Assessment of Physical Examination Skills for the Cardiovascular SystemNCT07733479

Examining the Effects of ARCS-Based Education on Cardiovascular System Physical Examination Skills, Motivation, and Self-Efficacy Levels in Nursing Students

A study testing ARCS Model Education and Structured Supplementary Training Based on the ARCS Motivation Model in people with Assessment of Physical Examination Skills for the Cardiovascular System and Determining Levels of Academic Self-Efficacy, run by Cumhuriyet University at 1 site in Turkey (Türkiye).

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record

Search all trials

Trial summary

Objective: The purpose of this study is to determine the effect of ARCS-based nursing education on skill levels, motivation, and self-efficacy in the physical examination of the cardiovascular system. Read more about this study

Who is it for?: Any ageHealthy volunteers can take part
Conditions the study is for: Assessment of Physical Examination Skills for the Cardiovascular System, Determining Levels of Academic Self-Efficacy, Determining Motivation Levels
What is being tested?: ARCS Model Education and Structured Supplementary Training Based on the ARCS Motivation Model
Could I receive a placebo?: No, everyone receives an active treatment
How many people: 100 participants
Where: 1 siteTurkey (Türkiye)
Study dates: 7 May 2026to 15 Jun 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 Any age
All sexes
Healthy volunteers accepted
Child, Adult, Older adult

Who may be able to join

Being a second-year nursing student (18-25 years old),
Taking the physical examination course for the first time
Voluntarily agreeing to participate in the study

Who cannot join

Being a student transferring from another program,
Having difficulty understanding and speaking Turkish
Having graduated from a Health Vocational High School
Currently participating in any training related to physical examination in nursing; Not having taken courses related to physical examination of the cardiovascular system Withdrawing from the study or revoking consent during the research,

Trial locations and contacts

1 site in 1 country.

Turkey (Türkiye)1 site

TOGÜ SBF
Tokat Province, 60000

Other trials in Turkey (Türkiye)

About this study

Official title: Examining the Effects of ARCS-Based Education on Cardiovascular System Physical Examination Skills, Motivation, and Self-Efficacy Levels in Nursing Students: A Randomized Controlled Experimental Study

Background: In nursing education, it is crucial for students to acquire skills in comprehensive patient assessment and physical examination. Motivation and academic self-efficacy are key factors in education and academic success.

Methods: This study was conducted during the Spring Semester of 2025-2026 with 100 second-year students enrolled in the Department of Nursing at Tokat Gaziosmanpaşa University's Faculty of Health Sciences, as part of the Health Assessment course. Students who received cardiovascular system education using traditional methods were assigned to experimental and control groups. The experimental group also received training based on the ARCS motivation model. Data were collected using a Personal Information Form, a Cardiovascular System Examination Skills Assessment Form, the "Motivation Scale for Instructional Material," and the "Academic Self-Efficacy Scale." This randomized controlled experimental study was conducted and reported in accordance with the CONSORT guidelines

Conditions: Assessment of Physical Examination Skills for the Cardiovascular System, Determining Levels of Academic Self-Efficacy, Determining Motivation Levels, Evaluation of the Effectiveness of the ARCS Intervention
Being tested: ARCS Model Education, Structured Supplementary Training Based on the ARCS Motivation Model
Keywords: Physical Examination, Motivation, Nursing Education, ARCS
Medical subject headings: Arthrogryposis renal dysfunction cholestasis syndrome

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

ARCS Model EducationOther
The experimental group received a total of two hours (120 minutes) of supplementary training, structured by the same instructor based on the ARCS (Attention, Relevance, Confidence, Satisfaction) Motivation Model. This training was conducted in accordance with the model's four components, using the following activities in sequence:
Structured Supplementary Training Based on the ARCS Motivation ModelOther
The experimental group received a total of two hours (120 minutes) of supplementary training, structured by the same instructor based on the ARCS (Attention, Relevance, Confidence, Satisfaction) Motivation Model. This training was conducted in accordance with the model's four components, using the following activities in sequence:

