Blockchain-Enabled E-Portfolios for Competency Tracking in Undergraduate Nursing Education: A Randomized Controlled Trial

Competency-based nursing education requires students to demonstrate progressive attainment of clinical and professional competencies across time and settings. Conventional electronic portfolios are commonly used to document reflections, skills, assessments, and learning evidence, but these systems often have limitations, including fragmented documentation across rotations, weak portability of records, restricted external verifiability, and limited learner ownership of competency evidence.

This study evaluates a blockchain-enabled electronic portfolio (BC-EP) model developed to support competency tracking and lifelong learning in undergraduate nursing education. The intervention was designed to provide a tamper-evident and portable framework for documenting competency attainment while also supporting reflective learning and personalized feedback. The BC-EP model was implemented using a permissioned blockchain architecture and included three core components: (1) a verifiable competency ledger in which competency-related artifacts were linked to cryptographically signed attestations; (2) a reflective evidence layer that connected clinical events, competency tags, reflective narratives, and preceptor attestations; and (3) a data-driven dashboard designed to identify competency gaps and guide individualized development.

The study used an explanatory sequential mixed-methods design. In the quantitative phase, a two-arm parallel randomized controlled trial was conducted among third-year undergraduate nursing students enrolled in a medical-surgical clinical rotation at the College of Nursing, Jouf University, Saudi Arabia. Participants were randomized in a 1:1 ratio to either the BC-EP intervention group or a control group using the institution's conventional Moodle-based electronic portfolio. Both groups received the same clinical rotation, but the intervention group used the blockchain-enabled platform for competency documentation, reflective evidence submission, and personalized progress monitoring.

The primary educational outcome was clinical competence, assessed using a six-station Objective Structured Clinical Examination (OSCE). Secondary outcomes included lifelong learning orientation, portfolio quality, and trust in the credibility and portability of educational records. Baseline demographic and educational data were also collected. Following completion of the quantitative phase, qualitative focus group interviews were conducted with a purposive sample of intervention-group participants to explore user experiences, perceived benefits, challenges, and possible mechanisms of effect.

The study seeks to determine whether a blockchain-enabled e-portfolio can improve educational outcomes in nursing students compared with a conventional e-portfolio system and to generate implementation-relevant insights for future digital credentialing models in nursing education.

Inclusion criteria

• Third-year undergraduate nursing students
• Enrolled in the medical-surgical clinical rotation at the College of Nursing, Jouf University
• Admitted through the standard national admission route
• Willing to participate and able to provide informed consent

Exclusion criteria

• Prior formal training in blockchain or distributed-ledger applications
• Expected absence for more than two weeks during the clinical rotation
• Self-reported lack of proficiency in basic digital learning tools
• Enrollment in a non-standard curriculum track, such as bridging or transfer programs