Examining the Effects of ARCS-Based Education on Cardiovascular System Physical Examination Skills, Motivation, and Self-Efficacy Levels in Nursing Students

Cumhuriyet University100 enrolled

Overview

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

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

OTHER

Masking

SINGLE

Enrollment

100

Conditions

Assessment of Physical Examination Skills for the Cardiovascular System

Interventions

ARCS Model EducationOTHER

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:

Structured Supplementary Training Based on the ARCS Motivation ModelOTHER

Eligibility

Sex: ALLHealthy volunteers:

Medical Language ↔ Plain English

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,

Outcomes

Primary Outcomes

Motivation Scale for Instructional Material

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.

Time frame: 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).

Academic Self-Efficacy Scale:

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.

Cardiac and Circulatory System Examination Skills Assessment Form:

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.

Time frame: The assessment will be conducted by OSCE two weeks after the training, during the students' practical applications.