EducationFlashcardsNCT07869459
Digital Flashcards for Fluid and Electrolyte Education in Surgical Nursing: A Solomon Four-Group Study
A study testing Digital Flashcard Training & Pre-test/Post-test, Digital Flashcard Training & Post-test Only and Standard Lecture Only & Pre-test/Post-test in people with Education and Surgical Nursing, run by Saglik Bilimleri Universitesi at 1 site in Turkey (Türkiye).
Trial summary
This study aims to investigate the effect of the digital flashcard method, compared to traditional lecturing, on students' knowledge levels and self-efficacy perceptions regarding fluid-electrolyte balance in the surgical nursing course, within a Solomon four-group experimental design framework. Read more about this study
- Who is it for?
- Ages 18 years and olderHealthy volunteers can take part
- Conditions the study is for
- Education, Surgical Nursing, Teaching Methods
- What is being tested?
- Digital Flashcard Training & Pre-test/Post-test, Digital Flashcard Training & Post-test Only and Standard Lecture Only & Pre-test/Post-test
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 180 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 25 Sep 2026to Nov 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 18 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Being enrolled in the Surgical Nursing Course
- Agreeing to participate voluntarily in the research
- Not having previously received fluid-electrolyte education through any digital flashcard application
Who cannot join
- Having previously taken the Surgical Nursing Course
- Failing to attend any of the measurement sessions
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Neslihan ILKAZ, PhD contact
Turkey (Türkiye)1 site
University of Health Sciences
Ankara
Cansu YESİLFİDAN, PhD Candidate, +90 538 819 2590, c.cansucil@gmail.com
Neslihan ILKAZ, PhD, +90 555 694 8662, neslihanilkaz@yahoo.com
About this study
Official title: The Effect of the Digital Flashcard Method on Nursing Students' Knowledge and Self-Efficacy in Teaching Fluid-Electrolyte and Acid-Base Imbalances in a Surgical Nursing Course: A Solomon Four-Group Experimental Study
This study aims to investigate the effect of the digital flashcard method, compared to traditional lecturing, on students' knowledge levels and self-efficacy perceptions regarding fluid-electrolyte balance in the surgical nursing course, within a Solomon four-group experimental design framework.
Read the detailed description
In nursing education, the topic of fluid-electrolyte balance is one of the challenging subjects for students due to its physicochemical complexity, the multidimensionality of its clinical reflections, and the requirement to simultaneously comprehend processes such as preoperative fasting, intraoperative fluid-blood losses, and postoperative drainage management. Since traditional lecturing is based on passive learning, it alone may remain limited in supporting the long-term retention of knowledge in memory. To overcome this limitation, the digital flashcard method, which is based on the principles of active recall and spaced repetition, offers effective learning support. Moreover, pre-testing posing a potential artificial increase (sensitization) effect on post-test performance constitutes a methodological issue in nursing education. The lack of studies in the literature investigating the effect of the digital flashcard method on fluid-electrolyte balance using a Solomon four-group experimental design (controlling for the pre-test effect) renders this study necessary and original in terms of both knowledge level and self-efficacy perception based on Bandura's social cognitive theory. This research is a prospective study with a Solomon four-group experimental design to be conducted with second-year students. The study will include a total of four groups: two experimental (D1, D2) and two control (K1, K2) groups.Standard Practice: Students in all groups will receive the fluid-electrolyte content through traditional lecturing, writing boards, and written materials within the scope of the standard curriculum.
Group Applications: While a pre-test will be administered to the D1 and K1 groups prior to the education/application, no pre-test will be administered to the D2 and K2 groups. In addition to standard education, the experimental groups (D1 and D2) will receive digital flashcard training specific to the fluid-electrolyte topic via the Brainscape platform, which operates with a spaced-repetition algorithm. These cards will not be provided to the control groups during the intervention period; instead, access will be provided after the study in accordance with the ethical balance principle.Data: Data will be collected through the Introductory Information Form prepared by the researchers, the Fluid-Electrolyte Knowledge Test, and the Student Self-Efficacy Scale (SSES) developed by Rowbotham and Schmitz (2013).
