Education, Fall, Accidental, Fall Prevention, Nursing Students, Online Learning, Patient Safety
Conditions
Keywords
online learning, patient falls, fall prevention, patient safety, nursing students
Brief summary
This randomized controlled study will evaluate the effectiveness of an online Watch-Summarize-Question-Ask (WSQA) learning method on nursing students' knowledge, skills, attitudes, and behaviors related to patient fall prevention and management. Sixty-six nursing students will be randomly assigned to intervention and control groups. Both groups will receive standard patient safety education, while the intervention group will additionally participate in an online, evidence-based fall prevention training program structured according to the WSQA method, including video-based learning, summarization, question generation, and interactive discussions. Outcomes will be assessed using validated instruments measuring fall management knowledge, self-efficacy, attitudes toward fall prevention, care planning performance, and student satisfaction. The study aims to determine the effectiveness of an innovative educational approach to improve fall prevention competencies and enhance the quality and safety of nursing care.
Detailed description
Objective The aim of this study is to evaluate the effect of an online fall prevention training program, developed based on the Watch-Summarize-Question-Ask instructional strategy, on the knowledge, skills, attitudes, and behaviors of fourth-year undergraduate nursing students. This evaluation will be conducted using the four levels of the Kirkpatrick's Four-Level Evaluation Model, and it aims to comprehensively determine both the learning outcomes of the training and its reflection on clinical practice. Type of Research This research will be conducted using a randomized controlled experimental design. Participants will be randomly assigned to two groups using the block randomization method. Location and Time of the Study The study will be conducted at the Faculty of Nursing, İnönü University, between February and June 2026. Participants/Sample The study population will consist of fourth-year undergraduate nursing participants enrolled in the Nursing Internship Course at the Faculty of Nursing, İnönü University, during the 2025-2026 academic year. Power analysis indicated a minimum sample size of 56 participants; however, considering potential attrition, a total of 66 participants will be recruited. Participants who meet the inclusion criteria will be assigned to the experimental and control groups using a block randomization method. Each group will include 33 participants (Experimental Group = 33; Control Group = 33). Method / Intervention Participants in both groups will receive the standard patient safety education included in the undergraduate nursing curriculum. In addition, participants in the experimental group will receive an evidence-based fall prevention training delivered through an online learning model structured according to the Watch-Summarize-Question (WSQ) teaching strategy. The intervention will include video-based learning, structured summarization activities, question generation, and interactive online discussion sessions to reinforce learning and promote active participation. The control group will continue with the standard curriculum without receiving the WSQ-based training. Outcomes will be evaluated using validated measurement tools assessing knowledge, skills, attitudes, and behavioral outcomes related to fall management. Data Collection Tools Participant Information Form: Participants' demographic characteristics, educational background, and access to technological resources required for participation in online learning platforms. Satisfaction with E-Learning Scale (Turkish version: E-Derslere Yönelik Memnuniyet Ölçeği): The scale consists of 35 items and five subdimensions. The response options are designed as a five-point Likert-type scale scored between 1 and 5. Falls Management Knowledge Test: This test will be developed by the researcher based on a literature review to assess participants' knowledge levels on falls management and to evaluate the effectiveness of the education on the patient safety knowledge subdimension Scales for Assessing Self-Efficacy: The scale consists of 11 items prepared in a 6-point Likert-type format. Attitudes of Nurses Toward Falls Prevention Scale (Turkish version: Hemşirelerin Düşmelerin Önlenmesine Yönelik Tutumları Ölçeği): The scale consists of 19 items and 5 subdimensions. The response options are designed as a five-point Likert scale scored between 1 and 5. Care Plan Evaluation Form: A structured seven-item assessment form developed by the researchers will be used to determine the extent to which students reflect their knowledge and awareness of fall management in their care plans. Expected Results/Significance The study is expected to determine the effectiveness of the online fall prevention education developed based on the WSQ learning strategy in improving nursing students' knowledge, skills, attitudes, and behaviors regarding fall management. The findings are anticipated to support the integration of structured, evidence-based online teaching methods into nursing education, enhance patient safety awareness, strengthen clinical decision-making skills, and contribute to the quality of nursing care
Interventions
BEHAVIORALOnline Watch Summarize Question Learning Model
The intervention consists of a structured online fall prevention education program based on the WSQ instructional strategy. Unlike traditional lecture-based education, this intervention integrates active learning components including video-based instruction, structured summarization tasks, student-generated question development, synchronous interactive discussion sessions, and peer-supported learning through an online discussion forum. The program is delivered through a distance education platform and is designed to promote reflective learning, cognitive engagement, and collaborative knowledge construction. The WSQ model ensures that participants actively process educational content rather than passively receiving information. The intervention is implemented in addition to the standard undergraduate patient safety curriculum and is specifically tailored to improve nursing students' competencies in fall risk assessment and fall prevention management.
