 212. As the level of competence increases, the score obtained from the scale also increases
At the end of the third week,

Collaborators and Investigators

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

Sponsor

Gazi University

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)

March 28, 2025

Primary Completion (Actual)

May 15, 2025

Study Completion (Actual)

May 15, 2025

Study Registration Dates

First Submitted

March 28, 2025

First Submitted That Met QC Criteria

March 28, 2025

First Posted (Actual)

March 30, 2025

Study Record Updates

Last Update Posted (Estimated)

September 17, 2025

Last Update Submitted That Met QC Criteria

September 16, 2025

Last Verified

July 1, 2025

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • 2025 -397

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

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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