World Café Teaching Method on Pharmacology Academic Performance and Self-Regulated Learning Among Nursing Students

The Impact of the World Café Teaching Method on Pharmacology Academic Performance and Self-Regulated Learning Among Nursing Students: A Two-Round Cluster Randomized Controlled Trial

The study hypothesis was that introducing the World Café teaching method into pharmacology education would significantly improve students' final examination scores, which included performance in accurate knowledge identification and discrimination, and in knowledge integration, reasoning and clinical decision-making, as well as students' subjective ratings of their pharmacology learning ability. This study evaluated the World Café method, a structured participatory teaching approach, in pharmacology education for nursing students, focusing on its impact on academic achievement and self-regulated learning.

Study Overview

• Status: Completed
• Conditions: Nursing Education Research
• Intervention / Treatment: Behavioral: World Café Teaching Method; Behavioral: Traditional Lecture Method

Detailed Description

Background:

Pharmacology is a core component of nursing education. Traditional lecture-based teaching has limitations in fostering knowledge integration and clinical decision-making skills, often yielding suboptimal academic performance. The World Café method is a structured participatory teaching approach featuring rotating small-group discussions, cross-group exchange, plenary synthesis, and instructor feedback. This study investigated whether integrating the World Café method into pharmacology education could improve academic performance and self-regulated learning among nursing students.

Objective:

To evaluate the impact of the World Café teaching method, compared with traditional lecture-based instruction, on pharmacology final examination scores (including accurate knowledge identification and discrimination, and knowledge integration, reasoning, and clinical decision-making) and on self-regulated learning among third-year undergraduate nursing students.

Study Design:

A two-round cluster randomized controlled trial was conducted. Intact classes were the unit of randomization. Classes were randomly allocated to either the experimental group (World Café method integrated into pharmacology instruction) or the control group (traditional lecture-based instruction). The study comprised two independent experimental rounds (Round 1: March--July 2023; Round 2: March--July 2024) using the same design, interventions, and assessment protocols to assess the stability and reproducibility of the intervention effect.

Setting:

Department of Pharmacology, Faculty of Basic Medical Science, Kunming Medical University, Kunming, Yunnan, China.

Participants:

A total of 890 third-year undergraduate nursing students were enrolled: 396 in Round 1 (100 experimental, 296 control) and 494 in Round 2 (124 experimental, 370 control). All participants provided written informed consent prior to enrollment. Baseline characteristics (gender, age, baseline assessment scores) were comparable between experimental and control groups within each round and across rounds.

Intervention (Experimental Group):

The experimental group received the same core pharmacology content as the control group but with the World Café discussion model integrated into instruction. The World Café procedure involved: (1) dividing each class into several small groups; (2) presenting a pharmacology case for initial intra-group discussion; (3) members rotating to other groups for inter-group exchange, bringing new insights back to their original group; (4) synthesizing insights from all groups through plenary discussion to form collective understanding; and (5) receiving instructor feedback on each group's presentation and synthesis. The intervention was delivered by instructors from the same teaching group and spanned the full semester.

Comparator (Control Group):

The control group received traditional pharmacology teaching via PowerPoint presentations and blackboard instruction. Students completed classroom assignments, homework, and the same final examination based on the standard pharmacology curriculum. No structured group discussion or participatory components were included.

Primary Outcome:

Pharmacology final examination performance, comprising two dimensions: (1) accurate knowledge identification and discrimination ability; and (2) knowledge integration, reasoning, and clinical decision-making ability. The examination was unified and graded blindly. Assessment occurred at the end of the semester (Week 18).

Secondary Outcomes:

(1) Student perceptions of the World Café method and group discussion, assessed via Likert-scale questionnaires (5-point scale, 1=strongly disagree to 5=strongly agree) administered before and after the intervention. (2) Self-regulated learning abilities, assessed via a post-session subjective assessment questionnaire after each World Café discussion.

Statistical Analysis:

Normality was assessed using the Shapiro-Wilk test. Between-group comparisons were performed using independent-samples t-tests (for normally distributed data) or Mann-Whitney U tests (for non-normally distributed data). A P-value < 0.05 was considered statistically significant. Analyses were conducted using GraphPad Prism 10.1.2.

