Examining the Effects of ARCS-Based Education on Cardiovascular System Physical Examination Skills, Motivation, and Self-Efficacy Levels in Nursing Students
Examining the Effects of ARCS-Based Education on Cardiovascular System Physical Examination Skills, Motivation, and Self-Efficacy Levels in Nursing Students: A Randomized Controlled Experimental Study
Objective: The purpose of this study is to determine the effect of ARCS-based nursing education on skill levels, motivation, and self-efficacy in the physical examination of the cardiovascular system.
Background: In nursing education, it is crucial for students to acquire skills in comprehensive patient assessment and physical examination. Motivation and academic self-efficacy are key factors in education and academic success.
Methods: This study was conducted during the Spring Semester of 2025-2026 with 100 second-year students enrolled in the Department of Nursing at Tokat Gaziosmanpaşa University's Faculty of Health Sciences, as part of the Health Assessment course. Students who received cardiovascular system education using traditional methods were assigned to experimental and control groups. The experimental group also received training based on the ARCS motivation model. Data were collected using a Personal Information Form, a Cardiovascular System Examination Skills Assessment Form, the "Motivation Scale for Instructional Material," and the "Academic Self-Efficacy Scale." This randomized controlled experimental study was conducted and reported in accordance with the CONSORT guidelines
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Tipo di studio
Tipo di studio
Iscrizione (Effettivo)
Iscrizione
Fase
Fase
- Non applicabile
Contatti e Sedi
Luoghi di studio
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Tokat Province, Turchia (Türkiye), 60000
- TOGÜ SBF
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Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
- Bambino
- Adulto
- Adulto più anziano
Accetta volontari sani
Descrizione
Inclusion Criteria:
- Being a second-year nursing student (18-25 years old),
- Taking the physical examination course for the first time
- Voluntarily agreeing to participate in the study
Exclusion Criteria:
- Being a student transferring from another program,
- Having difficulty understanding and speaking Turkish
- Having graduated from a Health Vocational High School
- Currently participating in any training related to physical examination in nursing; Not having taken courses related to physical examination of the cardiovascular system Withdrawing from the study or revoking consent during the research,
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Altro
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Separare
Numero di armi
Armi e interventi
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Sperimentale: ARCS Experimental Group
ARCS Model Training The experimental group received a total of two hours (120 minutes) of supplementary training, structured by the same instructor based on the ARCS (Attention, Relevance, Confidence, Satisfaction) Motivation Model.
This training was conducted in accordance with the model's four components, using the following activities in sequence: Attention Component , Relevance Component , Confidence Component , Satisfaction Component
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The experimental group received a total of two hours (120 minutes) of supplementary training, structured by the same instructor based on the ARCS (Attention, Relevance, Confidence, Satisfaction) Motivation Model.
This training was conducted in accordance with the model's four components, using the following activities in sequence:
The experimental group received a total of two hours (120 minutes) of supplementary training, structured by the same instructor based on the ARCS (Attention, Relevance, Confidence, Satisfaction) Motivation Model.
This training was conducted in accordance with the model's four components, using the following activities in sequence:
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Nessun intervento: Control Group: Traditional Reinforcement Training
The control group received reinforcement training using the traditional question-and-answer method, conducted by the same instructor during the same time period (one week later).
During this process, the instructor summarized and reviewed the topics covered in the four-hour basic training on cardiovascular system examination (history-taking, inspection, palpation, percussion, auscultation, heart sounds, peripheral pulse, and circulation assessment); the instructor verbally assessed the students' level of understanding by asking them questions in sequence.
Based on the students' responses, any gaps or misunderstandings were verbally corrected; however, motivational and interactive activities-such as scenario-based exercises, role-playing, station-based activities, immediate feedback, or rewards-which were implemented in the experimental group, were not included.
The control group's training was completed in the same amount of time (two hours) as the experimental group's but was conduct
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Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
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Motivation Scale for Instructional Material
Lasso di tempo: The assessment will be conducted in two separate time periods. The first assessment will be immediately before the training, and the second assessment will be two weeks after the training (post-training test).
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It is assessed using a 5-point Likert-type scale, and the total score range is between 33 and 165 point; an increase in score is interpreted as an increase in motivation.
an increase in score is interpreted as an increase in motivation.
The lower and upper score ranges are categorized as very low (33-37) and very high (161-165), respectively.
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The assessment will be conducted in two separate time periods. The first assessment will be immediately before the training, and the second assessment will be two weeks after the training (post-training test).
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Academic Self-Efficacy Scale:
Lasso di tempo: The assessment will be conducted in two separate time periods. The first assessment will be immediately before the training, and the second assessment will be two weeks after the training (post-training test).
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To assess academic self-efficacy, the "Academic Self-Efficacy Scale"-developed by Owen and Froman (1988) and adapted into Turkish by Ekici (2012) was used.
It is noted that the scale consists of a total of 33 items and 3 dimensions, and that it can be used as a single-dimension scale.
The scale is scored on a five-point Likert scale.
The total score ranges from 33 to 165.
