World Café Teaching Method on Pharmacology Academic Performance and Self-Regulated Learning Among Nursing Students

Overview

The study hypothesis was that introducing the World Café teaching method into pharmacology education would significantly improve students' final examination scores, which included performance in accurate knowledge identification and discrimination, and in knowledge integration, reasoning and clinical decision-making, as well as students' subjective ratings of their pharmacology learning ability. This study evaluated the World Café method, a structured participatory teaching approach, in pharmacology education for nursing students, focusing on its impact on academic achievement and self-regulated learning.

Background: Pharmacology is a core component of nursing education. Traditional lecture-based teaching has limitations in fostering knowledge integration and clinical decision-making skills, often yielding suboptimal academic performance. The World Café method is a structured participatory teaching approach featuring rotating small-group discussions, cross-group exchange, plenary synthesis, and instructor feedback. This study investigated whether integrating the World Café method into pharmacology education could improve academic performance and self-regulated learning among nursing students. Objective: To evaluate the impact of the World Café teaching method, compared with traditional lecture-based instruction, on pharmacology final examination scores (including accurate knowledge identification and discrimination, and knowledge integration, reasoning, and clinical decision-making) and on self-regulated learning among third-year undergraduate nursing students. Study Design: A two-round cluster randomized controlled trial was conducted. Intact classes were the unit of randomization. Classes were randomly allocated to either the experimental group (World Café method integrated into pharmacology instruction) or the control group (traditional lecture-based instruction). The study comprised two independent experimental rounds (Round 1: March--July 2023; Round 2: March--July 2024) using the same design, interventions, and assessment protocols to assess the stability and reproducibility of the intervention effect. Setting: Department of Pharmacology, Faculty of Basic Medical Science, Kunming Medical University, Kunming, Yunnan, China. Participants: A total of 890 third-year undergraduate nursing students were enrolled: 396 in Round 1 (100 experimental, 296 control) and 494 in Round 2 (124 experimental, 370 control). All participants provided written informed consent prior to enrollment. Baseline characteristics (gender, age, baseline assessment scores) were comparable between experimental and control groups within each round and across rounds. Intervention (Experimental Group): The experimental group received the same core pharmacology content as the control group but with the World Café discussion model integrated into instruction. The World Café procedure involved: (1) dividing each class into several small groups; (2) presenting a pharmacology case for initial intra-group discussion; (3) members rotating to other groups for inter-group exchange, bringing new insights back to their original group; (4) synthesizing insights from all groups through plenary discussion to form collective understanding; and (5) receiving instructor feedback on each group's presentation and synthesis. The intervention was delivered by instructors from the same teaching group and spanned the full semester. Comparator (Control Group): The control group received traditional pharmacology teaching via PowerPoint presentations and blackboard instruction. Students completed classroom assignments, homework, and the same final examination based on the standard pharmacology curriculum. No structured group discussion or participatory components were included. Primary Outcome: Pharmacology final examination performance, comprising two dimensions: (1) accurate knowledge identification and discrimination ability; and (2) knowledge integration, reasoning, and clinical decision-making ability. The examination was unified and graded blindly. Assessment occurred at the end of the semester (Week 18). Secondary Outcomes: (1) Student perceptions of the World Café method and group discussion, assessed via Likert-scale questionnaires (5-point scale, 1=strongly disagree to 5=strongly agree) administered before and after the intervention. (2) Self-regulated learning abilities, assessed via a post-session subjective assessment questionnaire after each World Café discussion. Statistical Analysis: Normality was assessed using the Shapiro-Wilk test. Between-group comparisons were performed using independent-samples t-tests (for normally distributed data) or Mann-Whitney U tests (for non-normally distributed data). A P-value \< 0.05 was considered statistically significant. Analyses were conducted using GraphPad Prism 10.1.2.