Pressure UlcersNCT06899282
The Effect of Pressure Ulcer Management Program Applied With Jigsaw Technique
A study testing Jigsaw method and The theoretical training in people with Pressure Ulcers and Nursing Students, run by Kutahya Health Sciences University at 1 site in Turkey (Türkiye).
Trial summary
The aim of this study is to evaluate the effectiveness of the jigsaw method on pressure ulcer prevention in senior nursing students. In addition, the study will also examine student views on the jigsaw technique. Read more about this study
- Who is it for?
- Ages 18 years and olderHealthy volunteers can take part
- Conditions the study is for
- Pressure Ulcers, Nursing Students, Training Effectiveness
- What is being tested?
- Jigsaw method and The theoretical training
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 62 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 11 Apr 2025to 6 Jun 2025
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- To be a 4th year student of the Department of Nursing, Faculty of Health Sciences, Kütahya University of Health Sciences
- To be enrolled in the Basic Principles and Practices in Nursing Course
Who cannot join
- Nursing students who did not volunteer to participate in the study
- Not participating in theoretical and clinical practices during the academic semester
- Graduated from health vocational high school and working with the title of nurse
Trial locations and contacts
1 site in 1 country.
Turkey (Türkiye)1 site
Kütahya Health Science Univercity
Kütahya, Kütahya, 4300
About this study
Official title: The Effect of Pressure Ulcer Management Program Applied With Jigsaw Technique on Nursing Students' Pressure Ulcer Knowledge, Attitude and Self-efficacy: A Double-blind Randomized Controlled Trial
The aim of this study is to evaluate the effectiveness of the jigsaw method on pressure ulcer prevention in senior nursing students. In addition, the study will also examine student views on the jigsaw technique.
Hypotheses of the study are as follows:
Read more
Hypothesis 1: The pressure injury management program applied with the Jigsaw technique has an effect on the pressure ulcer knowledge scores of nursing students.
Hypothesis 2: The pressure injury management program applied with the Jigsaw technique has an effect on the pressure ulcer prevention attitude of nursing students.
Hypothesis 3: The pressure injury management program applied with the Jigsaw technique has an effect on nursing students' pressure ulcer management self-efficacy.
The participant characteristics were being a 4th grade student of Kütahya University of Health Sciences, Faculty of Health Sciences, Department of Nursing and being enrolled in the Basic Principles and Practices in Nursing Practices Course. Nursing students who did not volunteer to participate in the study, those who did not participate in theoretical and clinical practices during the academic semester, and nursing students working as high school graduate nurses due to their past education will be excluded from the study.
Intervention and measurements: Participants (N=70) will be randomly divided into intervention and control groups. The intervention group will study pressure ulcer management with the jigsaw technique. The control group will receive theoretical education with the traditional method. Students' pressure ulcer knowledge, attitude and self-efficacy levels will be assessed with standardized tools. Baseline assessment before the intervention, post-intervention and 6 weeks after the intervention will be done. Measurements will be made by students through self-reporting. However, a researcher blinded to the groups will administer the instruments and enter data. Data analysis will also be done by the researcher blinded to the groups. Thus, double blindness will be ensured. Statistical analysis will be based on significance tests.
Read the detailed description
Nurses should identify patients at high risk of pressure ulcers and provide preventive care accordingly. However, two recently published meta-analysis studies found that the pressure ulcer knowledge of nurses and nursing students measured by standard tools was below the acceptable level (60%). However, the attitudes of nursing students towards pressure ulcer prevention were found to be positive and at a high level. In addition, a multicentre study conducted in Türkiye showed that nursing students' self-efficacy in pressure ulcer prevention was also low and there was a positive relationship between knowledge and self-efficacy. This situation reveals the need for the use of better educational methods to improve nursing students' pressure ulcer knowledge.
Nursing educators are responsible for improving students' knowledge, skills and attitudes about pressure ulcers and preparing them for clinical practice. In the literature, there are studies showing that active teaching methods such as six-hat thinking technique, case-supported concept map, make significant improvements in some results including nursing students' pressure sore knowledge. However, no study evaluating the effect of jigsaw technique on nursing students' pressure ulcer knowledge, attitudes and self-efficacy has been found. A meta-analysis study examining the results of the jigsaw technique in nursing students reported that the technique was an effective method in the results of students such as knowledge, skills and attitudes. In this context, this study was planned to evaluate the effectiveness of the jigsaw method on pressure ulcer prevention in senior nursing students.