The scale's subdimensions are listed as social status, cognitive applications, and technical skills.
In the validity and reliability study of the Turkish version of the scale, the Cronbach's Alpha value was found to be 0.86 (Ekici, 2012).
In this study, Cronbach's Alpha values were found to be 0.904 for the pretest and 0.963 for the posttest.
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The assessment will be conducted in two separate time periods. The first assessment will be immediately before the training, and the second assessment will be two weeks after the training (post-training test).
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Cardiac and Circulatory System Examination Skills Assessment Form:
Lasso di tempo: The assessment will be conducted by OSCE two weeks after the training, during the students' practical applications.
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A 54-item form covering the cardiovascular system examination-including taking a medical history, identifying key areas when auscultating heart sounds, and using inspection, palpation, and auscultation methods, as well as assessing the jugular vein, carotid artery, and capillary refill-has been developed in accordance with the literature (Özden, 2024; Yava and Koyuncu, 2017).
This form was used as part of a post-education structured clinical examination (OSCE) to assess students' skills.
Three categories were established for student evaluations, and the ability to perform the task described in the relevant item was scored as follows: Performed: 2 points; Incomplete/Incorrect: 1 point; Did Not Perform: 0 points.
A maximum score of 0-108 points can be achieved on the skills form.
A high score indicates good skill development.
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The assessment will be conducted by OSCE two weeks after the training, during the students' practical applications.
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Collaboratori e investigatori
Sponsor
Sponsor
Pubblicazioni e link utili
Pubblicazioni generali
- Chen PJ, Liou WK, Chen MJ. Effects of an ARCS-based interactive e-book featuring clinical scenarios on the learning motivation, self-efficacy and practical competence of nursing students in foetal heart rate interpretation. Nurse Educ Pract. 2025 Feb;83:104261. doi: 10.1016/j.nepr.2025.104261. Epub 2025 Jan 18.
- Jeong, H., Kim, S., & Park, Y. (2023a). Effectiveness of ARCS-based simulation on nursing students' communication competence. Nurse Education Today, 124, 105690. https://doi.org/10.1016/j.nedt.2023.105690
- Erden Y, Uludag E, Albayrak O. Examining the effects of ARCS-based urinary catheter education on first-year nursing students' learning motivation, self-efficacy and clinical skill levels. Nurse Educ Pract. 2025 Nov;89:104598. doi: 10.1016/j.nepr.2025.104598. Epub 2025 Oct 30.
- Chao HM, Chen SW, Chao SM. Effects of mobile learning applications for physical examination among nurse students: Use of the cardiovascular system. Nurse Educ Pract. 2025 Nov;89:104620. doi: 10.1016/j.nepr.2025.104620. Epub 2025 Oct 31.
- Chang, C. C., Lee, T. H., & Tseng, H. H. (2024). Applying the ARCS model to enhance student motivation and engagement in distance education. Interactive Learning Environments, 32(1), 45-62. https://doi.org/10.1080/10494820.2022.2045721
- Cai, Y., Xie, X., & Zhang, L. (2022). Enhancing nursing students' critical thinking and self-directed learning via ARCS-based blended teaching. BMC Nursing, 21(1), 1-9. https://doi.org/10.1186/s12912-022-00842-5
- Andrade IRC, Queiroz JC, Farias MS, Maia NPDS, Silva LFD. Clinical simulation in the teaching of cardiovascular physical examination with nursing students: a systematic review. Rev Bras Enferm. 2025 Mar 10;78(1):e20230429. doi: 10.1590/0034-7167-2023-0429. eCollection 2025.
- Althubaiti A. Sample size determination: A practical guide for health researchers. J Gen Fam Med. 2022 Dec 14;24(2):72-78. doi: 10.1002/jgf2.600. eCollection 2023 Mar.
- Alharbi, M., Kang, H., & Noh, H. (2021). The effects of ARCS-based e-learning on learners' motivation and learning achievement in a medical informatics course. International Journal of Emerging Technologies in Learning (iJET), 16(9), 203-214. https://doi.org/10.3991/ijet.v16i09.21459
- Ajemba, M. N., Ikwe, C., & Iroanya, J. C. (2024). Effectiveness of simulation-based training in medical education: assessing the impact of simulation-based training on clinical skills acquisition and retention: a systematic review. World Journal of Advanced Research and Reviews, 21(1), 1833-1843. https://doi.org/10.30574/wjarr.2024.21.1.0163
- Kavak HK, Kazanc S. The effect of ARCS motivational model-based education on nursing students' communication skills, learning motivation, and self-efficacy: a mixed-methods randomized controlled intervention study. BMC Med Educ. 2026 Feb 7;26(1):525. doi: 10.1186/s12909-026-08724-8.
- Bozkurt T, Nacak UA, Karakas E, Ciftci B. The effect of stoma care teaching based on the ARCS motivation model on nursing students' learning motivation, self-efficacy and knowledge levels. Nurse Educ Pract. 2025 Jan;82:104207. doi: 10.1016/j.nepr.2024.104207. Epub 2024 Dec 2.
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