NotebookLM-Supported Vital Signs Education for Nursing Students Within the PICRAT Framework

Vital signs assessment is a fundamental component of nursing care and one of the first essential clinical skills taught in undergraduate nursing education. Accurate measurement and interpretation of body temperature, pulse, respiratory rate, and blood pressure are important for recognizing changes in a patient's physiological condition and supporting timely clinical decision-making. However, nursing students may experience difficulties in accurately interpreting vital signs, consistently monitoring critical parameters, and reporting changes in patient condition.

Technology-supported educational approaches may help improve students' engagement, knowledge acquisition, and retention of clinical information. NotebookLM is a generative artificial intelligence-supported learning tool that enables educational content to be presented through multiple formats, such as audio summaries, flashcards, review questions, and mind maps. The educational integration of NotebookLM in this study was structured according to the PICRAT model. The PICRAT model evaluates technology integration through two dimensions: students' relationship with technology, classified as passive, interactive, or creative, and the effect of technology on the teacher's existing practice, classified as replacement, amplification, or transformation.

This study used a randomized controlled, parallel-group design. First-year undergraduate nursing students who voluntarily agreed to participate were randomly assigned to an intervention group or a control group using a computer-based randomization procedure.

The control group received vital signs education through the traditional teaching methods used in the existing nursing curriculum and did not receive any additional educational intervention. The intervention group received a 20- to 30-minute orientation on the use of NotebookLM one day before the vital signs lesson. Following the orientation, students were provided with access to a NotebookLM page prepared by the instructor. The page included educational materials related to vital signs, such as an audio podcast, flashcards, a topic review test, and a mind map. Students were encouraged to interact with these materials before and during the lesson. Classroom instruction in the intervention group used a NotebookLM-supported interactive teaching approach designed to promote active student participation.

To reduce variation related to the instructor, the lessons for both groups were delivered by the same educator. The educational content covered the measurement and assessment of blood pressure, apical pulse, peripheral pulse, body temperature, and respiratory rate.

Academic achievement was assessed using a 26-item multiple-choice achievement test developed to measure nursing students' knowledge and measurement skills related to vital signs. Each correct answer was scored as one point and each incorrect answer as zero points, resulting in a total score ranging from 0 to 26. The first assessment was administered face-to-face after completion of the educational intervention. The same test was administered again six weeks later to evaluate the retention of learning. Test scores were used only for research purposes and did not affect the students' course grades or academic evaluation.

The primary objective of the study was to determine whether NotebookLM-supported instruction improved nursing students' academic achievement in vital signs education compared with traditional teaching. The study also examined whether the effect of the intervention was maintained at the six-week follow-up assessment.

Inclusion criteria

• Being a first-year undergraduate student enrolled in the Department of Nursing at Muğla Sıtkı Koçman University, Fethiye Faculty of Health Sciences.
• Being between 18 and 65 years of age.
• Voluntarily agreeing to participate in the study and providing informed consent.
• Having access to email and an internet-enabled device, such as a smartphone or computer, capable of accessing and playing the NotebookLM educational materials if assigned to the intervention group.

Exclusion criteria

• Withdrawing consent at any time during the study.
• Having previously received education or training on vital signs.