- Being tested
- Jigsaw method, The theoretical training
- Keywords
- jigsaw technique, nursing student, training effectiveness, randomized controlled trial, pressure ulcers
- Medical subject headings
- Pressure Ulcer
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Jigsaw methodBehavioural
Jigsaw/puzzle method is one of the collaborative learning techniques. The Jigsaw technique requires each student to focus on a particular aspect of the topic, become an "expert" on that topic and teach it to their peers. Once the students have learned the topic in their expert group, they return to the original group and teach what they have learned back to them as if solving a jigsaw puzzle (Geiselman et al., 2024). For the application of the technique, the "Jigsaw Technique Application Directive" was prepared as a training material to be delivered to the students.
The theoretical trainingBehavioural
The theoretical training will be conducted in 2 sessions. The first session will cover the definition, prevalence and importance of pressure ulcers, etiology and classification, risk assessment and pressure ulcers in special patient groups. The second session will cover prevention and treatment of pressure ulcers.
| Study group | Role | What they receive |
|---|---|---|
| Intervention group: The group to be taught with jigsaw technique. | Experimental | Intervention Group: The lecture on pressure ulcer prevention and management to the intervention group will be conducted with the jigsaw technique. Pressure ulcer knowledge, attitude and prevention self-efficacy will be evaluated with standardized tools before, after the theoretical training and at the end of clinical practice. In addition, a standard student opinion questionnaire regarding the method will be applied. Receives: Behavioral: Jigsaw method |
| Control Group: This is the group that will receive theoretical training with the traditional method. | Active comparator | Control group: Control group students will receive theoretical training prepared by the researchers. Pressure ulcer knowledge, attitude and prevention self-efficacy will be evaluated with standardized tools before, after the theoretical training and at the end of clinical practice. Receives: Behavioral: The theoretical training |
What is being measured
The primary outcome is the main question the study is designed to answer.
Pressure Ulcer Knowledge Assessment Tool-Updated Version
Pressure Ulcer Knowledge Assessment Tool-Updated is a tool that measures nurses' knowledge about pressure ulcers within the framework of evidence-based guidelines.It consists of 25 multiple-choice questions on six themes: Etiology, Classification and Observation, Risk Assessment, Nutrition, Prevention of Pressure Ulcers and Specific Patient Groups. In scoring, 1 point is given for each correct answer and 0 points for incorrect and "Don't know" answers. The total score ranges from 0 to 25. Cronbach's alpha value is 0.72.
Measured: Baseline (Time 0), After 4 hours (Time 1), After 6 weeks (Time 2)
Pressure Ulcer Prevention Attitude Scale
Pressure Ulcer Prevention Attitude Scale The scale aims to assess attitudes towards pressure ulcer prevention. It consists of 13 items and 5 subscales including personal competence to prevent pressure ulcers (3 items), priority of pressure ulcer prevention (3 items), impact of pressure ulcers (3 items), personal responsibility in pressure ulcer prevention (2 items) and confidence in the effectiveness of prevention (2 items). Seven items (items 3, 5, 7, 8, 9, 10 and 13) are reverse scored as they are negative. The items are scored on a 4-point Likert scale (1 = strongly disagree, 4 = strongly agree) and score between 13 and 52 points. A higher score is interpreted as a more positive attitude. The Cronbach's alpha values of the original scale and the Turkish adaptation study are 0.79 and 0.71, respectively.
Measured: Baseline (Time 0), After 4 hours (Time 1), After 6 weeks (Time 2)
Pressure Ulcer Management Self-Efficacy Scale for Nurses
The scale measures nurses' self-efficacy in managing pressure ulcers. The scale consists of a total of 10 items and four main subscales: Assessment, Planning, Supervision and Decision Making. Each item is scored from 1 (not at all competent) to 5 (completely competent). The scale does not include reverse items. The total score range is 0-100. The level of self-efficacy increases with the total score. The Cronbach Alpha value of the scale is 0.83.