- Conditions
- Education, Surgical Nursing, Teaching Methods
- Being tested
- Digital Flashcard Training & Pre-test/Post-test, Digital Flashcard Training & Post-test Only, Standard Lecture Only & Pre-test/Post-test, Standard Lecture Only & Post-test Only
- Keywords
- Fluid and Electrolyte Balance, Solomon Four-Group Design, digital flashcard, surgical nursing education
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Digital Flashcard Training & Pre-test/Post-testOther
A pre-test will be administered to students in Group-D1. Students will receive standard lectures and will be trained using digital flashcards on the fluid-electrolyte topic via the Brainscape platform, with an interval of spaced repetition. Post-tests (Fluid-Electrolyte Knowledge Test, and the Student Self-Efficacy Scale) will be administered at the end of the process.
Digital Flashcard Training & Post-test OnlyOther
Students in Group-D2 will receive standard lectures and will be trained using digital flashcards on the fluid-electrolyte topic via the Brainscape platform without taking a pre-test. Post-tests (Fluid-Electrolyte Knowledge Test, and the Student Self-Efficacy Scale) will be administered at the end of the process.
Standard Lecture Only & Pre-test/Post-testOther
A pre-test will be administered to students in Group-K1. Students will receive only standard lectures and traditional learning materials without any digital flashcard intervention. Post-tests (Fluid-Electrolyte Knowledge Test, and the Student Self-Efficacy Scale) will be administered at the end of the process.
Standard Lecture Only & Post-test OnlyOther
Students in Group-K2 will receive only standard lectures and traditional learning materials without taking a pre-test and without any digital flashcard intervention. Post-tests (Fluid-Electrolyte Knowledge Test, and the Student Self-Efficacy Scale) will be administered at the end of the process.
| Study group | Role | What they receive |
|---|---|---|
| Digital Flashcard Group 1 (D1) | Experimental | Students in this experimental group will take a pre-test (Fluid-Electrolyte Knowledge Test and Student Self-Efficacy Scale). They will receive standard lectures and will also be trained using digital flashcards on the fluid-electrolyte topic via the Brainscape platform. Finally, they will be administered the post-tests. Receives: Other: Digital Flashcard Training & Pre-test/Post-test |
| Digital Flashcard Group 2 (D2) | Experimental | Students in this experimental group will not take a pre-test. They will receive standard lectures and will be trained using digital flashcards on the fluid-electrolyte topic via the Brainscape platform. Finally, they will be administered the post-tests. Receives: Other: Digital Flashcard Training & Post-test Only |
| Control Group 1 (K1) | Active comparator | Students in this control group will take a pre-test (Fluid-Electrolyte Knowledge Test and Student Self-Efficacy Scale). They will receive only standard lectures and traditional learning materials without any digital flashcard intervention. Finally, they will be administered the post-tests. Receives: Other: Standard Lecture Only & Pre-test/Post-test |
| Control Group 2 (K2) | Active comparator | Students in this control group will not take a pre-test. They will receive only standard lectures and traditional learning materials without any digital flashcard intervention. Finally, they will be administered the post-tests. Receives: Other: Standard Lecture Only & Post-test Only |
What is being measured
The primary outcome is the main question the study is designed to answer.
Knowledge Level
The students' level of knowledge regarding fluid-electrolyte balance, tonicity, electrolyte imbalances, acid-base balance, and the associated surgical nursing care will be assessed using the Fluid-Electrolyte Knowledge Test developed by the researchers.
This test is an assessment tool consisting of 10 questions, each worth 10 points, for a total of 100 points. A high score will indicate a high level of knowledge on the part of the student.
Measured: Three days after the time of inclusion in the study.
Self-Efficacy Level
Students' self-efficacy levels and beliefs regarding the educational process will be evaluated using The Student Self-Efficacy Scale, developed by Rowbotham and Schmitz (2013) and adapted into Turkish by Yurtçiçek Eren and Başgöl (2023).
The scale, developed to assess students' self-efficacy levels, is unidimensional and consists of 10 items. The scale is designed using a 4-point Likert-type format. Higher scores indicate a high level of self-efficacy.
