Three Teaching Strategies in Nursing Education: Effects on Learning and Knowledge Retention

The Effect of Three Different Instructional Strategies on Learning Outcomes and Knowledge Retention in Nursing Education: A Randomized Controlled Trial

The goal of this clinical trial is to learn whether three different instructional strategies improve learning outcomes and knowledge retention in nursing students receiving education on peritoneal dialysis catheter care. The main questions it aims to answer are:

Does Pecha Kucha-based education improve students' knowledge of peritoneal dialysis catheter care compared with concept map-based education and traditional education? Do the three instructional strategies differ in terms of knowledge retention, learning satisfaction, learning experience, and perceived cognitive load? Researchers will compare Pecha Kucha-based education, concept map-based education, and traditional education to see which instructional strategy is more effective in improving students' knowledge, supporting knowledge retention, and providing a positive learning experience.

Participants will:

Complete a pre-test before the education. Receive one of three educational interventions on peritoneal dialysis catheter care: Pecha Kucha-based education, concept map-based education, or traditional education.

Complete a post-test after the education. Complete forms evaluating learning satisfaction, learning experience, and perceived cognitive load.

Complete a follow-up knowledge test to assess knowledge retention.

Study Overview

• Status: Not yet recruiting
• Conditions: Nursing Education; Peritoneal Dialysis Catheter Care; Knowledge Retention; Instructional Strategies
• Intervention / Treatment: Behavioral: Pecha Kucha-Based Education; Behavioral: Concept Map-Based Education; Behavioral: Traditional Education

Detailed Description

Detailed Description

This randomized controlled trial will evaluate the effects of three different instructional strategies on nursing students' learning outcomes and knowledge retention related to peritoneal dialysis catheter care. The instructional strategies are Pecha Kucha-based education, concept map-based education, and traditional education.

Peritoneal dialysis catheter care is an important nursing skill because appropriate care supports treatment continuity, helps prevent infection, and enables early recognition of catheter-related complications. Nursing students need to understand the purpose of the catheter, catheter exit-site care, hand hygiene, aseptic technique, dressing care, prevention of catheter trauma or blockage, signs of infection and peritonitis, risky practices, and situations requiring referral to a healthcare team.

Participants will be randomly assigned to one of three groups. All groups will receive education on the same content and learning objectives. The difference between groups will be the instructional strategy used to deliver the content.

The Pecha Kucha group will receive a structured, time-controlled visual micro-presentation. The concept map group will receive education through a structured concept map showing the relationships among key concepts related to peritoneal dialysis catheter care. The traditional education group will receive the same content through a standard teacher-centered presentation and verbal explanation.

The educational content will include the role of renal replacement therapy, the place of peritoneal dialysis among renal replacement therapy options, the definition and function of the peritoneal dialysis catheter, catheter exit-site care, infection prevention, hand hygiene, aseptic technique, daily observation, dressing care, catheter stabilization, prevention of catheter blockage, signs of exit-site infection and peritonitis, catheter-related complications, risky practices, patient education, and when to seek healthcare support.

Before the educational intervention, participants will complete a knowledge test on peritoneal dialysis catheter care. After the education, participants will complete the same or equivalent knowledge test to evaluate immediate learning. They will also complete forms assessing learning satisfaction, learning experience, and perceived cognitive load. A follow-up knowledge test will be administered later to evaluate knowledge retention.

The primary outcome of the study is students' knowledge level related to peritoneal dialysis catheter care. Secondary outcomes include knowledge retention, learning satisfaction, learning experience, and perceived cognitive load. The study will compare the three instructional strategies to determine which method is more effective in improving learning outcomes and supporting retention of knowledge in nursing education.

• Study Type: Interventional
• Enrollment (Estimated): 90
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Zehra AYDIN, PhD; Phone Number: +905447141911; Email: zehra.aydin@atlas.edu.tr

Study Locations

• Turkey (Türkiye)
  • Istanbul
    • Istanbul, Istanbul, Turkey (Türkiye), 34390
      • Istanbul Atlas University
      • Contact: Zehra AYDIN, PhD; Phone Number: 905447141911; Email: zehra.aydin@atlas.edu.tr
      • Contact: Email: zehra.aydin@atlas.edu.tr
      • Principal Investigator: Zehra AYDIN, PhD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Being a second- or third-year undergraduate nursing student.
• Being enrolled in the relevant nursing course during the study period.
• Being scheduled to participate in the educational intervention on peritoneal dialysis catheter care.
• Voluntarily agreeing to participate in the study.
• Providing informed consent.
• Being able to complete the pre-test, immediate post-test, and 4-week follow-up assessments.

Exclusion Criteria:

