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

Effect of Digital Microlearning on Patient Safety Awareness and Clinical Decision-Making Among Nursing Students Before Surgical Clinical Practice: A Randomized Controlled Trial

This randomized controlled study aims to evaluate the effect of a patient safety-focused digital microlearning program on nursing students before they begin surgical clinical practice.

Nursing students often face challenges related to patient safety and clinical decision-making during the transition from classroom learning to clinical settings. This study will examine whether short, structured digital learning modules can improve patient safety awareness, recognition of clinical errors, and decision-making skills.

Second-year undergraduate nursing students will be randomly assigned to either a digital microlearning intervention group or a control group receiving standard education. Outcomes will be measured before the intervention, immediately after the intervention, and during the first week of clinical practice.

Study Overview

• Status: Recruiting
• Conditions: Medical Education; Patient Safety
• Intervention / Treatment: Behavioral: Digital Microlearning Program on Patient Safety

Detailed Description

The transition from preclinical education to clinical practice represents a critical period for patient safety among nursing students. During this phase, limited clinical experience combined with increased responsibility may increase the risk of errors related to patient safety and clinical decision-making. Educational strategies that strengthen patient safety awareness and cognitive readiness before clinical exposure are therefore essential.

This study is designed as a single-center, parallel-group, randomized controlled trial. It will be conducted at the Faculty of Health Sciences, Department of Nursing, Agri Ibrahim Cecen University. Participants will consist of second-year undergraduate nursing students who are preparing to begin surgical clinical practice for the first time.

After baseline assessment, eligible participants will be randomly assigned to either an intervention group or a control group using stratified randomization based on gender and grade point average. The intervention group will receive a patient safety-focused digital microlearning program delivered online for seven consecutive days. The program consists of short, scenario-based modules lasting approximately 3-5 minutes each and addresses topics such as patient safety risks, clinical error recognition, prioritization, and decision-making under stress. Participants will be able to access the modules flexibly within a daily time limit.

The control group will receive standard patient safety education as part of the undergraduate nursing curriculum without additional intervention.

Outcome measures will be collected at three time points: baseline prior to the intervention (T0), immediately after completion of the intervention (T1), and during the first week of surgical clinical practice (T2). Primary outcomes include changes in patient safety awareness and clinical error recognition performance. Secondary outcomes include clinical decision-making under stress, perceived readiness for clinical practice, self-confidence, and acceptability of the digital microlearning program.

This study involves an educational intervention only and does not include any invasive procedures, drugs, or medical devices. Participation is voluntary, and written informed consent will be obtained from all participants. The study has been submitted for ethical review and will be conducted in accordance with ethical principles for research involving human participants.

• Study Type: Interventional
• Enrollment (Estimated): 100
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: VOLKAN GOKMEN, Assistant Professor; Phone Number: +905327390938; Email: vgokmen@agri.edu.tr

Study Locations

• Turkey (Türkiye)
  • Merkez
    • AĞRI, Merkez, Turkey (Türkiye), 04100
      • Recruiting
      • Agri Ibrahim Cecen University Faculty of Health Sciences
      • Contact: VOLKAN GOKMEN, Assist. Prof.; Phone Number: +905327390938; Email: vgokmen@agri.edu.tr
      • Contact: BURCU DEMIR GOKMEN, Assoc. Prof.; Phone Number: +905067516888; Email: budemir@agri.edu.tr

