Applying Interactive E-books on Breastfeeding to Enhance Nursing Students' Learning

Primary outcomes

1. Breastfeeding Knowledge Questionnaire

   Time frame: The experimental group and the control group will Baseline (prior to intervention), immediately after intervention, and 4 weeks after intervention

   This questionnaire consists of 10 multiple-choice questions. Each correct answer is scored 10 points, and each incorrect answer is scored 0 points, yielding a total score range of 0-100. The questions were self-developed in the form of clinical scenario-based multiple-choice items, focusing on the benefits of breastfeeding, breastfeeding positions, breast milk storage methods, breast milk expression (hand expression), and nursing interventions to maintain milk supply.

2. Breastfeeding Skills Assessment Scale

   Time frame: The experimental group and the control group will Baseline (prior to intervention), immediately after intervention, and 4 weeks after intervention

   Breastfeeding skills were assessed using a "Breastfeeding Skills Assessment Scale," which includes 20 steps such as hand hygiene before procedures, self-introduction, patient identification, ensuring privacy, explaining the purpose and process, breastfeeding positions, and hand expression techniques. Each step is scored as follows: completely correct = 5 points, partially correct = 3 points, and incorrect = 0 points. The total score ranges from 0-100, with higher scores indicating better application of breastfeeding skills.

3. Breastfeeding Self-Efficacy Scale

   Time frame: The experimental group and the control group will Baseline (prior to intervention), immediately after intervention, and 4 weeks after intervention

   Breastfeeding self-efficacy was evaluated using a 10-item Breastfeeding Self-Efficacy Scale. Each item is rated on a 4-point Likert scale, where 1 = not at all capable and 4 = expert level. The total score ranges from 10 to 40, with higher scores indicating greater self-efficacy in performing breastfeeding skills.

4. ARCS-Based Learning Motivation Scale

   Time frame: The experimental group and the control group will Baseline (prior to intervention), immediately after intervention, and 4 weeks after intervention

   The scale assesses learners' motivation toward the educational materials across four dimensions: Attention (12 items), Relevance (9 items), Confidence (9 items), and Satisfaction (6 items), for a total of 36 items. Responses are rated on a 5-point Likert scale, ranging from 5 ("Strongly Agree") to 1 ("Strongly Disagree"). The total score ranges from 36 to 180 points, with higher scores indicating stronger learning motivation.

5. Critical Thinking Disposition Scale

   Time frame: The experimental group and the control group will Baseline (prior to intervention), immediately after intervention, and 4 weeks after intervention

   This scale consists of 20 items and adopts a 6-point Likert scoring method: 1 (Never), 2 (Almost Never), 3 (Rarely), 4 (Sometimes), 5 (Often), and 6 (Always). It measures critical thinking disposition, which refers to an individual's tendency to engage in systematic analysis, maintain an open-minded attitude with empathy, and possess a wise curiosity for questioning, integration, and reflection, all of which facilitate critical thinking processes.