• Not providing informed consent.
• Not attending the educational intervention.
• Being unable to complete the study assessment forms.
• Participating in another educational activity or training program specifically related to peritoneal dialysis catheter care during the study period.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Arm 1: Pecha Kucha-Based Education; Participants in this arm will receive standardized education on peritoneal dialysis catheter care using a Pecha Kucha-based instructional strategy. The education will be delivered as a time-controlled visual micro-presentation consisting of 20 slides, with each slide presented for 20 seconds. The content will focus on peritoneal dialysis catheter function, catheter exit-site care, infection prevention, hand hygiene, aseptic technique, dressing care, catheter protection, complications, risky practices, and situations requiring healthcare referral.	Behavioral: Pecha Kucha-Based Education; Participants assigned to this group will receive standardized education on peritoneal dialysis catheter care using a Pecha Kucha-based instructional strategy. The session will include a structured, time-controlled visual presentation consisting of 20 slides, with each slide presented for 20 seconds, followed by a brief summary. The content will cover catheter function, exit-site care, hand hygiene, aseptic technique, dressing care, catheter protection, infection signs, complications, risky practices, and situations requiring healthcare referral.
Experimental: Arm 2: Concept Map-Based Education; Participants in this arm will receive standardized education on peritoneal dialysis catheter care using a structured concept map-based instructional strategy. The education will present the same core content as the other groups, but the information will be organized through a concept map showing the relationships among key concepts such as catheter care, exit-site observation, infection prevention, aseptic technique, dressing care, complications, and patient safety.	Behavioral: Concept Map-Based Education; Participants assigned to this group will receive standardized education on peritoneal dialysis catheter care using a structured concept map-based instructional strategy. The same educational content will be presented through a concept map that visually organizes the relationships among key concepts, including catheter care, exit-site observation, infection prevention, aseptic technique, dressing care, catheter protection, complications, risky practices, and patient safety.
Experimental: Arm 3: Traditional Education; Participants in this arm will receive standardized education on peritoneal dialysis catheter care using a traditional instructional strategy. The education will be delivered through a standard teacher-centered presentation and verbal explanation. The content will be the same as in the other groups and will include catheter function, exit-site care, hand hygiene, aseptic technique, dressing care, catheter protection, infection signs, complications, risky practices, and situations requiring healthcare referral.	Behavioral: Traditional Education; Participants assigned to this group will receive standardized education on peritoneal dialysis catheter care using a traditional teacher-centered instructional strategy. The same educational content will be delivered through a standard presentation and verbal explanation. The content will include catheter function, exit-site care, hand hygiene, aseptic technique, dressing care, catheter protection, infection signs, complications, risky practices, and situations requiring healthcare referral.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Knowledge Level on Peritoneal Dialysis Catheter Care	Students' knowledge level regarding peritoneal dialysis catheter care will be assessed using a researcher-developed multiple-choice knowledge test. The test includes 15 questions related to catheter exit-site care, hand hygiene, aseptic technique, dressing care, infection signs, catheter protection, risky practices, and situations requiring healthcare referral. Scores range from 0 to 15, with higher scores indicating better knowledge related to peritoneal dialysis catheter care.	Baseline, immediately after the educational intervention, and 4 weeks after the educational intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Knowledge Retention on Peritoneal Dialysis Catheter Care	Knowledge retention will be evaluated by comparing participants' knowledge test scores obtained 4 weeks after the educational intervention with their immediate post-test scores. The same 15 multiple-choice question knowledge test will be used (min 0-max 15 score). Higher scores indicate better retention of knowledge related to peritoneal dialysis catheter care.	Immediately after the educational intervention and 4 weeks after the educational intervention
Learning Satisfaction and Learning Experience	Students' satisfaction and learning experience after the educational intervention will be assessed using a Learning Satisfaction / Learning Experience Form. This is a 5 lLikert-type form which total score varies between 12-60. The form evaluates perceived usefulness, clarity of the educational content, satisfaction with the instructional method, attention, engagement, and perceived contribution to learning. Higher scores indicate a more positive learning experience and higher satisfaction.	Immediately after the educational intervention
Perceived Cognitive Load	Students' perceived cognitive load during the educational intervention will be assessed using a Perceived Cognitive Load Scale. The scale evaluates perceived mental effort, difficulty in following the content, information load, and ease of organizing the learned information. Total score varies between 8-40. Higher scores indicate greater perceived cognitive load.	Immediately after the educational intervention

Collaborators and Investigators

• Sponsor: Atlas University

Publications and helpful links

General Publications

• Yildiz Celik H, Ugur E. Turkish validity and reliability study of the simulation self-report cognitive load measurement tool 2.0. BMC Med Educ. 2025 Jul 1;25(1):919. doi: 10.1186/s12909-025-07504-0.
• White A, Louis K. Pecha Kucha: An Innovative Pedagogy to Cultivate Cultural Competency in 21 st Century Nursing Students. Nurse Educ. 2023 May-Jun 01;48(3):168-169. doi: 10.1097/NNE.0000000000001321. Epub 2022 Nov 16. No abstract available.
• Cevheroglu S, Firat Kilic H, Budak V. The effect of the PechaKucha presentation method on nursing students' deep breathing and coughing exercise skills and their satisfaction with the educational method: a randomized controlled trial. BMC Med Educ. 2025 Dec 2;25(1):1667. doi: 10.1186/s12909-025-08258-5.
• Chow KM, Li PK, Cho Y, Abu-Alfa A, Bavanandan S, Brown EA, Cullis B, Edwards D, Ethier I, Hurst H, Ito Y, de Moraes TP, Morelle J, Runnegar N, Saxena A, So SW, Tian N, Johnson DW. ISPD Catheter-related Infection Recommendations: 2023 Update. Perit Dial Int. 2023 May;43(3):201-219. doi: 10.1177/08968608231172740. Epub 2023 May 26.

Study record dates

Study Major Dates

• Study Start (Estimated): May 25, 2026
• Primary Completion (Estimated): June 30, 2026
• Study Completion (Estimated): August 30, 2026

Study Registration Dates

• First Submitted: May 8, 2026
• First Submitted That Met QC Criteria: May 13, 2026
• First Posted (Actual): May 20, 2026

Study Record Updates

• Last Update Posted (Actual): May 20, 2026
• Last Update Submitted That Met QC Criteria: May 13, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: Educational intervention; Nursing education; Concept map; Pecha Kucha; Peritoneal dialysis catheter care
• Other Study ID Numbers: 23.02.2026- 02/77

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data will not be shared publicly because the study will include educational assessment data from nursing students. Only aggregated and anonymized results will be reported.

Drug and device information, study documents

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