Measured: Baseline (Time 0), After 4 hours (Time 1), After 6 weeks (Time 2)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted27 Mar 2025
- Study start11 Apr 2025
- Primary completion6 Jun 2025
- Study completion6 Jun 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (4)Papers the sponsor has linked to this study.
- Other trials for Pressure UlcersStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Investigator, Outcomes assessor
- Enrolment
- 62 participants (actual)
Sponsor and investigators
- Lead sponsor
- Kutahya Health Sciences University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Senay Takmak, Kutahya Health Sciences University
- Investigators
- Necibe Dağcan Şahin, Asst. Prof., Study chair, Kutahya Health Science UniversityFerzan Kalaycı Emek, RA, Study chair, Kutahya Health Science UniversityBurcu Nal, Asst. Prof., Study chair, Kutahya Health Science University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06899282
- Sponsor's protocol ID
- 2025/03-13
- Status last verified
- Aug 2025
- First submitted
- 17 Mar 2025
- Last updated
- 3 Sep 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: Research data can be shared upon request from the authors.
Publications
Turhan Damar H, Erkin O. The effect of case-supported concept map education on nursing students' knowledge of and attitudes toward pressure injury prevention. J Tissue Viability. 2025 Feb;34(1):100848. doi: 10.1016/j.jtv.2024.12.012. Epub 2024 Dec 9.
PubMed 39665940Ozkan S, Uslusoy ECN. Outcomes of jigsaw technique in nurse education: A systematic review and meta-analysis. Nurse Educ Pract. 2024 Feb;75:103902. doi: 10.1016/j.nepr.2024.103902. Epub 2024 Jan 20.
PubMed 38301377Dalli OE, Yildirim Y, Caliskan G, Girgin NK. Reliability and validity of the Turkish version of pressure ulcer knowledge assessment tool-updated version (PUKAT 2.0). J Tissue Viability. 2022 Feb;31(1):52-57. doi: 10.1016/j.jtv.2021.08.001. Epub 2021 Aug 11.
PubMed 34429220Iseri O, Ursavas FE. The influence of the online education provided using the six thinking hat method on the knowledge and attitudes of nursing students regarding pressure injury prevention; a pilot study. J Tissue Viability. 2024 Aug;33(3):465-471. doi: 10.1016/j.jtv.2024.04.009. Epub 2024 Apr 16.
PubMed 38679544
Study at a glance
From the registry record, last updated by the sponsor on 3 Sep 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Effect of Pressure Ulcer Management Program Applied With Jigsaw Technique on Nursing Students' Pressure Ulcer Knowledge, Attitude and Self-efficacy: A Double-blind Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT06899282
- Acronym / sponsor ID
- 2025/03-13
- Keywords
- jigsaw technique, nursing student, training effectiveness, randomized controlled trial, pressure ulcers
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 62 participants (actual)
- Lead sponsor
- Kutahya Health Sciences UniversityUniversity, hospital or other
- Study start
- 11 Apr 2025 (actual)
- Primary completion
- 6 Jun 2025 (actual)
- Study completion
- 6 Jun 2025 (actual)
- First posted
- 27 Mar 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The aim of this study is to evaluate the effectiveness of the jigsaw method on pressure ulcer prevention in senior nursing students. In addition, the study will also examine student views on the jigsaw technique.
Hypotheses of the study are as follows:
Hypothesis 1: The pressure injury management program applied with the Jigsaw technique has an effect on the pressure ulcer knowledge scores of nursing students.
Hypothesis 2: The pressure injury management program applied with the Jigsaw technique has an effect on the pressure ulcer prevention attitude of nursing students.
Hypothesis 3: The pressure injury management program applied with the Jigsaw technique has an effect on nursing students' pressure ulcer management self-efficacy.
The participant characteristics were being a 4th grade student of Kütahya University of Health Sciences, Faculty of Health Sciences, Department of Nursing and being enrolled in the Basic Principles and Practices in Nursing Practices Course. Nursing students who did not volunteer to participate in the study, those who did not participate in theoretical and clinical practices during the academic semester, and nursing students working as high school graduate nurses due to their past education will be excluded from the study.