Participation Criteria

Eligibility Criteria

• 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

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Digital Microlearning Intervention Group; Participants in this group will receive a patient safety-focused digital microlearning program before starting surgical clinical practice.	Behavioral: Digital Microlearning Program on Patient Safety; A structured digital microlearning program consisting of short, scenario-based modules (3-5 minutes each) focusing on patient safety awareness, clinical error recognition, prioritization, and clinical decision-making. The program will be delivered online for seven consecutive days before surgical clinical practice.
No Intervention: Control Group Standard Education; Participants in this group will receive standard patient safety education as part of the undergraduate nursing curriculum without additional intervention.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Patient Safety Awareness	Change in patient safety awareness assessed using the Patient Safety Awareness Questionnaire, which evaluates students' understanding of patient safety principles, risk recognition, and safe clinical practices in surgical care. Outcome Measure: Total score on the Patient Safety Awareness Questionnaire, ranging from 0 to 100, where higher scores indicate greater patient safety awareness.	Baseline (T0): Prior to the educational intervention (Day 0) Post-intervention (T1): Within 1 week after completion of the intervention Follow-up (T2): During the first week of surgical clinical practice
Clinical Error Recognition Performance	Change in clinical error recognition performance assessed using scenario-based clinical error recognition tests evaluating students' ability to identify patient safety risks and potential clinical errors. Outcome Measure: Total score on the Clinical Error Recognition Test, ranging from 0 to 100, where higher scores indicate better clinical error recognition performance.	Baseline (T0): Prior to the educational intervention (Day 0) Post-intervention (T1): Within 1 week after completion of the intervention Follow-up (T2): During the first week of surgical clinical practice

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Clinical Decision-Making Under Stress	Change in clinical decision-making performance under stress assessed using scenario-based decision-making evaluations simulating stressful surgical clinical situations. Outcome Measure: Total score on the Clinical Decision-Making Under Stress Assessment, ranging from 0 to 100, where higher scores indicate better clinical decision-making performance under stress.	Baseline (T0): Prior to the educational intervention (Day 0) Post-intervention (T1): Within 1 week after completion of the intervention Follow-up (T2): During the first week of surgical clinical practice
Perceived Readiness and Self-Confidence for Clinical Practice	Change in perceived readiness and self-confidence for surgical clinical practice measured using the Clinical Practice Readiness and Self-Confidence Scale. Outcome Measure: Total score on the Clinical Practice Readiness and Self-Confidence Scale, ranging from 1 to 5, where higher scores indicate greater perceived readiness and self-confidence.	Baseline (T0): Prior to the educational intervention (Day 0) Post-intervention (T1): Within 1 week after completion of the intervention Follow-up (T2): During the first week of surgical clinical practice
Acceptability of the Digital Microlearning Program	Participant satisfaction and perceived usefulness of the digital microlearning program assessed using a post-intervention program acceptability questionnaire in the intervention group. Outcome Measure: Total score on the Program Acceptability Questionnaire, ranging from 1 to 5, where higher scores indicate greater acceptability and perceived usefulness.	Post-intervention (T1): Within 1 week after completion of the intervention

Collaborators and Investigators

• Sponsor: Agri Ibrahim Cecen University

Publications and helpful links

General Publications

• World Health Organization. Patient safety curriculum guide: Multi-professional edition. Geneva: WHO; 2011.
• Lee SE, Morse BL, Kim NW. Patient safety educational interventions: A systematic review with recommendations for nurse educators. Nurs Open. 2022 Jul;9(4):1967-1979. doi: 10.1002/nop2.955. Epub 2021 May 28.
• De Gagne JC, Park HK, Hall K, Woodward A, Yamane S, Kim SS. Microlearning in Health Professions Education: Scoping Review. JMIR Med Educ. 2019 Jul 23;5(2):e13997. doi: 10.2196/13997.

Helpful Links

• World Health Organization resources providing background information on patient safety principles relevant to the study protocol.

Study record dates

Study Major Dates

• Study Start (Actual): February 1, 2026
• Primary Completion (Estimated): April 30, 2026
• Study Completion (Estimated): April 30, 2026

Study Registration Dates

• First Submitted: January 13, 2026
• First Submitted That Met QC Criteria: January 20, 2026
• First Posted (Actual): January 26, 2026

Study Record Updates

• Last Update Posted (Actual): April 30, 2026
• Last Update Submitted That Met QC Criteria: April 28, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Nursing students; Educational intervention; Digital microlearning; Patient safety awareness; Clinical error recognition; Surgical clinical practice
• Other Study ID 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 student participants and includes questionnaire-based and educational performance data. Sharing individual-level data could pose risks to participant confidentiality and privacy. All data will be used solely for the purposes of this study and reported in aggregate form.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No