• Study Type: Interventional
• Enrollment (Actual): 890
• Phase: Not Applicable

Contacts and Locations

Study Locations

• China
  • Yunnan
    • Kunming, Yunnan, China, 650500
      • Kunming Medical University

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Third-year undergraduate nursing students at Kunming Medical University
• Enrolled in the pharmacology course during the study semester (March-July 2023 or March-July 2024)
• Willing to participate and provided informed consent

Exclusion Criteria:

• Students who did not complete the pharmacology course or did not take the final examination
• Students who did not provide informed consent

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: World Café Group; Participants in this arm received the World Café teaching method integrated into the standard pharmacology curriculum. The World Café is a structured participatory teaching approach involving: (1) division of the class into several small groups; (2) presentation of a pharmacology case for initial intra-group discussion; (3) rotation of members to other groups for inter-group exchange, bringing new insights back to the original group; (4) plenary synthesis of insights from all groups to form collective understanding; and (5) instructor feedback on each group's presentation and synthesis. The intervention was delivered by instructors from the Department of Pharmacology, Faculty of Basic Medical Science, Kunming Medical University, and spanned the full semester (March-July). The same core pharmacology content was covered as in the control group.	Behavioral: World Café Teaching Method; A structured participatory teaching method featuring rotating small-group discussions on pharmacology topics, guided by a facilitator, with plenary sharing of insights.
Active Comparator: Traditional Lecture Group; Participants in this arm received traditional lecture-based pharmacology instruction via PowerPoint presentations and blackboard instruction. Students completed classroom assignments, homework, and the same final examination based on the standard pharmacology curriculum. No structured group discussion or participatory components were included. The course was delivered by the same teaching group and spanned the full semester (March-July).	Behavioral: Traditional Lecture Method; Instructor-delivered didactic lectures using PowerPoint slides, with limited interactive components, covering the same pharmacology content as the experimental group.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pharmacology Final Examination Total Score	The final total score was obtained from a unified, blindly graded written pharmacology examination. The total score was the sum of two sub-scores: (1) accurate knowledge identification and discrimination ability, and (2) knowledge integration, reasoning, and clinical decision-making ability. Higher scores indicate better performance. The examination was administered at the end of the semester (Week 19).	At the end of the semester (Week 19), after completion of the pharmacology course.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Student Perceptions of the World Café Teaching Method	Assessed using the World Café Learning Questionnaire, a self-developed Likert-scale instrument. After a standardized instructor-led introduction to the World Café method, students rated their understanding and acceptance of the method across multiple dimensions, including perceived efficacy, stimulation of new perspectives, support for independent thinking, promotion of multi-angle reasoning, and facilitation of communication. Each item was scored on a 5-point scale (1 = strongly disagree to 5 = strongly agree). Higher scores indicate more positive perceptions.	Pre-intervention (approximately Week 1 of each semester)
Self-Regulated Learning Abilities Score	Assessed using the World Café Teaching Method Subjective Assessment Questionnaire on Self-Regulated Learning Abilities, a self-developed Likert-scale instrument administered at the end of the semester after completion of all World Café sessions. Students retrospectively rated the method's perceived impact on learning drive, time management awareness, independent thinking, active learning and knowledge extension, independent problem-solving, information exchange and knowledge sharing, problem-solving motivation, and innovative thinking. Each item was scored on a 5-point scale (1 = strongly disagree to 5 = strongly agree). Higher scores indicate greater perceived improvement in self-regulated learning abilities.	End of the semester (Week 18)

Collaborators and Investigators

• Sponsor: Ying Guo
• Investigators: Principal Investigator: Ying Guo, Kunming Medical University

Study record dates

Study Major Dates

• Study Start (Actual): March 1, 2023
• Primary Completion (Actual): July 30, 2024
• Study Completion (Actual): July 30, 2024

Study Registration Dates

• First Submitted: May 9, 2026
• First Submitted That Met QC Criteria: May 15, 2026
• First Posted (Actual): May 22, 2026

Study Record Updates

• Last Update Posted (Actual): May 22, 2026
• Last Update Submitted That Met QC Criteria: May 15, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: KMMU2023MEC016

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: De-identified individual participant data that underlie the results reported in this article will be made available upon reasonable request to the corresponding author. Study materials (e.g., questionnaires) are available as supplementary materials. Data will be shared for academic purposes only, subject to institutional approval and completion of a data sharing agreement.

Drug and device information, study documents

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