Sequential Case Triangle-Based Learning and Psychosocial Care Competency in Nursing Students
Effect of Sequential Case Triangle-Based Project-Based Learning on Psychosocial Care Competency, Cooperative Learning, and Clinical Reasoning in Nursing Students
Study Overview
Status
Intervention / Treatment
Detailed Description
Background: Nursing education aims to develop critical thinking, problem-solving, and clinical reasoning skills, alongside the ability to provide holistic psychosocial care. Case-based and project-based learning are student-centered strategies shown to support these outcomes, but their combined application in a sequential, team-dependent format has not been widely studied in psychosocial nursing education.
Objective: To evaluate the effect of a Sequential Case Triangle-based project-based learning approach, applied within a Psychosocial Nursing course, on nursing students' self-assessed psychosocial care competency, cooperative learning, and clinical reasoning levels.
Hypotheses:
H1: Students' psychosocial care competency self-assessment scores will increase after the intervention.
H2: Students' cooperative learning scores will increase after the intervention. H3: Students' clinical reasoning levels will increase after the intervention.
Design: Single-group, pretest-posttest quasi-experimental design.
Setting: Fourth-year nursing students enrolled in the "Psychosocial Nursing" elective course (Turkish-medium and English-medium sections) at Istanbul Medipol University, Faculty of Health Sciences, Department of Nursing, during the 2025-2026 spring semester.
Intervention: Over the 15-week course, the class was divided into 20 main groups of 9 to 12 students each (179 participants in total), and every main group was split into three subgroups responsible for a sequential stage of the nursing process: case creation (depicting psychosocial responses to illness), psychosocial assessment, and planning/implementing psychosocial nursing interventions. Each subgroup prepared a short role-play video for its stage and submitted it to the course instructor, who forwarded it unedited to the next subgroup. Subgroups had no access to or prior knowledge of the case content created by the preceding subgroup; each stage was developed solely on the basis of the video received, without the ability to view or revise earlier work. In the final stage, the three videos were combined into one case narrative and discussed in class.
Outcomes were assessed using validated self-report instruments, administered face-to-face at baseline (course week 1) and post-intervention (course week 15).
Statistical Analysis: Data were analyzed using SPSS 22.0. Descriptive statistics (mean, SD, median, min-max for quantitative variables; frequency and percentage for categorical variables) were reported. Pretest-posttest comparisons used the paired-samples t-test; group comparisons used the Student's t-test (two groups) or one-way ANOVA with Bonferroni post-hoc test (three or more groups); associations between variables were assessed with Pearson correlation. Significance was set at p<0.05, 95% confidence interval.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Kavacık
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Istanbul, Kavacık, Turkey (Türkiye), 34810
- İstanbul Medipol University
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Enrolled in the "Psychosocial Nursing" elective course
- Willing to voluntarily participate in the study and sign the Informed Consent Form
Exclusion Criteria:
- Unable to complete the course (e.g., more than five absences, failure to submit the project assignment, or withdrawal from the course)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
Experimental: Experimental Group
|
Intervention: Over the 15-week course, the class was divided into 20 main groups of 9 to 12 students each and every main group was split into three subgroups responsible for a sequential stage of the nursing process: case creation (depicting psychosocial responses to illness), psychosocial assessment, and planning/implementing psychosocial nursing interventions.
Each subgroup prepared a short role-play video for its stage and submitted it to the course instructor, who forwarded it unedited to the next subgroup.
Subgroups had no access to or prior knowledge of the case content created by the preceding subgroup; each stage was developed solely on the basis of the video received, without the ability to view or revise earlier work.
In the final stage, the three videos were combined into one case narrative and discussed in class.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Psychosocial Care Competency Self-Assessment
Time Frame: Baseline (course week 1) and post-intervention (course week 15)
|
The Psychosocial Care Competency Self-Assessment Scale is an 18-item, 5-point Likert-type self-report scale with four subscales (symptom identification, use of knowledge, intervention, and diagnosis).
Total scores range from 18 (minimum) to 90 (maximum), with higher scores indicating better self-assessed psychosocial care competency.
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Baseline (course week 1) and post-intervention (course week 15)
|
|
Clinical Reasoning
Time Frame: Baseline (course week 1) and post-intervention (course week 15)
|
The Clinical Reasoning Scale for Nursing Students is a 16-item, 5-point Likert-type self-report scale with four subscales (awareness of clinical clues, verification of clinical problems, action determination and implementation, and evaluation and reflection).
Total scores range from 16 (minimum) to 80 (maximum), with higher scores indicating a higher level of clinical reasoning.
|
Baseline (course week 1) and post-intervention (course week 15)
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Cooperative Learning
Time Frame: Baseline (course week 1) and post-intervention (course week 15)
|
The Cooperative Learning Scale is a 15-item, 5-point Likert-type self-report scale with five factors (interpersonal skills, group processing, positive interdependence, supportive interaction, and individual accountability), with no reverse-scored items.
Total scores range from 15 (minimum) to 75 (maximum), with higher scores indicating higher cooperative learning skills.
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Baseline (course week 1) and post-intervention (course week 15)
|
Collaborators and Investigators
Sponsor
Investigators
- Study Chair: Seda Er, Medipol University
Publications and helpful links
General Publications
- Thought process Thought process 2,000 karakter sınırına uyacak şekilde sadece ölçeklerin geçerlik/uyarlama kaynaklarını seçtim (arka plan/literatür atıflarını çıkardım): Karataş, H., Kelleci, M.; Psikososyal Bakım Yetkinliği Öz Değerlendirme Ölçeği'nin geliştirilmesi geçerlik ve güvenirlik çalışması; Psikiyatri Hemşireliği Dergisi; 2021; 12(3); 263-271. Fernandez-Rio, J., Cecchini, J. A., Morgan, K., Mendez-Gimenez, A., Lloyd, R.; Validation of the cooperative learning scale and cooperation global factor using bifactor structural equation modelling; Psicología Educativa; 2022; 28(2); 91-97. Güngör, P., Kaya Uyanık, G., Yeşil, R.; İşbirlikli Öğrenme Ölçeği: Türkçeye Uyarlama Çalışması; MANAS Sosyal Araştırmalar Dergisi; 2025; 14(Eğitim Bilimleri Ek Sayısı); 31-49. Huang, H. M., Huang, C. Y., Lin, K. C., Yu, C. H., Cheng, S. F.; Development and psychometric testing of the clinical reasoning scale among nursing students enrolled in three types of programs in Taiwan; Journal of Nursing Research; 2023; 31(2); e263. Bal, B., Kaba, N. K., Öztürk, H.; Hemşirelik Öğrencileri için Klinik Muhakeme Ölçeğinin Türkçe Geçerliği ve Güvenirliği: Bir Metodolojik Çalışma; Journal of Nursology; 2024; 27(2); 129-135.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Other Study ID Numbers
- E-10840098-50.04-1698
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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