Applying the ADDIE Model to Develop a Multimedia Program to Enhance Chemotherapy Knowledge and Self-Efficacy Among Intensive Care Unit Nurses

This study adopted a quasi-experimental research design using a one-group pretest-posttest approach, and participants were recruited through convenience sampling. The overall research framework followed the ADDIE model, which consists of four main phases: Analysis, Design, Development & Implementation, and Evaluation. The study integrated the clinical needs of the intensive care unit (ICU) to develop and apply an interactive multimedia educational program. The research process is described as follows:

• Analysis Phase

In this phase, the research team conducted a situational analysis in the ICU through on-site interviews and structured interview guides with nurses to gain a comprehensive understanding of the challenges they face during chemotherapy administration. The key areas of investigation included nurses' familiarity with drug characteristics, mastery of administration and standard procedures, monitoring of chemotherapy-related side effects, and their ability to respond to unexpected situations.

To assess nurses' self-efficacy comprehensively, a self-efficacy questionnaire was distributed to collect data on their confidence and practical needs regarding chemotherapy administration and medication safety. The findings from this phase served as the foundation for the subsequent system design, ensuring that the system functions aligned closely with clinical practice needs.

• Design Phase

Based on the results of the analysis phase, the second phase focused on constructing a blueprint for the interactive multimedia education program. The research unit established an Oncology Treatment Task Force in 2021 and released a revised version of the "Oncology Treatment Manual" in the same year. The 32-page manual covers topics such as pre-administration assessment, introduction to common oral and injectable chemotherapy drugs, principles for handling medical orders, and procedures for managing extravasation. It also integrates audiovisual teaching resources to provide multiple learning channels.

Drawing upon the manual and clinical requirements, the research team developed a scenario-based interactive multimedia design emphasizing common clinical issues and medication processes. This allows nurses to receive accurate, real-time guidance when encountering problems or seeking information in clinical practice.

• Development & Implementation Phase

In this phase, the research team developed and implemented the multimedia educational content and system interface based on the needs and materials identified in the previous stages. The process included functional development, content verification, and multiple rounds of pilot testing. ICU nurses were invited to test the system and provide feedback. The research team continuously refined the interface and content presentation according to user feedback to ensure that the educational system met real clinical requirements and was user-friendly.

• Evaluation Phase

During the evaluation phase, the research team collected nurses' feedback after using the multimedia system. The evaluation incorporated the Technology Acceptance Model (TAM) and the System Usability Scale (SUS) to assess the system's usability and acceptance. If the results indicated areas for improvement, the team would return to the design or development phase for revision and optimization, achieving continuous iteration and quality enhancement of the system.

The study site is located in the intensive care unit (ICU) of a medical center in southern Taiwan, and the primary participants are nurses working in this unit. Considering the characteristics of ICU work and its unique clinical environment, participating nurses are required to have sufficient clinical experience to ensure meaningful feedback and accurately reflect the practical impact of the interactive multimedia education program in real clinical settings.

Inclusion criteria

• Participants must meet all of the following criteria:
• Currently employed as nurses in the Intensive Care Unit (ICU) and actively engaged in patient care involving chemotherapy ad-ministration or chemotherapy-related nursing responsibilities.

This ensures that participants possess foundational knowledge and clinical experience relevant to chemotherapy procedures.

Exclusion criteria

• Participants meeting any of the following conditions will be excluded:
• Nurses who are temporarily away from clinical duties, such as those on personal leave, leave of absence, or unpaid leave.
• Nurses who are unable to participate consistently due to job reassignment or changes in work responsibilities.
• Nurses currently participating in other chemotherapy-related research that may interfere with data collection or study outcomes.