Nursing StudentsNCT07670481
CREATIVE DRAMA-BASED FORGIVENESS TRAINING FOR NURSING STUDENTS
A study testing Creative Drama and Case-Based Learning in people with Nursing Students, run by Abant Izzet Baysal University at 1 site in Turkey (Türkiye).
Trial summary
Nursing students frequently encounter difficult patient behaviors that may evoke negative emotions such as anger, frustration, and helplessness. Forgiveness may be a useful resource for managing these experiences; however, evidence on effective educational approaches for fostering forgiveness in nursing education is… Read more about this study
- Who is it for?
- Ages 18 years and olderHealthy volunteers can take part
- Conditions the study is for
- Nursing Students
- What is being tested?
- Creative Drama and Case-Based Learning
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 80 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 6 Apr 2025to 6 Apr 2026
- 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
- Fourth-year nursing student enrolled in the nursing department of the study university
- Aged 18 years or older
- Able to speak and understand Turkish
- Not repeating the academic year
- Willing to participate and provided written informed consent
Who cannot join
- Refused to participate or withdrew consent
- Did not meet the inclusion criteria
- Did not complete the educational intervention or post-intervention assessments
Trial locations and contacts
1 site in 1 country.
Turkey (Türkiye)1 site
Sivas Cumhuriyet University
Sivas, Sivas, 58600
About this study
Official title: CREATIVE DRAMA-BASED FORGIVENESS EDUCATION FOR DIFFICULT PATIENT ENCOUNTERS AMONG NURSING STUDENTS: A RANDOMIZED CONTROLLED TRIAL
Nursing students frequently encounter difficult patient behaviors that may evoke negative emotions such as anger, frustration, and helplessness. Forgiveness may be a useful resource for managing these experiences; however, evidence on effective educational approaches for fostering forgiveness in nursing education is limited. This randomized controlled trial evaluated the effects of creative drama-based and case-based forgiveness education on nursing students' forgiveness of others and self-forgiveness in the context of difficult patient encounters. Eighty fourth-year nursing students were randomly assigned to either a creative drama group or a case-based learning group. Both groups participated in four educational sessions (200 minutes in total). Outcomes were assessed using the Forgiveness of Others Scale and the Self-Forgiveness Scale before and immediately after the intervention.
Read the detailed description
Nursing students interact with patients with diverse characteristics during clinical practice. While some patients are cooperative and communicative, others may display aggressive, anxious, demanding, resistant, manipulative, or verbally abusive behaviors. Such difficult patient behaviors may evoke negative emotions in students, including anger, frustration, helplessness, anxiety, and emotional distress. These experiences may also negatively affect students' caregiving relationships, communication processes, and professional development.
Forgiveness is defined as a dynamic process through which individuals transform negative emotions, such as anger, resentment, hostility, and the desire for revenge, into more understanding, accepting, and compassionate responses. In addition to forgiving others, self-forgiveness may help individuals acknowledge their own mistakes and cope more adaptively with feelings of guilt, regret, and self-criticism. Therefore, forgiveness is considered an important personal and professional resource that may support healthcare professionals and students in coping with difficult interpersonal experiences.
However, evidence regarding effective educational approaches for fostering forgiveness in nursing education remains limited. The abstract and multidimensional nature of forgiveness requires students not only to understand the concept theoretically but also to experience it, develop different perspectives, and cultivate empathy. In this context, student-centered and experiential teaching methods, such as creative drama and case-based learning, may represent potentially useful approaches for developing forgiveness skills.
This randomized controlled pretest-posttest study aimed to evaluate the effects of creative drama-based and case-based forgiveness education on nursing students' forgiveness of others and self-forgiveness in the context of difficult patient encounters. The study was conducted with 80 fourth-year nursing students enrolled in the nursing department of a university in Eastern Türkiye. Participants were randomly assigned to either a creative drama group (n=40) or a case-based learning group (n=40).
Both groups participated in four structured educational sessions totaling 200 minutes. The interventions were based on difficult patient scenarios and were organized around the themes of forgiveness of others and self-forgiveness. In the creative drama group, students actively participated in role-playing, enactment, perspective-taking, empathy development, and reflective activities. In the case-based learning group, students analyzed the same scenarios, identified problems, discussed potential causes, and evaluated alternative courses of action. Outcomes were assessed using the Forgiveness of Others Scale and the Self-Forgiveness Scale before and immediately after the intervention.
- Conditions
- Nursing Students
- Being tested
- Creative Drama, Case-Based Learning
- Keywords
- Forgiveness, Difficult Patient, Creative Drama, Case-Based Learning, Nursing Students
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Creative DramaOther
Participants received creative drama-based forgiveness education focusing on forgiveness of others and self-forgiveness in the context of difficult patient encounters. The intervention consisted of four structured sessions totaling 200 minutes. Educational activities included role-playing, improvisation, perspective-taking, empathy development, and reflection exercises. Students experienced both nurse and difficult patient roles and explored the emotions and unmet needs underlying difficult patient behaviors from multiple perspectives.
