Clinical Competence, Competency-Based Education, Electronic Portfolios, Lifelong Learning, Nursing Education
Conditions
Keywords
Blockchain, Blockchain-Enabled E-Portfolio, Competency Tracking, Undergraduate Nursing Students, Medical-Surgical Clinical Rotation
Brief summary
This study evaluates whether a blockchain-enabled electronic portfolio can improve competency tracking and lifelong learning in undergraduate nursing education. Conventional electronic portfolios are often fragmented across courses and clinical rotations, difficult to verify across institutions, and limited in supporting learner ownership of records. To address these challenges, this study compares a blockchain-enabled e-portfolio system with a conventional Moodle-based e-portfolio during a medical-surgical clinical rotation. Third-year undergraduate nursing students at Jouf University, Saudi Arabia, were randomly assigned to use either the blockchain-enabled e-portfolio intervention or the conventional e-portfolio control. The intervention was designed to support cryptographically verifiable competency records, structured reflective evidence, and personalized competency feedback through dashboard analytics. The main outcomes include clinical competence assessed by an Objective Structured Clinical Examination (OSCE), lifelong learning orientation, portfolio quality, and trust in the credibility and portability of competency records. After the quantitative phase, focus group interviews were conducted with students in the intervention group to explore their experiences with the system and the mechanisms through which it may influence learning. The study aims to determine whether blockchain-enabled e-portfolios offer educational advantages over conventional portfolio systems in competency-based nursing education and to identify implementation factors that may support or hinder adoption.
Detailed description
Competency-based nursing education requires students to demonstrate progressive attainment of clinical and professional competencies across time and settings. Conventional electronic portfolios are commonly used to document reflections, skills, assessments, and learning evidence, but these systems often have limitations, including fragmented documentation across rotations, weak portability of records, restricted external verifiability, and limited learner ownership of competency evidence. This study evaluates a blockchain-enabled electronic portfolio (BC-EP) model developed to support competency tracking and lifelong learning in undergraduate nursing education. The intervention was designed to provide a tamper-evident and portable framework for documenting competency attainment while also supporting reflective learning and personalized feedback. The BC-EP model was implemented using a permissioned blockchain architecture and included three core components: (1) a verifiable competency ledger in which competency-related artifacts were linked to cryptographically signed attestations; (2) a reflective evidence layer that connected clinical events, competency tags, reflective narratives, and preceptor attestations; and (3) a data-driven dashboard designed to identify competency gaps and guide individualized development. The study used an explanatory sequential mixed-methods design. In the quantitative phase, a two-arm parallel randomized controlled trial was conducted among third-year undergraduate nursing students enrolled in a medical-surgical clinical rotation at the College of Nursing, Jouf University, Saudi Arabia. Participants were randomized in a 1:1 ratio to either the BC-EP intervention group or a control group using the institution's conventional Moodle-based electronic portfolio. Both groups received the same clinical rotation, but the intervention group used the blockchain-enabled platform for competency documentation, reflective evidence submission, and personalized progress monitoring. The primary educational outcome was clinical competence, assessed using a six-station Objective Structured Clinical Examination (OSCE). Secondary outcomes included lifelong learning orientation, portfolio quality, and trust in the credibility and portability of educational records. Baseline demographic and educational data were also collected. Following completion of the quantitative phase, qualitative focus group interviews were conducted with a purposive sample of intervention-group participants to explore user experiences, perceived benefits, challenges, and possible mechanisms of effect. The study seeks to determine whether a blockchain-enabled e-portfolio can improve educational outcomes in nursing students compared with a conventional e-portfolio system and to generate implementation-relevant insights for future digital credentialing models in nursing education.
Interventions
BEHAVIORALBlockchain-Enabled E-Portfolio Platform
A blockchain-enabled educational portfolio system used to support competency tracking and lifelong learning in undergraduate nursing education. The intervention included a verifiable competency ledger, structured reflective evidence linked to competency tags and preceptor attestations, learner-held credential ownership, and dashboard-based personalized competency feedback during a 14-week clinical rotation.
BEHAVIORALConventional Moodle-Based E-Portfolio
A conventional institutional electronic portfolio system used for routine documentation during a 14-week clinical rotation. The control platform included portfolio templates, artifact uploads, self-assessment activities, and discussion forums, but did not include blockchain verification, cryptographic attestation, portable credentials, or personalized competency dashboards.
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
SINGLE (Outcomes Assessor)
Masking description
OSCE examiners, portfolio raters, and the statistician were blinded to group allocation. Participants and educators were not blinded due to the nature of the educational intervention.
Intervention model description
Participants were randomly assigned in a 1:1 ratio to either a blockchain-enabled e-portfolio intervention group or a conventional Moodle-based e-portfolio control group during a 14-week medical-surgical clinical rotation. Both groups received the same clinical training, differing only in the portfolio system used for competency tracking and reflective documentation.
Eligibility
Sex/Gender
ALL
Age
20 Years to 24 Years
Healthy volunteers
Yes
Inclusion criteria
* Third-year undergraduate nursing students * Enrolled in the medical-surgical clinical rotation at the College of Nursing, Jouf University * Admitted through the standard national admission route * Willing to participate and able to provide informed consent
Exclusion criteria
* Prior formal training in blockchain or distributed-ledger applications * Expected absence for more than two weeks during the clinical rotation * Self-reported lack of proficiency in basic digital learning tools * Enrollment in a non-standard curriculum track, such as bridging or transfer programs
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Lifelong Learning Orientation Assessed by Jefferson Scale of Physician Lifelong Learning-Nursing Adaptation | One week after completion of the 14-week clinical rotation | Lifelong learning orientation was assessed using the Jefferson Scale of Physician Lifelong Learning-Nursing adaptation (JSPLL-N), a 14-item measure assessing learning beliefs and motivation, scanning for learning opportunities, and attention to learning opportunities. Higher scores indicate stronger lifelong learning orientation. |
| Clinical Competence Assessed by Objective Structured Clinical Examination Total Score | At the end of the 14-week clinical rotation (approximately 14 weeks after allocation) | Clinical competence was assessed using a six-station Objective Structured Clinical Examination (OSCE) aligned with medical-surgical nursing competencies. The six stations assessed comprehensive health assessment, medication administration and safety, aseptic technique and infection control, patient education and discharge counselling, clinical reasoning and prioritization, and professionalism/interprofessional communication/ethics. Total scores ranged from 0 to 100, with higher scores indicating better clinical competence. |
Countries
Saudi Arabia
Contacts
PRINCIPAL_INVESTIGATORMostafa Shaban
Cairo University
Outcome results
None listed