Measured: Three days after the time of inclusion in the study.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted9 Oct 2026
- Study start25 Sep 2026 (estimated)
- Primary completionOct 2026 (estimated)
- Study completionNov 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (6)Papers the sponsor has linked to this study.
- Other trials for EducationStudies of the same condition, open and under way.
- More trials run by Saglik Bilimleri UniversitesiThe 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
- Masking
- None (open label)
- Enrolment
- 180 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Saglik Bilimleri Universitesi
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Cansu YESİLFİDAN, Study director, Saglik Bilimleri Universitesi
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07869459
- Sponsor's protocol ID
- Flashcard Study
- Acronym
- Flashcards
- Status last verified
- Oct 2026
- First submitted
- 12 Sep 2026
- Last updated
- 9 Oct 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Sun M, Tsai S, Engle DL, Holmer S. Spaced Repetition Flashcards for Teaching Medical Students Psychiatry. Med Sci Educ. 2021 Apr 6;31(3):1125-1131. doi: 10.1007/s40670-021-01286-y. eCollection 2021 Jun.
PubMed 34457956Santos-Ferreira D, Guimaraes B, Ladeiras-Lopes R, Goncalves-Teixeira P, Diaz SO, Ferreira P, Goncalves F, Cardoso RG, Ferreira MA, Chaves PC, Fontes-Carvalho R, Leite-Moreira A. Digital flashcards and medical physiology performance: a dose-dependent effect. Adv Physiol Educ. 2024 Mar 1;48(1):80-87. doi: 10.1152/advan.00138.2023. Epub 2023 Nov 30.
PubMed 38031724Dunlosky J, Rawson KA, Marsh EJ, Nathan MJ, Willingham DT. Improving Students' Learning With Effective Learning Techniques: Promising Directions From Cognitive and Educational Psychology. Psychol Sci Public Interest. 2013 Jan;14(1):4-58. doi: 10.1177/1529100612453266.
PubMed 26173288Brocker, A., Sills, S., & Park, H. (2024). Self-efficacy and skill performance in undergraduate student nurses: A systematic review. Nurse Education Today.
Kornell, N. (2009). Optimising learning using flashcards: Spacing is more effective than cramming. Applied Cognitive Psychology, 23(9), 1297-1317.
Borhani F, Vatanparast M, Zadeh AA, Ranjbar H, Pour RS. Virtual education effect on cognitive learning and attitude of nursing students towards it. Iran J Nurs Midwifery Res. 2011 Fall;16(4):321-4.
PubMed 23450257
Study at a glance
From the registry record, last updated by the sponsor on 9 Oct 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Effect of the Digital Flashcard Method on Nursing Students' Knowledge and Self-Efficacy in Teaching Fluid-Electrolyte and Acid-Base Imbalances in a Surgical Nursing Course: A Solomon Four-Group Experimental Study
- ClinicalTrials.gov ID
- NCT07869459
- Acronym / sponsor ID
- Flashcards / Flashcard Study
- Conditions
- Education, Surgical Nursing, Teaching Methods
- Keywords
- Fluid and Electrolyte Balance, Solomon Four-Group Design, digital flashcard, surgical nursing education
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 180 participants (estimated)
- Lead sponsor
- Saglik Bilimleri UniversitesiUniversity, hospital or other
- Study start
- 25 Sep 2026 (estimated)
- Primary completion
- Oct 2026 (estimated)
- Study completion
- Nov 2026 (estimated)
- First posted
- 9 Oct 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 aims to investigate the effect of the digital flashcard method, compared to traditional lecturing, on students' knowledge levels and self-efficacy perceptions regarding fluid-electrolyte balance in the surgical nursing course, within a Solomon four-group experimental design framework.
