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NCT Number: NCT07525700

The Effects of Combining Electronic Picture Books With RPG-Based Gamified Learning on Nursing Students' Motivation and Learning Outcomes in Breastfeeding Education

This study aimed to explore the impact of electronic picture books combined with RPG on breastfeeding learning outcomes among nursing students. The study participants were third-year nursing students from a university in central Taiwan. A randomized controlled design was used, with the experimental group receiving electronic picture books combined with RPG, while the control group received traditional face-to-face instruction. Changes in students' breastfeeding knowledge, learning motivation, self-efficacy, and cognitive load were assessed. The expected results can provide a reference for innovative teaching models in nursing education and promote the future clinical application of breastfeeding.

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Key information

Conditions

Nursing Education Research Breastfeeding Education Nursing Students

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

About this study

Breastfeeding is widely considered to be the best source of nutrition for infants, helping to reduce infant morbidity and mortality, reduce the risk of infection and chronic diseases, and promote intellectual development. However, in current nursing education, how to effectively improve students' knowledge and skills of breastfeeding has yet to be developed. Common traditional face-to-face courses are limited by time and venue, which requires students to re-adapt and learn when entering the clinical internship stage, affecting learning efficiency and clinical application.

This study adopts a randomized controlled experimental design and is expected to recruit 100 third-year nursing students from a university in central Taiwan, divided into an experimental group and a control group. The experimental group studied with electronic picture books combined with RPG on breastfeeding learning, and the control group took a traditional face-to-face course. Data were collected through a structured questionnaire, and changes in breastfeeding knowledge, learning motivation, self-efficacy, and cognitive load were assessed analyzed using descriptive and inferential statistics. The expected results showed that the interactive e-book not only significantly improved students' learning outcomes, but also helped overcome gender restrictions, enhance learning motivation, promote future clinical promotion of breastfeeding, and serve as an important reference for innovative nursing education models.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • It is expected to include 100 people.
  • A third-year nursing student.
  • Studying obstetrics and gynecology nursing this semester.
  • Agree to participate in this study and sign the research consent form.

Exclusion criteria

  • Students who are planning to take a leave of absence at the time of data collection.
  • Students who have not taken obstetrics and gynecology nursing this semester or have taken it in the past.
  • Students who are unable to use 3C products.

Treatment and study plan

face-to-face teaching

Behavioral

face-to-face teaching of breastfeeding

Electronic picture books and Online RPG interactive adventure game

Behavioral

Integration of online RPG interactive adventure games with an electronic picture books learning mode for the instruction of breastfeeding.

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 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 self-efficacy .

  3. 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.

  4. Cognitive Load Scale

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

    The cognitive load of learners taking electronic picture books and RPGs or face-to-face courses was assessed using an 8-item cognitive load scale. All items were rated on a 1-point Likert scale, ranging from 5 ("strongly agree") to 1 ("strongly disagree"). The total score ranged from 8 to 40, with higher scores indicating stronger cognitive load.

Study contacts

Contact information is provided by the study sponsor or research team.

Ting-Shan Chang

CONTACT

[email protected]

+886422053366 ext. 7116

Ya-Ling Tzeng

CONTACT

[email protected]

+886422053366 ext. 7112

Sponsors and collaborators

Lead sponsor

China Medical University Hospital

Other

Collaborators

  • China Medical University, Taiwan

Registry information

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
Apr 13, 2026
Registry last updated
Apr 13, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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