Nursing Education ResearchNCT07525700
The Effects of Combining Electronic Picture Books With RPG-Based Gamified Learning on Nursing Students' Motivation and Learning Outcomes in Breastfeeding Education
A study testing face-to-face teaching and Electronic picture books and Online RPG interactive adventure game in people with Nursing Education Research and Nursing Students, run by China Medical University Hospital.
Trial summary
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. Read more about this study
- Who is it for?
- Any ageHealthy volunteers can take part
- Conditions the study is for
- Nursing Education Research, Nursing Students, Breastfeeding Education
- What is being tested?
- face-to-face teaching and Electronic picture books and Online RPG interactive adventure game
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 100 participants
- Where
- No sites listed yet
- Study dates
- 30 Sep 2026to 31 Dec 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
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 Any age
- All sexes
- Healthy volunteers accepted
- Child, Adult, Older adult
Who may be able to join
- 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.
Who cannot join
- 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.
Trial locations and contacts
No sites are listed yet. Contact the study team or a site near you to ask about taking part.
About this study
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.
Read the detailed description
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.
- Being tested
- face-to-face teaching, Electronic picture books and Online RPG interactive adventure game
- Keywords
- nursing education, learning motivation, Breastfeeding Education, Nursing Students, electronic picture books, RPG
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
face-to-face teachingBehavioural
face-to-face teaching of breastfeeding
Electronic picture books and Online RPG interactive adventure gameBehavioural
Integration of online RPG interactive adventure games with an electronic picture books learning mode for the instruction of breastfeeding.
| Study group | Role | What they receive |
|---|---|---|
| face-to-face teaching | Active comparator | face-to-face teaching of breastfeeding Receives: Behavioral: face-to-face teaching |
| Electronic picture books and Online RPG interactive adventure game | Experimental | Integration of online RPG interactive adventure games with an electronic picture books learning mode for the instruction of breastfeeding. Receives: Behavioral: Electronic picture books and Online RPG interactive adventure game |
What is being measured
The primary outcome is the main question the study is designed to answer.
Breastfeeding Knowledge Questionnaire
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.
Measured: The experimental group and the control group will Baseline (prior to intervention), immediately after intervention, and 4 weeks after intervention
Breastfeeding Self-Efficacy Scale
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 .
Measured: The experimental group and the control group will Baseline (prior to intervention), immediately after intervention, and 4 weeks after intervention
ARCS-Based Learning Motivation Scale
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.
Measured: The experimental group and the control group will Baseline (prior to intervention), immediately after intervention, and 4 weeks after intervention
Cognitive Load Scale
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.
Measured: The experimental group and the control group will Baseline (prior to intervention), immediately after intervention, and 4 weeks after intervention
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted13 Apr 2026
- Study start30 Sep 2026 (estimated)
- Primary completion1 Dec 2026 (estimated)
- Study completion31 Dec 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Nursing Education ResearchStudies of the same condition, open and under way.
- More trials run by China Medical University HospitalThe sponsor's other registered studies.
- 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
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- The study design will adopt a randomized controlled trial with repeated measures. A 60-minute intervention has been developed.Block randomization stratified by gender will be used, and eligible participants will be randomly assigned to either the experimental or control group in a 1:1 ratio using Random Allocation Software.Research assistants will code group assignments ("Group 1" and "Group 2") according to the randomization list, place the assignments into opaque sealed envelopes, and arrange them sequentially.On the day of the study, envelopes will be distributed in the order participants submit their consent forms. Participants will open the envelope themselves to learn their group assignment.
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 100 participants (estimated)
Sponsor and investigators
- Lead sponsor
- China Medical University Hospital
- Sponsor type
- University, hospital or other
- Collaborators
- China Medical University, Taiwan
- Responsible party
- Principal investigator, Ting-Shan Chang, China Medical University, Taiwan
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07525700
- Sponsor's protocol ID
- CMUH115-REC1-069
- Status last verified
- Apr 2026
- First submitted
- 7 Apr 2026
- Last updated
- 13 Apr 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Study at a glance
From the registry record, last updated by the sponsor on 13 Apr 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Effects of Combining Electronic Picture Books With RPG-Based Gamified Learning on Nursing Students' Motivation and Learning Outcomes in Breastfeeding Education
- ClinicalTrials.gov ID
- NCT07525700
- Acronym / sponsor ID
- CMUH115-REC1-069
- Keywords
- nursing education, learning motivation, Breastfeeding Education, Nursing Students, electronic picture books, RPG
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 100 participants (estimated)
- Lead sponsor
- China Medical University HospitalUniversity, hospital or other
- Collaborators
- China Medical University, Taiwan
- Study start
- 30 Sep 2026 (estimated)
- Primary completion
- 1 Dec 2026 (estimated)
- Study completion
- 31 Dec 2026 (estimated)
- First posted
- 13 Apr 2026 (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.
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.
Detailed description
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.
Study design
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
- Model description
- The study design will adopt a randomized controlled trial with repeated measures. A 60-minute intervention has been developed.Block randomization stratified by gender will be used, and eligible participants will be randomly assigned to either the experimental or control group in a 1:1 ratio using Random Allocation Software.Research assistants will code group assignments ("Group 1" and "Group 2") according to the randomization list, place the assignments into opaque sealed envelopes, and arrange them sequentially.On the day of the study, envelopes will be distributed in the order participants submit their consent forms. Participants will open the envelope themselves to learn their group assignment.
| Arm | Type | Receives |
|---|---|---|
| face-to-face teaching | Active comparator | Behavioral: face-to-face teachingface-to-face teaching of breastfeeding |
| Electronic picture books and Online RPG interactive adventure game | Experimental | Behavioral: Electronic picture books and Online RPG interactive adventure gameIntegration of online RPG interactive adventure games with an electronic picture books learning mode for the instruction of breastfeeding. |
Who may qualify
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (4 listed)
- 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.
Key exclusion criteria (3 listed)
- 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.
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 |
|---|---|---|
| face-to-face teachingface-to-face teaching of breastfeeding | Behavioural | face-to-face teaching |
| Electronic picture books and Online RPG interactive adventure gameIntegration of online RPG interactive adventure games with an electronic picture books learning mode for the instruction of breastfeeding. | Behavioural | Electronic picture books and Online RPG interactive adventure game |
Primary outcome
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.
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 .
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.
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.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 13 Apr 2026.
- Individual participant dataSharing planned: Undecided
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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.
Questions about this trial
What is this clinical trial studying?
A study testing face-to-face teaching and Electronic picture books and Online RPG interactive adventure game in people with Nursing Education Research and Nursing Students, run by China Medical University Hospital.
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 4 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: opening soon, as of the sponsor's last update on 13 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.
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?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Ting-Shan Chang (+886422053366 ext. 7116, tingshan@mail.cmu.edu.tw), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
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). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 13 Apr 2026.