Intervention and measurements: Participants (N=70) will be randomly divided into intervention and control groups. The intervention group will study pressure ulcer management with the jigsaw technique. The control group will receive theoretical education with the traditional method. Students' pressure ulcer knowledge, attitude and self-efficacy levels will be assessed with standardized tools. Baseline assessment before the intervention, post-intervention and 6 weeks after the intervention will be done. Measurements will be made by students through self-reporting. However, a researcher blinded to the groups will administer the instruments and enter data. Data analysis will also be done by the researcher blinded to the groups. Thus, double blindness will be ensured. Statistical analysis will be based on significance tests.
Detailed description
Nurses should identify patients at high risk of pressure ulcers and provide preventive care accordingly. However, two recently published meta-analysis studies found that the pressure ulcer knowledge of nurses and nursing students measured by standard tools was below the acceptable level (60%). However, the attitudes of nursing students towards pressure ulcer prevention were found to be positive and at a high level. In addition, a multicentre study conducted in Türkiye showed that nursing students' self-efficacy in pressure ulcer prevention was also low and there was a positive relationship between knowledge and self-efficacy. This situation reveals the need for the use of better educational methods to improve nursing students' pressure ulcer knowledge.
Nursing educators are responsible for improving students' knowledge, skills and attitudes about pressure ulcers and preparing them for clinical practice. In the literature, there are studies showing that active teaching methods such as six-hat thinking technique, case-supported concept map, make significant improvements in some results including nursing students' pressure sore knowledge. However, no study evaluating the effect of jigsaw technique on nursing students' pressure ulcer knowledge, attitudes and self-efficacy has been found. A meta-analysis study examining the results of the jigsaw technique in nursing students reported that the technique was an effective method in the results of students such as knowledge, skills and attitudes. In this context, this study was planned to evaluate the effectiveness of the jigsaw method on pressure ulcer prevention in senior nursing students.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Intervention group: The group to be taught with jigsaw technique. | Experimental | Behavioral: Jigsaw methodIntervention Group: The lecture on pressure ulcer prevention and management to the intervention group will be conducted with the jigsaw technique. Pressure ulcer knowledge, attitude and prevention self-efficacy will be evaluated with standardized tools before, after the theoretical training and at the end of clinical practice. In addition, a standard student opinion questionnaire regarding the method will be applied. |
| Control Group: This is the group that will receive theoretical training with the traditional method. | Active comparator | Behavioral: The theoretical trainingControl group: Control group students will receive theoretical training prepared by the researchers. Pressure ulcer knowledge, attitude and prevention self-efficacy will be evaluated with standardized tools before, after the theoretical training and at the end of clinical practice. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (2 listed)
- To be a 4th year student of the Department of Nursing, Faculty of Health Sciences, Kütahya University of Health Sciences
- To be enrolled in the Basic Principles and Practices in Nursing Course
Key exclusion criteria (3 listed)
- Nursing students who did not volunteer to participate in the study
- Not participating in theoretical and clinical practices during the academic semester
- Graduated from health vocational high school and working with the title of nurse
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Jigsaw methodJigsaw/puzzle method is one of the collaborative learning techniques. The Jigsaw technique requires each student to focus on a particular aspect of the topic, become an "expert" on that topic and teach it to their peers. Once the students have learned the topic in their expert group, they return to the original group and teach what they have learned back to them as if solving a jigsaw puzzle (Geiselman et al., 2024). For the application of the technique, the "Jigsaw Technique Application Directive" was prepared as a training material to be delivered to the students. | Behavioural | Intervention group: The group to be taught with jigsaw technique. |
| The theoretical trainingThe theoretical training will be conducted in 2 sessions. The first session will cover the definition, prevalence and importance of pressure ulcers, etiology and classification, risk assessment and pressure ulcers in special patient groups. The second session will cover prevention and treatment of pressure ulcers. | Behavioural | Control Group: This is the group that will receive theoretical training with the traditional method. |
Primary outcome
Pressure Ulcer Knowledge Assessment Tool-Updated Version
Time frame: Baseline (Time 0), After 4 hours (Time 1), After 6 weeks (Time 2)
Pressure Ulcer Knowledge Assessment Tool-Updated is a tool that measures nurses' knowledge about pressure ulcers within the framework of evidence-based guidelines.It consists of 25 multiple-choice questions on six themes: Etiology, Classification and Observation, Risk Assessment, Nutrition, Prevention of Pressure Ulcers and Specific Patient Groups. In scoring, 1 point is given for each correct answer and 0 points for incorrect and "Don't know" answers. The total score ranges from 0 to 25. Cronbach's alpha value is 0.72.
