Mobile Application-Supported Education in Nursing Students

Mobile technologies may support nursing education by enabling students to review clinical skills repeatedly and independently of time and place. This study was designed to examine whether adding a structured mobile learning resource to standard Fundamentals of Nursing instruction improves students' short-term learning outcomes.

Before randomization, all participants received the same classroom-based theoretical instruction and laboratory skills training. Eligible students were then randomly allocated in a 1:1 ratio to the mobile application-supported education group or the standard education group. Allocation was performed using a computer-generated block randomization sequence. The researcher responsible for the OSCE assessment was not involved in the randomization or intervention process and remained blinded to group allocation.

Students assigned to the intervention group received individual, password-protected access to the mobile application for 14 days. The application contained instructional materials and skill demonstration videos related to oral and local medication administration, subcutaneous and intramuscular injections, blood glucose measurement, blood sampling, and intravenous catheter insertion. Separate student and instructor interfaces were available. Through the instructor interface, the course instructor monitored each participant's access and application completion percentage during the intervention period. Participants were asked to complete at least 50% of the available content.

During the initial randomized comparison period, the control group continued with standard course instruction and did not have access to the educational modules in the mobile application. At the end of the 14-day period, both groups completed the knowledge assessment and the Student Satisfaction and Self-Confidence in Learning Scale before the skills examination.

Clinical skills were evaluated through an Objective Structured Clinical Examination conducted in the nursing skills laboratory. Immediately before each participant in the control group entered the examination, only the OSCE assessment module of the application was activated to allow electronic recording of the skills evaluation. The educational modules remained inaccessible to the control group during the assessment. The OSCE was conducted by the second researcher, who was blinded to group allocation, while the course instructor, who was aware of the group assignments, did not participate in performance scoring.

After the initial knowledge, satisfaction, self-confidence, and OSCE assessments had been completed, the educational content of the mobile application was made available to the control group. Following a two-week access period for the control group, all participants completed the Attitude Toward E-Learning Scale. This assessment was used to describe students' overall attitudes toward mobile and electronic learning after experiencing the application and was not intended to estimate a randomized between-group intervention effect.

Mobile application usability and participant engagement were also evaluated. Student-level completion data obtained from the application were used to document adherence to the mobile learning intervention. The study was conducted as an assessor-blinded randomized controlled educational trial in which the control group was provided with two weeks of access to the mobile application after the initial assessments were completed.

Inclusion criteria

- Aged 18 years or older. - First-year undergraduate nursing student enrolled in the Fundamentals of Nursing course. - Willing to participate in the study and provide written informed consent. - Possession of a smartphone compatible with the mobile application.

Exclusion criteria

- Previous formal training in oral, local, or parenteral medication administration skills. - Previous clinical or laboratory experience in oral, local, or parenteral medication administration skills. - Failure to meet any of the inclusion criteria.