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NCT Number: NCT07780448

Case-Based Collaborative Learning for Arrhythmia Recognition in Novice Intensive Care Nurses

This randomized controlled trial evaluates the effectiveness of case-based collaborative learning (CBCL) in improving arrhythmia recognition and patient safety attitudes among novice intensive care nurses. Newly graduated nurses with less than one year of professional nursing experience working in coronary or cardiovascular surgery intensive care units are randomly assigned to an intervention or control group.

Both groups participate in the institution's routine orientation process for newly employed intensive care nurses. In addition, the intervention group receives a structured CBCL-based arrhythmia education program delivered in two 120-minute sessions over two consecutive weeks. The program uses clinical case scenarios, ECG tracings, individual assessment, small-group collaborative discussion, shared clinical decision-making, and structured feedback. The control group receives no additional study-specific arrhythmia education during the study period.

The primary outcome is arrhythmia recognition and awareness, and the secondary outcome is patient safety attitudes. Outcomes are assessed at baseline and at the three-month follow-up in both groups. An additional immediate post-intervention assessment is conducted in the intervention group to examine short-term changes following the educational program.

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Key information

Conditions

Arrhythmia Recognition Arrhythmia Arrhythmias, Cardiac Cardiovascular Diseases Heart Diseases Pathologic Processes Pathological Conditions, Signs and Symptoms Patient Safety Attitudes

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Koşuyolu High Specialization Training and Research Hospital

Istanbul, Kartal, 17100, Turkey (Türkiye)

Location status: Recruiting

Location contact

Huriye ARSLANER, PhD

CONTACT

[email protected]

+905053027009

About this study

Early recognition and appropriate interpretation of cardiac arrhythmias are important competencies for nurses working in intensive care settings, where changes in cardiac rhythm may require rapid clinical assessment and timely escalation of care. Novice nurses may have limited opportunities to develop these competencies through clinical experience alone. This study therefore evaluates a case-based collaborative learning (CBCL) approach designed to integrate arrhythmia recognition with clinical reasoning, nursing decision-making, and patient-safety principles.

The CBCL intervention uses clinically oriented arrhythmia scenarios accompanied by ECG tracings. Participants first assess each case individually and then work in small groups to discuss their interpretations and reach a shared clinical decision. Group conclusions are subsequently discussed with the educator, who facilitates analysis of the case, clarification of misconceptions, and structured feedback. Patient-safety principles, including recognition of hemodynamic instability, timely escalation of care, differentiation of true arrhythmias from monitoring artefacts, and assessment of the patient's clinical condition, are integrated throughout the educational activities.

The main effectiveness evaluation compares the intervention and control groups at the three-month follow-up while accounting for baseline outcome levels. An additional assessment immediately after completion of the educational program is conducted only in the intervention group to explore the immediate educational response and whether the observed improvement is maintained at three months.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Newly graduated nurses with less than one year of professional nursing experience
  • Currently working in the coronary intensive care unit or cardiovascular surgery intensive care unit
  • Voluntary participation in the study
  • Provision of written informed consent

Exclusion criteria

  • Previous participation in a structured arrhythmia or ECG training program

Treatment and study plan

Case-Based Collaborative Learning-Based Arrhythmia Education

Behavioral

The intervention consists of two 120-minute educational sessions delivered once weekly over two consecutive weeks by a researcher with formal ECG training and certification in ECG interpretation. Each session uses clinically oriented arrhythmia cases accompanied by ECG tracings. Participants first assess the case individually and then work in small groups of 5-6 nurses to discuss their interpretations and reach a shared clinical decision. Groups present their conclusions, followed by facilitator-guided whole-group analysis, clarification of misconceptions, and structured feedback. The program addresses ECG interpretation, life-threatening rhythms, bradyarrhythmias, atrioventricular blocks, atrial tachyarrhythmias, medication- and electrolyte-related ECG changes, QT prolongation, and monitoring problems. Patient-safety principles and appropriate nursing responses and escalation of care are integrated throughout the cases.

Other names: CBCL-Based Arrhythmia Education

Primary outcomes

  1. Arrhythmia Recognition and Awareness Test (ARAT)

    Time frame: Baseline and 3 months after randomization

    The Arrhythmia Recognition and Awareness Test (ARAT) consists of 27 items assessing arrhythmia recognition and awareness. Each correct response is scored as 1 and each incorrect response as 0, yielding a total score ranging from 0 to 27. Higher scores indicate better arrhythmia recognition and awareness.

Secondary outcomes

  1. Safety Attitudes Questionnaire (SAQ)

    Time frame: Baseline and 3 months after randomization

    The Safety Attitudes Questionnaire (SAQ) is used to assess participants' attitudes toward patient safety. The questionnaire includes 46 items rated on a 5-point Likert scale and comprises six dimensions: teamwork climate, safety climate, job satisfaction, stress recognition, perceptions of management, and working conditions. Higher scores indicate more positive attitudes toward patient safety.

Study contacts

Contact information is provided by the study sponsor or research team.

Naile Alankaya, Associate Prof. PhD

CONTACT

[email protected]

+905334256510

Sponsors and collaborators

Lead sponsor

Naile ALANKAYA

Other

Registry information

Official study title

Effect of Case-Based Collaborative Learning on Arrhythmia Recognition and Patient Safety Attitudes Among Novice Intensive Care Nurses: A Randomized Controlled Trial

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
Aug 21, 2026
Registry last updated
Aug 26, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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