Case-Based LearningOther
Participants received case-based forgiveness education focusing on forgiveness of others and self-forgiveness in the context of difficult patient encounters. The intervention consisted of four structured sessions totaling 200 minutes. Difficult patient scenarios were used during the sessions, and students read and analyzed the cases, identified problems, discussed underlying causes and different perspectives, and evaluated potential courses of action.
| Study group | Role | What they receive |
|---|---|---|
| Creative Drama | Experimental | Not described Receives: Other: Creative Drama |
| Case-Based Learning | Active comparator | Not described Receives: Other: Case-Based Learning |
What is being measured
The primary outcome is the main question the study is designed to answer.
Forgiveness of Others
Change in Forgiveness of Others Scale (FOS) scores from baseline to immediately after the educational intervention.
Forgiveness of Others Scale (FOS): The Forgiveness of Others Scale was developed by Rye (1998) and later revised by Rye et al. (2001) to assess individuals' tendency to forgive others (Rye et al., 2001). The Turkish validity and reliability study of the scale was conducted by Havare and Gizir (2020). The Turkish version consists of 15 items, and items 1, 3, 4, 5, 8, 10, 12, and 14 are reverse scored. Responses are rated on a 5-point Likert-type scale ranging from "strongly disagree (1)" to "strongly agree (5)." Higher scores indicate a greater tendency to forgive others. The Cronbach's α coefficient of the Turkish version was reported as 0.75 (Havare \& Gizir, 2020). In the present study, the Cronbach's α coefficient calculated from the pretest data was 0.77 for the experimental group and 0.81 for the control group.
Measured: Baseline and immediately after completion of the intervention (same day)
Secondary outcomes (1)
Self-Forgiveness
Change in Self-Forgiveness Scale (SFS) scores from baseline to immediately after the educational intervention.
Self-Forgiveness Scale (SFS): The Self-Forgiveness Scale, developed by Wohl, DeShea, and Wahkinney (2008), was designed to assess individuals' tendency toward self-forgiveness (Wohl et al., 2008). The Turkish validity and reliability study of the scale was conducted by Havare and Gizir (2020). The Turkish version consists of 12 items rated on a 4-point Likert-type scale ranging from 1 (never) to 4 (always). Higher scores indicate a greater tendency toward self-forgiveness. The Cronbach's α coefficient of the Turkish version was reported as 0.87 (Havare \& Gizir, 2020). In the present study, the Cronbach's α coefficient calculated from the pretest data was 0.74 for the experimental group and 0.78 for the control group.
Measured: Baseline and immediately after completion of the intervention (same day)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted26 Jun 2026
- Study start6 Apr 2025
- Primary completion6 Apr 2025
- Study completion6 Apr 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Nursing StudentsStudies 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
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Participants were randomly assigned in a 1:1 ratio to either a creative drama-based forgiveness education group or a case-based forgiveness education group. Both groups received four structured educational sessions totaling 200 minutes and covering the themes of forgiveness of others and self-forgiveness in the context of difficult patient encounters. Outcomes were assessed before and immediately after the intervention.
- Masking
- None (open label)
- Enrolment
- 80 participants (actual)
Sponsor and investigators
- Lead sponsor
- Abant Izzet Baysal University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Lutfiye Nur Uzun, Cumhuriyet University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07670481
- Sponsor's protocol ID
- FORGIVE-RCT-2025
- Status last verified
- Jun 2026
- First submitted
- 22 Jun 2026
- Last updated
- 29 Jun 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 29 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- CREATIVE DRAMA-BASED FORGIVENESS EDUCATION FOR DIFFICULT PATIENT ENCOUNTERS AMONG NURSING STUDENTS: A RANDOMIZED CONTROLLED TRIAL
- ClinicalTrials.gov ID
- NCT07670481
- Acronym / sponsor ID
- FORGIVE-RCT-2025
- Conditions
- Nursing Students
- Keywords
- Forgiveness, Difficult Patient, Creative Drama, Case-Based Learning, Nursing Students
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 80 participants (actual)
- Lead sponsor
- Abant Izzet Baysal UniversityUniversity, hospital or other
- Study start
- 6 Apr 2025 (actual)
- Primary completion
- 6 Apr 2025 (actual)
- Study completion
- 6 Apr 2026 (actual)
- First posted
- 26 Jun 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.
Nursing students frequently encounter difficult patient behaviors that may evoke negative emotions such as anger, frustration, and helplessness. Forgiveness may be a useful resource for managing these experiences; however, evidence on effective educational approaches for fostering forgiveness in nursing education is limited. This randomized controlled trial evaluated the effects of creative drama-based and case-based forgiveness education on nursing students' forgiveness of others and self-forgiveness in the context of difficult patient encounters. Eighty fourth-year nursing students were randomly assigned to either a creative drama group or a case-based learning group. Both groups participated in four educational sessions (200 minutes in total). Outcomes were assessed using the Forgiveness of Others Scale and the Self-Forgiveness Scale before and immediately after the intervention.
Detailed description
Nursing students interact with patients with diverse characteristics during clinical practice. While some patients are cooperative and communicative, others may display aggressive, anxious, demanding, resistant, manipulative, or verbally abusive behaviors. Such difficult patient behaviors may evoke negative emotions in students, including anger, frustration, helplessness, anxiety, and emotional distress. These experiences may also negatively affect students' caregiving relationships, communication processes, and professional development.
