Kahoot!-Integrated Education for Stroke Patient Positioning (Kahoot-SPP)

I. Content

1. Research Motive and Purpose The Interactive Response System (IRS) is a technology-enhanced instructional tool that allows students to provide real-time feedback to instructors through electronic devices such as smartphones, tablets, or personal digital assistants (PDAs), thereby improving the quality of classroom instruction. Previous studies have demonstrated that IRS is one of the key tools that significantly enhances student engagement and learning motivation.Detailed Description

Interactive response systems provide real-time questions and feedback during classroom instruction and may increase students' attention, participation, and understanding of course content. Kahoot! is a game-based interactive response platform that allows learners to answer questions using mobile devices and receive immediate feedback. Its use may transform conventional instructor-centered teaching into a more interactive learning experience.

Learning motivation is an important factor in clinical skills education. The Attention, Relevance, Confidence, and Satisfaction (ARCS) model describes four dimensions of learning motivation that may influence students' engagement and learning outcomes. This study evaluated whether integrating Kahoot! into clinical skills instruction improved learning motivation and stroke patient-positioning performance among physical therapy interns.

This study used a randomized, two-arm educational intervention design. Approximately 60 physical therapy interns at a medical center in southern Taiwan were randomly assigned in a 1:1 ratio to an experimental group or an active comparator group.

Both groups received instruction covering the same learning objectives and course content related to correct bed positioning of patients with stroke and caregiver education. The experimental group received conventional classroom teaching followed by a Kahoot!-based interactive activity involving quiz questions and immediate feedback. The active comparator group received conventional lecture-based instruction without Kahoot!-based activities.

Participants in both groups completed assessments at baseline and immediately after the course. Clinical performance was evaluated using a single-station objective structured clinical examination (OSCE) of stroke patient positioning. Performance was scored using a standardized checklist, with higher scores indicating better clinical performance.

Learning motivation was evaluated using the 24-item ARCS Learning Motivation Scale. The scale contains four six-item subscales: Attention, Relevance, Confidence, and Satisfaction. Items were rated on a five-point Likert scale, with higher scores indicating greater learning motivation.

Participants in the experimental group also completed a 14-item satisfaction questionnaire concerning the Kahoot!-integrated instruction. Items were rated on a five-point Likert scale ranging from 1, "strongly disagree," to 5, "strongly agree," with higher scores indicating greater satisfaction. Open-ended questions collected feedback about participants' learning experiences, perceived benefits, suggestions, and areas for improvement.

Changes in OSCE performance and ARCS learning-motivation scores from baseline to the immediate post-course assessment were compared between the two groups.