Sponsors
Inonu University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
Participants will be randomly assigned to two parallel groups (experimental and control) using block randomization. All participants will receive standard patient safety education included in the undergraduate nursing curriculum through face-to-face instruction. After this stage, only the experimental group will receive WSQ-based online fall prevention education. The WSQ education will include watching educational videos via an online platform, summarizing course content using researcher-provided materials, generating questions based on the learning content, and participating in an interactive online session where student-generated questions will be discussed to reinforce learning. Additionally, a forum integrated into the distance education system will support peer interaction, question-answer exchange, and collaborative learning. The control group will receive no additional intervention during the study period.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Volunteers from the 4th year students of the Nursing Faculty at İnönü University
Exclusion criteria
* Graduates of high school, associate's degree, or bachelor's degree programs in a health-related field * Students who have enrolled in the 4th grade for the second time * Students who do not have the technical means to access the online education platform * Students who wish to withdraw from the research at any stage * Students who do not participate in the training sessions * Students who do not complete the data collection forms
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Participant Information Form | at baseline | Participants' demographic characteristics, educational background, and access to technological resources required for participation in online learning platforms. |
| Satisfaction with E-Learning Scale (Turkish version: E-Derslere Yönelik Memnuniyet Ölçeği) | Immediately after completion of the intervention | The scale developed by Kolburan Geçer and Deveci Topal aims to determine university students' satisfaction levels with the online courses they attend. The Cronbach's alpha reliability coefficient of the scale was calculated as 0.97. The scale consists of 35 items and 5 subdimensions. The response options are designed as a five-point Likert-type scale scored between 1 and 5. |
| Falls Management Knowledge Test | At baseline and immediately after completion of the education program and at least 3 weeks after the training | This test will be developed by the researcher based on a literature review to assess participants' knowledge levels on falls management and to evaluate the effectiveness of the education on the patient safety knowledge subdimension |
| Scales for Assessing Self-Efficacy | At baseline and immediately after completion of the education program and at least 3 weeks after the training | The Cronbach's Alpha value of the scale developed by Dykes and colleagues and validated in Turkish by Ekin and Uğur was found to be 0.97, and it has no subscales. The scale consists of 11 items prepared on a 6-point Likert scale. In the evaluation of the scale, the item mean of the scores obtained from all items is used, and as the scores increase, the level of self-efficacy also increases. |
| Attitudes of Nurses Toward Falls Prevention Scale (Turkish version: Hemşirelerin Düşmelerin Önlenmesine Yönelik Tutumları Ölçeği) | At baseline and immediately after completion of the education program and at least 3 weeks after the training. | The Cronbach's Alpha reliability coefficient of the scale developed by Özbudak and Koç in 2023 was found to be 0.84. The scale consists of 19 items and 5 sub-dimensions. The scale's response options are designed as a five-point Likert scale scored on a 1-5 point range. The scale is evaluated based on the mean score. |
| Care Plan Evaluation Form | At baseline and at least 3 weeks after the training | A structured seven-item assessment form developed by the researchers will be used to determine the extent to which students reflect their knowledge and awareness of fall management in their care plans. |
Countries
Turkey (Türkiye)
Contacts
CONTACTZeliha Cengiz, Associate Professor
CONTACTGözde Küçükkarakurt, Phd student
STUDY_DIRECTORZeliha Cengiz, Associate Professor
Inonu University Faculty of Nursing
Outcome results
None listed