Forgiveness is defined as a dynamic process through which individuals transform negative emotions, such as anger, resentment, hostility, and the desire for revenge, into more understanding, accepting, and compassionate responses. In addition to forgiving others, self-forgiveness may help individuals acknowledge their own mistakes and cope more adaptively with feelings of guilt, regret, and self-criticism. Therefore, forgiveness is considered an important personal and professional resource that may support healthcare professionals and students in coping with difficult interpersonal experiences.
However, evidence regarding effective educational approaches for fostering forgiveness in nursing education remains limited. The abstract and multidimensional nature of forgiveness requires students not only to understand the concept theoretically but also to experience it, develop different perspectives, and cultivate empathy. In this context, student-centered and experiential teaching methods, such as creative drama and case-based learning, may represent potentially useful approaches for developing forgiveness skills.
This randomized controlled pretest-posttest study aimed to evaluate the effects of creative drama-based and case-based forgiveness education on nursing students' forgiveness of others and self-forgiveness in the context of difficult patient encounters. The study was conducted with 80 fourth-year nursing students enrolled in the nursing department of a university in Eastern Türkiye. Participants were randomly assigned to either a creative drama group (n=40) or a case-based learning group (n=40).
Both groups participated in four structured educational sessions totaling 200 minutes. The interventions were based on difficult patient scenarios and were organized around the themes of forgiveness of others and self-forgiveness. In the creative drama group, students actively participated in role-playing, enactment, perspective-taking, empathy development, and reflective activities. In the case-based learning group, students analyzed the same scenarios, identified problems, discussed potential causes, and evaluated alternative courses of action. Outcomes were assessed using the Forgiveness of Others Scale and the Self-Forgiveness Scale before and immediately after the intervention.
Study design
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
- Model description
- Participants were randomly assigned in a 1:1 ratio to either a creative drama-based forgiveness education group or a case-based forgiveness education group. Both groups received four structured educational sessions totaling 200 minutes and covering the themes of forgiveness of others and self-forgiveness in the context of difficult patient encounters. Outcomes were assessed before and immediately after the intervention.
| Arm | Type | Receives |
|---|---|---|
| Creative Drama | Experimental | Other: Creative Drama |
| Case-Based Learning | Active comparator | Other: Case-Based Learning |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- Fourth-year nursing student enrolled in the nursing department of the study university
- Aged 18 years or older
- Able to speak and understand Turkish
- Not repeating the academic year
- Willing to participate and provided written informed consent
Key exclusion criteria (3 listed)
- Refused to participate or withdrew consent
- Did not meet the inclusion criteria
- Did not complete the educational intervention or post-intervention assessments
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 |
|---|---|---|
| Creative DramaParticipants received creative drama-based forgiveness education focusing on forgiveness of others and self-forgiveness in the context of difficult patient encounters. The intervention consisted of four structured sessions totaling 200 minutes. Educational activities included role-playing, improvisation, perspective-taking, empathy development, and reflection exercises. Students experienced both nurse and difficult patient roles and explored the emotions and unmet needs underlying difficult patient behaviors from multiple perspectives. | Other | Creative Drama |
| Case-Based LearningParticipants received case-based forgiveness education focusing on forgiveness of others and self-forgiveness in the context of difficult patient encounters. The intervention consisted of four structured sessions totaling 200 minutes. Difficult patient scenarios were used during the sessions, and students read and analyzed the cases, identified problems, discussed underlying causes and different perspectives, and evaluated potential courses of action. | Other | Case-Based Learning |
Primary outcome
Forgiveness of Others
Time frame: Baseline and immediately after completion of the intervention (same day)
Change in Forgiveness of Others Scale (FOS) scores from baseline to immediately after the educational intervention. Forgiveness of Others Scale (FOS): The Forgiveness of Others Scale was developed by Rye (1998) and later revised by Rye et al. (2001) to assess individuals' tendency to forgive others (Rye et al., 2001). The Turkish validity and reliability study of the scale was conducted by Havare and Gizir (2020). The Turkish version consists of 15 items, and items 1, 3, 4, 5, 8, 10, 12, and 14 are reverse scored. Responses are rated on a 5-point Likert-type scale ranging from "strongly disagree (1)" to "strongly agree (5)." Higher scores indicate a greater tendency to forgive others. The Cronbach's α coefficient of the Turkish version was reported as 0.75 (Havare \& Gizir, 2020). In the present study, the Cronbach's α coefficient calculated from the pretest data was 0.77 for the experimental group and 0.81 for the control group.
1 secondary outcome
Self-Forgiveness
Time frame: Baseline and immediately after completion of the intervention (same day)
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 29 Jun 2026.
- 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. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Creative Drama and Case-Based Learning in people with Nursing Students, run by Abant Izzet Baysal 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 5 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 29 Jun 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?
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?
Forgiveness of Others (time frame: Baseline and immediately after completion of the intervention (same day)). 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 29 Jun 2026.