Detailed description
In nursing education, the topic of fluid-electrolyte balance is one of the challenging subjects for students due to its physicochemical complexity, the multidimensionality of its clinical reflections, and the requirement to simultaneously comprehend processes such as preoperative fasting, intraoperative fluid-blood losses, and postoperative drainage management. Since traditional lecturing is based on passive learning, it alone may remain limited in supporting the long-term retention of knowledge in memory. To overcome this limitation, the digital flashcard method, which is based on the principles of active recall and spaced repetition, offers effective learning support. Moreover, pre-testing posing a potential artificial increase (sensitization) effect on post-test performance constitutes a methodological issue in nursing education. The lack of studies in the literature investigating the effect of the digital flashcard method on fluid-electrolyte balance using a Solomon four-group experimental design (controlling for the pre-test effect) renders this study necessary and original in terms of both knowledge level and self-efficacy perception based on Bandura's social cognitive theory. This research is a prospective study with a Solomon four-group experimental design to be conducted with second-year students. The study will include a total of four groups: two experimental (D1, D2) and two control (K1, K2) groups.Standard Practice: Students in all groups will receive the fluid-electrolyte content through traditional lecturing, writing boards, and written materials within the scope of the standard curriculum.
Group Applications: While a pre-test will be administered to the D1 and K1 groups prior to the education/application, no pre-test will be administered to the D2 and K2 groups. In addition to standard education, the experimental groups (D1 and D2) will receive digital flashcard training specific to the fluid-electrolyte topic via the Brainscape platform, which operates with a spaced-repetition algorithm. These cards will not be provided to the control groups during the intervention period; instead, access will be provided after the study in accordance with the ethical balance principle.Data: Data will be collected through the Introductory Information Form prepared by the researchers, the Fluid-Electrolyte Knowledge Test, and the Student Self-Efficacy Scale (SSES) developed by Rowbotham and Schmitz (2013).
Study design
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 4
| Arm | Type | Receives |
|---|---|---|
| Digital Flashcard Group 1 (D1) | Experimental | Other: Digital Flashcard Training & Pre-test/Post-testStudents in this experimental group will take a pre-test (Fluid-Electrolyte Knowledge Test and Student Self-Efficacy Scale). They will receive standard lectures and will also be trained using digital flashcards on the fluid-electrolyte topic via the Brainscape platform. Finally, they will be administered the post-tests. |
| Digital Flashcard Group 2 (D2) | Experimental | Other: Digital Flashcard Training & Post-test OnlyStudents in this experimental group will not take a pre-test. They will receive standard lectures and will be trained using digital flashcards on the fluid-electrolyte topic via the Brainscape platform. Finally, they will be administered the post-tests. |
| Control Group 1 (K1) | Active comparator | Other: Standard Lecture Only & Pre-test/Post-testStudents in this control group will take a pre-test (Fluid-Electrolyte Knowledge Test and Student Self-Efficacy Scale). They will receive only standard lectures and traditional learning materials without any digital flashcard intervention. Finally, they will be administered the post-tests. |
| Control Group 2 (K2) | Active comparator | Other: Standard Lecture Only & Post-test OnlyStudents in this control group will not take a pre-test. They will receive only standard lectures and traditional learning materials without any digital flashcard intervention. Finally, they will be administered the post-tests. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- Being enrolled in the Surgical Nursing Course
- Agreeing to participate voluntarily in the research
- Not having previously received fluid-electrolyte education through any digital flashcard application
Key exclusion criteria (2 listed)
- Having previously taken the Surgical Nursing Course
- Failing to attend any of the measurement sessions
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 |
|---|---|---|
| Digital Flashcard Training & Pre-test/Post-testA pre-test will be administered to students in Group-D1. Students will receive standard lectures and will be trained using digital flashcards on the fluid-electrolyte topic via the Brainscape platform, with an interval of spaced repetition. Post-tests (Fluid-Electrolyte Knowledge Test, and the Student Self-Efficacy Scale) will be administered at the end of the process. | Other | Digital Flashcard Group 1 (D1) |
| Digital Flashcard Training & Post-test OnlyStudents in Group-D2 will receive standard lectures and will be trained using digital flashcards on the fluid-electrolyte topic via the Brainscape platform without taking a pre-test. Post-tests (Fluid-Electrolyte Knowledge Test, and the Student Self-Efficacy Scale) will be administered at the end of the process. | Other | Digital Flashcard Group 2 (D2) |
| Standard Lecture Only & Pre-test/Post-testA pre-test will be administered to students in Group-K1. Students will receive only standard lectures and traditional learning materials without any digital flashcard intervention. Post-tests (Fluid-Electrolyte Knowledge Test, and the Student Self-Efficacy Scale) will be administered at the end of the process. | Other | Control Group 1 (K1) |
| Standard Lecture Only & Post-test OnlyStudents in Group-K2 will receive only standard lectures and traditional learning materials without taking a pre-test and without any digital flashcard intervention. Post-tests (Fluid-Electrolyte Knowledge Test, and the Student Self-Efficacy Scale) will be administered at the end of the process. | Other | Control Group 2 (K2) |
Primary outcome
Knowledge Level
Time frame: Three days after the time of inclusion in the study.
