Development and quasi-experimental evaluation of a self-directed case-based digital learning model for emergency nursing competence

Journal of Educational and Learning Studies October 12, 2026 Volume 9, Number 2 3 authors

Abstract

This study developed and evaluated a self-directed, case-based digital learning model for emergency nursing education. A sequential research-and-development approach was used. Phase 1 comprised needs assessment and model development using questionnaires, interviews, and input from clinical educators and students. Phase 2 used a quasi-experimental pretest-posttest control-group evaluation. Total sampling included all 90 students in the Professional Nursing Program. Two existing classes were allocated at class level by random selection, with class A assigned to the intervention group (n = 43) and class B to the control group (n = 47). The intervention was delivered through Google Sites three times per week for four weeks. Each session included 10-15 minutes of reading, 5-10 minutes of instructional video, and 5-10 minutes of an interactive quiz. A 12-item competency instrument covering Emergency Nursing competencies was reviewed by two experts; content validity was strong (S-CVI/Ave = 1.00; mean Aiken's V = 0.92, range 0.83-1.00), with 100% expert agreement, although Cohen's kappa was not estimable because of zero variance. The intervention group increased from 49.19 ± 26.00 at pretest to 77.09 ± 21.66 at posttest, while the control group increased from 39.79 ± 11.93 to 58.83 ± 14.19. Paired improvements were significant in both groups (27.91 points, 95% CI 20.51-35.30, t(42) = 7.61, p < .001; and 19.04 points, 95% CI 14.10-23.98, t(46) = 7.76, p < .001, respectively). A supplementary gain-score comparison calculated from the supplied summary statistics showed an 8.86-point greater improvement in the intervention group, Welch's t(74.46) = 2.01, p = .048, Cohen's d = 0.43 (95% CI 0.01-0.85). Baseline scores were not equivalent between groups, which limits causal interpretation. The findings support the model as a feasible supplementary approach for emergency-nursing learning, while larger multi-site studies with stronger allocation procedures and objective clinical-performance measures are still needed.

Authors

  1. Sunarto Sunarto

    Politeknik Kesehatan Kemenkes Surakarta

  2. Addi Mardi Harnanto

    Politeknik Kesehatan Kemenkes Surakarta

  3. Sudiro Sudiro

    Politeknik Kesehatan Kemenkes Surakarta

Keywords

CompetenceEmergency NursingVirtual LearningWeb-Based LearningNursing Education

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