Pressure Ulcer Prevention Attitude Scale
Time frame: Baseline (Time 0), After 4 hours (Time 1), After 6 weeks (Time 2)
Pressure Ulcer Prevention Attitude Scale The scale aims to assess attitudes towards pressure ulcer prevention. It consists of 13 items and 5 subscales including personal competence to prevent pressure ulcers (3 items), priority of pressure ulcer prevention (3 items), impact of pressure ulcers (3 items), personal responsibility in pressure ulcer prevention (2 items) and confidence in the effectiveness of prevention (2 items). Seven items (items 3, 5, 7, 8, 9, 10 and 13) are reverse scored as they are negative. The items are scored on a 4-point Likert scale (1 = strongly disagree, 4 = strongly agree) and score between 13 and 52 points. A higher score is interpreted as a more positive attitude. The Cronbach's alpha values of the original scale and the Turkish adaptation study are 0.79 and 0.71, respectively.
Pressure Ulcer Management Self-Efficacy Scale for Nurses
Time frame: Baseline (Time 0), After 4 hours (Time 1), After 6 weeks (Time 2)
The scale measures nurses' self-efficacy in managing pressure ulcers. The scale consists of a total of 10 items and four main subscales: Assessment, Planning, Supervision and Decision Making. Each item is scored from 1 (not at all competent) to 5 (completely competent). The scale does not include reverse items. The total score range is 0-100. The level of self-efficacy increases with the total score. The Cronbach Alpha value of the scale is 0.83.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 3 Sep 2025.
- Background: PubMed 39665940Turhan Damar H, Erkin O. The effect of case-supported concept map education on nursing students' knowledge of and attitudes toward pressure injury prevention. J Tissue Viability. 2025 Feb;34(1):100848. doi: 10.1016/j.jtv.2024.12.012. Epub 2024 Dec 9.
- Background: PubMed 38301377Ozkan S, Uslusoy ECN. Outcomes of jigsaw technique in nurse education: A systematic review and meta-analysis. Nurse Educ Pract. 2024 Feb;75:103902. doi: 10.1016/j.nepr.2024.103902. Epub 2024 Jan 20.
- Background: PubMed 34429220Dalli OE, Yildirim Y, Caliskan G, Girgin NK. Reliability and validity of the Turkish version of pressure ulcer knowledge assessment tool-updated version (PUKAT 2.0). J Tissue Viability. 2022 Feb;31(1):52-57. doi: 10.1016/j.jtv.2021.08.001. Epub 2021 Aug 11.
- Background: PubMed 38679544Iseri O, Ursavas FE. The influence of the online education provided using the six thinking hat method on the knowledge and attitudes of nursing students regarding pressure injury prevention; a pilot study. J Tissue Viability. 2024 Aug;33(3):465-471. doi: 10.1016/j.jtv.2024.04.009. Epub 2024 Apr 16.
- Individual participant dataSharing planned: No. Research data can be shared upon request from the authors.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Necibe Dağcan Şahin, Asst. Prof. study chair
Kutahya Health Science University
Ferzan Kalaycı Emek, RA study chair
Kutahya Health Science University
Burcu Nal, Asst. Prof. study chair
Kutahya Health Science University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Jigsaw method and The theoretical training in people with Pressure Ulcers and Nursing Students, run by Kutahya Health Sciences University at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 2 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 3 Sep 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Pressure Ulcer Knowledge Assessment Tool-Updated Version (time frame: Baseline (Time 0), After 4 hours (Time 1), After 6 weeks (Time 2)). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06899282, which also lists 4 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 3 Sep 2025.