This cluster randomized controlled trial aims to evaluate the effectiveness of a digital video feedback strategy in improving physical assessment skills, learning motivation, self-regulated learning, and anxiety among undergraduate nursing students. Approximately 80 second-year nursing students enrolled in a physical examination and assessment course will be assigned to either a digital video feedback intervention group or a traditional teaching control group using cluster randomization. The intervention will be implemented in four physical assessment units, including head and neck/lymphatic assessment, musculoskeletal assessment, and two neurological assessment units. Students in the intervention group will record their physical assessment performance using a digital video system and receive structured feedback from peers and instructors. Outcomes will be assessed at baseline, mid-course, and at the end of the course.
Physical examination and assessment are fundamental competencies in nursing education and clinical practice. However, undergraduate nursing students may experience difficulties in mastering complex physical assessment procedures because of limited practice time, insufficient individualized feedback, and limited clinical experience. Based on Bandura's Social Learning Theory, this study incorporates a digital video feedback strategy into an undergraduate physical examination and assessment course. The intervention emphasizes observation, practice, feedback, reflection, and behavioral modification. Students assigned to the intervention group will record their performance of selected physical assessment procedures using the SimCapture digital platform. Recorded performances will be reviewed by peers and instructors, who will provide structured feedback based on standardized physical assessment evaluation criteria. Students will review the feedback, modify their performance, and subsequently repeat the recording and feedback process. Four course units will be included in the intervention: head and neck/lymphatic assessment, musculoskeletal assessment, neurological assessment I, and neurological assessment II. The control group will initially receive conventional classroom instruction and independent practice. For educational equity, students in the control group will subsequently receive the digital video feedback activity after the planned comparison assessment. Quantitative outcomes include physical assessment skill performance, learning strategies and motivation, learning motivation, and anxiety. Students' experiences with the digital video feedback strategy will also be explored using course evaluation and qualitative feedback.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
80
The digital video feedback intervention uses the SimCapture system to record students' physical assessment performance. Students practice selected physical assessment skills, including head and neck/lymphatic, musculoskeletal, and neurological assessments. Their recorded performances are reviewed by peers and instructors, who provide structured feedback based on standardized physical assessment evaluation criteria. Students review the feedback, modify their assessment techniques, and subsequently repeat the recording and feedback process.
Participants will receive traditional physical assessment instruction according to the standard course curriculum, including classroom instruction, instructor demonstration, and hands-on skills practice. Participants will also record and upload videos of their physical assessment skill performance as part of the course requirements. However, they will not participate in the structured video review and feedback activities provided to the Digital Video Feedback Group.
Physical Assessment Skill Performance
Physical assessment skill performance will be evaluated using the Physical Assessment Skills Performance Checklist. The checklist assesses students' ability to correctly perform essential physical assessment procedures. The total score ranges from 0 to 100, with higher scores indicating better physical assessment skill performance.
Time frame: Baseline (Week 1), Week 9, and Week 18
Change in Motivated Strategies for Learning Questionnaire Score
Learning strategies and motivational beliefs will be assessed using an adapted version of the Motivated Strategies for Learning Questionnaire (MSLQ). The instrument uses a 7-point Likert scale and assesses motivational beliefs and self-regulated learning strategies, including self-efficacy, intrinsic value, cognitive strategy use, and self-regulation. The total score ranges from 44 to 302. Higher scores indicate greater levels of learning motivation and self-regulated learning strategies.
Time frame: Baseline (Week 1), Week 9, and Week 18
ARCS-Based Learning Motivation Score
Learning motivation will be assessed using an Attention, Relevance, Confidence, and Satisfaction (ARCS)-based motivation scale assessing four domains: attention, relevance, confidence, and satisfaction. The scale consists of 16 items, with each item rated from 1 to 5. The total score ranges from 16 to 90, with higher scores indicating greater learning motivation.
Time frame: Baseline (Week 1), Week 9, and Week 18
Anxiety
Anxiety will be assessed using the Visual Analogue Scale for Anxiety (VAS-A), ranging from 0 (not anxious at all) to 10 (extremely anxious), with higher scores indicating greater anxiety.
Time frame: Baseline (Week 1), Week 9, and Week 18
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