The students' level of knowledge regarding fluid-electrolyte balance, tonicity, electrolyte imbalances, acid-base balance, and the associated surgical nursing care will be assessed using the Fluid-Electrolyte Knowledge Test developed by the researchers. This test is an assessment tool consisting of 10 questions, each worth 10 points, for a total of 100 points. A high score will indicate a high level of knowledge on the part of the student.
Self-Efficacy Level
Time frame: Three days after the time of inclusion in the study.
Students' self-efficacy levels and beliefs regarding the educational process will be evaluated using The Student Self-Efficacy Scale, developed by Rowbotham and Schmitz (2013) and adapted into Turkish by Yurtçiçek Eren and Başgöl (2023). The scale, developed to assess students' self-efficacy levels, is unidimensional and consists of 10 items. The scale is designed using a 4-point Likert-type format. Higher scores indicate a high level of self-efficacy.
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 9 Oct 2026.
- Background: PubMed 34457956Sun M, Tsai S, Engle DL, Holmer S. Spaced Repetition Flashcards for Teaching Medical Students Psychiatry. Med Sci Educ. 2021 Apr 6;31(3):1125-1131. doi: 10.1007/s40670-021-01286-y. eCollection 2021 Jun.
- Background: PubMed 38031724Santos-Ferreira D, Guimaraes B, Ladeiras-Lopes R, Goncalves-Teixeira P, Diaz SO, Ferreira P, Goncalves F, Cardoso RG, Ferreira MA, Chaves PC, Fontes-Carvalho R, Leite-Moreira A. Digital flashcards and medical physiology performance: a dose-dependent effect. Adv Physiol Educ. 2024 Mar 1;48(1):80-87. doi: 10.1152/advan.00138.2023. Epub 2023 Nov 30.
- Background: PubMed 26173288Dunlosky J, Rawson KA, Marsh EJ, Nathan MJ, Willingham DT. Improving Students' Learning With Effective Learning Techniques: Promising Directions From Cognitive and Educational Psychology. Psychol Sci Public Interest. 2013 Jan;14(1):4-58. doi: 10.1177/1529100612453266.
- BackgroundBrocker, A., Sills, S., & Park, H. (2024). Self-efficacy and skill performance in undergraduate student nurses: A systematic review. Nurse Education Today.
- BackgroundKornell, N. (2009). Optimising learning using flashcards: Spacing is more effective than cramming. Applied Cognitive Psychology, 23(9), 1297-1317.
- Background: PubMed 23450257Borhani F, Vatanparast M, Zadeh AA, Ranjbar H, Pour RS. Virtual education effect on cognitive learning and attitude of nursing students towards it. Iran J Nurs Midwifery Res. 2011 Fall;16(4):321-4.
- Individual participant dataSharing planned: No
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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.
Neslihan ILKAZ, PhD contact
Cansu YESİLFİDAN study director
Saglik Bilimleri Universitesi
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Digital Flashcard Training & Pre-test/Post-test, Digital Flashcard Training & Post-test Only and Standard Lecture Only & Pre-test/Post-test in people with Education and Surgical Nursing, run by Saglik Bilimleri Universitesi 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 3 inclusion and 2 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 9 Oct 2026. 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?
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 Cansu YESİLFİDAN, Ph.D. Candidate (+90 538 819 2590, c.cansucil@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Knowledge Level (time frame: Three days after the time of inclusion in the study.). The study lists 2 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 NCT07869459, which also lists 6 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 9 Oct 2026.