ChatGPT-Driven Blended Teaching for Pain Management in Nursing Students: A Randomized Controlled Trial

April 20, 2026 updated by: Sogand Sarmadi, Shahid Beheshti University of Medical Sciences

Effect of a ChatGPT-Driven Blended Teaching Model for Pain Management on Knowledge, Attitudes, Competence, and Self-Efficacy Among Nursing Students: A Two-Arm Parallel-Group Randomized Controlled Trial

Pain management is a core competency in nursing practice, yet nursing students consistently demonstrate insufficient knowledge, unfavorable attitudes, limited competence, and low self-efficacy in this area. Artificial intelligence (AI)-based educational tools, particularly ChatGPT, have emerged as promising resources in nursing education; however, rigorous experimental evidence on their effectiveness remains scarce.

This study is a two-arm, parallel-group randomized controlled trial (RCT) that aims to evaluate the effect of a ChatGPT-driven blended teaching model for pain management on nursing students' knowledge and attitudes toward pain, nursing competence, and learning self-efficacy.

Eligible nursing students at Shahid Beheshti University of Medical Sciences (Tehran, Iran) will be randomly assigned in a 1:1 ratio to either:

  • Intervention group: ChatGPT-assisted blended clinical nursing rounds (8 sessions over 4 weeks, each 90 minutes, combining bedside rounds with AI-assisted pre- and post-round activities)
  • Control group: Traditional clinical nursing rounds (same number and duration of sessions, without any AI tools)

Outcomes will be measured at baseline (1 week before intervention), immediate post-test (1 week after intervention), and 3-month follow-up using validated instruments: the Nurses' Knowledge and Attitudes Survey Regarding Pain (NKASRP), the Nursing Student Competence Scale (NSCS), and the Nursing Students' Learning Self-Efficacy instrument (NLSE).

Findings will provide empirical evidence to guide educational policy and curriculum design in nursing programs, with the goal of improving pain management education and patient care outcomes.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

156

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 Contact

Study Locations

  • Iran
    • Tehran Province
      • Tehran, Tehran Province, Iran
        • Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences
        • Contact:
        • Principal Investigator:
          • sogand sarmadi

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:

  1. Undergraduate nursing students in their fourth semester or higher, or master's or doctoral nursing students engaged in clinical training involving direct patient care
  2. Provision of electronic informed consent
  3. Access to the internet and a personal device (computer, tablet, or smartphone) for the asynchronous components of the blended teaching model
  4. No participation in a formal comprehensive pain management course within the previous 12 months

Exclusion Criteria:

  1. Inability to attend at least one face-to-face session or to complete online activities (e.g., due to repeated absences)
  2. Any self-reported or university-documented cognitive or mental health condition that prevented completion of questionnaires or participation in training
  3. Voluntary withdrawal at any stage of the study

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: ChatGPT-Driven Blended Teaching Group
Participants receive a blended teaching intervention integrating ChatGPT-assisted instruction with traditional in-person clinical nursing rounds focused on pain management. The intervention consists of 8 sessions over 4 weeks (2 sessions per week), each approximately 90 minutes, comprising three phases: pre-round preparation (30 min) using standardized ChatGPT prompts and case-based learning; bedside nursing round (30 min) with patient assessment and instructor feedback; and post-round activities (30 min) using ChatGPT to resolve uncertainties and complete case reports. Students are organized in groups of 4-6 and rotate through medical, surgical, and chronic pain clinical departments.
Behavioral: ChatGPT-Driven Blended Teaching Model for Pain Management
A blended teaching model integrating ChatGPT with in-person clinical nursing rounds for pain management education. Delivered over 4 weeks (8 sessions × 90 minutes). Each session includes: (1) pre-round preparation using standardized ChatGPT prompts for case analysis and evidence retrieval; (2) bedside nursing rounds with pain assessment, patient education, and instructor feedback; and (3) post-round activities using ChatGPT to resolve clinical uncertainties and complete case reports. All ChatGPT outputs were reviewed by supervising faculty for accuracy. Students used pre-designed, standardized prompts based on the WHO analgesic ladder and national clinical protocols.
Other Names:
  • AI-Assisted Blended Clinical Nursing Rounds
Active Comparator: Traditional Clinical Nursing Rounds Group
Participants receive traditional clinical nursing rounds without any ChatGPT or AI components. The instructor selects and introduces clinical cases; students review resources and prepare reports. During rounds, the instructor directs all activities, including case presentation, assessment, nursing diagnosis, intervention, and outcome evaluation. The control group receives an identical number and duration of sessions (8 sessions over 4 weeks, each approximately 90 minutes) in the same clinical departments to ensure exposure consistency.
Behavioral: Traditional Clinical Nursing Rounds
Standard clinical nursing rounds without AI tools. The instructor directs all activities including case introduction, bedside assessment, nursing diagnosis, intervention planning, and outcome evaluation. Students primarily observe and respond to instructor questions. Sessions match the intervention group in number, duration, and clinical setting (8 sessions × 90 minutes over 4 weeks).

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Knowledge and Attitudes Toward Pain
Time Frame: Baseline (1 week before intervention), immediate post-test (1 week after intervention), and 3-month follow-up
Measured using the Nurses' Knowledge and Attitudes Survey Regarding Pain (NKASRP), a 39-item instrument comprising 22 true/false questions, 13 multiple-choice questions, and 2 case studies. Each correct answer scores 1 point (range: 0-39); results expressed as percentage of correct responses. Higher scores indicate better knowledge and attitudes toward pain management. A Persian forward-backward translation was performed, with face and content validity confirmed by a nursing faculty panel.
Baseline (1 week before intervention), immediate post-test (1 week after intervention), and 3-month follow-up

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Nursing Competence
Time Frame: Baseline (1 week before intervention), immediate post-test (1 week after intervention), and 3-month follow-up
Measured using the Persian version of the Nursing Student Competence Scale (NSCS), a 28-item instrument across 6 subscales: medical-related knowledge, basic nursing skills, communication and cooperation, lifelong learning, global perspective, and critical thinking. Items rated on a 5-point Likert scale (range: 28-140). Higher scores indicate greater competence. The Persian version demonstrated Cronbach's α = 0.90 and ICC = 0.88.
Baseline (1 week before intervention), immediate post-test (1 week after intervention), and 3-month follow-up
Learning Self-Efficacy
Time Frame: Baseline (1 week before intervention), immediate post-test (1 week after intervention), and 3-month follow-up
Measured using the Persian version of the Nursing Students' Learning Self-Efficacy instrument (NLSE), a 21-item instrument across 5 dimensions: conceptual understanding, higher-order cognitive skills, practical work, everyday application, and nursing communication. Items rated on a 5-point Likert scale (range: 21-105). Higher scores indicate greater self-efficacy. The Persian version demonstrated Cronbach's α = 0.93 and ICC = 0.89.
Baseline (1 week before intervention), immediate post-test (1 week after intervention), and 3-month follow-up

Collaborators and Investigators

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

Sponsor

Shahid Beheshti University of Medical Sciences

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 (Estimated)

September 1, 2026

Primary Completion (Estimated)

December 1, 2026

Study Completion (Estimated)

January 1, 2027

Study Registration Dates

First Submitted

April 20, 2026

First Submitted That Met QC Criteria

April 20, 2026

First Posted (Actual)

April 27, 2026

Study Record Updates

Last Update Posted (Actual)

April 27, 2026

Last Update Submitted That Met QC Criteria

April 20, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • IR.SBMU.PHARMACY.REC.1405.046

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

IPD Plan Description

Due to privacy considerations, a final decision has not been made at this time.

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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