Study groups in NCT07733479
Study group	Role	What they receive
ARCS Experimental Group	Experimental	ARCS Model Training The experimental group received a total of two hours (120 minutes) of supplementary training, structured by the same instructor based on the ARCS (Attention, Relevance, Confidence, Satisfaction) Motivation Model. This training was conducted in accordance with the model's four components, using the following activities in sequence: Attention Component , Relevance Component , Confidence Component , Satisfaction Component Receives: Other: ARCS Model Education; Other: Structured Supplementary Training Based on the ARCS Motivation Model
Control Group: Traditional Reinforcement Training	No intervention	The control group received reinforcement training using the traditional question-and-answer method, conducted by the same instructor during the same time period (one week later). During this process, the instructor summarized and reviewed the topics covered in the four-hour basic training on cardiovascular system examination (history-taking, inspection, palpation, percussion, auscultation, heart sounds, peripheral pulse, and circulation assessment); the instructor verbally assessed the students' level of understanding by asking them questions in sequence. Based on the students' responses, any gaps or misunderstandings were verbally corrected; however, motivational and interactive activities-such as scenario-based exercises, role-playing, station-based activities, immediate feedback, or rewards-which were implemented in the experimental group, were not included. The control group's training was completed in the same amount of time (two hours) as the experimental group's but was conduct

What is being measured

The primary outcome is the main question the study is designed to answer.

Motivation Scale for Instructional Material
It is assessed using a 5-point Likert-type scale, and the total score range is between 33 and 165 point; an increase in score is interpreted as an increase in motivation. an increase in score is interpreted as an increase in motivation. The lower and upper score ranges are categorized as very low (33-37) and very high (161-165), respectively.
Measured: The assessment will be conducted in two separate time periods. The first assessment will be immediately before the training, and the second assessment will be two weeks after the training (post-training test).
Academic Self-Efficacy Scale:
To assess academic self-efficacy, the "Academic Self-Efficacy Scale"-developed by Owen and Froman (1988) and adapted into Turkish by Ekici (2012) was used. It is noted that the scale consists of a total of 33 items and 3 dimensions, and that it can be used as a single-dimension scale. The scale is scored on a five-point Likert scale. The total score ranges from 33 to 165. The scale's subdimensions are listed as social status, cognitive applications, and technical skills. In the validity and reliability study of the Turkish version of the scale, the Cronbach's Alpha value was found to be 0.86 (Ekici, 2012). In this study, Cronbach's Alpha values were found to be 0.904 for the pretest and 0.963 for the posttest.
Measured: The assessment will be conducted in two separate time periods. The first assessment will be immediately before the training, and the second assessment will be two weeks after the training (post-training test).
Cardiac and Circulatory System Examination Skills Assessment Form:
A 54-item form covering the cardiovascular system examination-including taking a medical history, identifying key areas when auscultating heart sounds, and using inspection, palpation, and auscultation methods, as well as assessing the jugular vein, carotid artery, and capillary refill-has been developed in accordance with the literature (Özden, 2024; Yava and Koyuncu, 2017). This form was used as part of a post-education structured clinical examination (OSCE) to assess students' skills. Three categories were established for student evaluations, and the ability to perform the task described in the relevant item was scored as follows: Performed: 2 points; Incomplete/Incorrect: 1 point; Did Not Perform: 0 points. A maximum score of 0-108 points can be achieved on the skills form. A high score indicates good skill development.
Measured: The assessment will be conducted by OSCE two weeks after the training, during the students' practical applications.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

7 May 202615 Jun 2026

First posted29 Jul 2026
Study start7 May 2026
Primary completion15 May 2026
Study completion15 Jun 2026

Resources

Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
Publications (12)Papers the sponsor has linked to this study.
Other trials for Assessment of Physical Examination Skills for the Cardiovascular SystemStudies 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
Masking: Single blind
Who is masked: Outcomes assessor
Enrolment: 100 participants (actual)

IDs, dates and publications

ClinicalTrials.gov ID: NCT07733479
Sponsor's protocol ID: TOGU SBF
Status last verified: Jul 2025
First submitted: 7 Jul 2026
Last updated: 29 Jul 2026
Results posted: No
Data monitoring committee: No
FDA-regulated drug: No
FDA-regulated device: No
Individual data sharing: No: In order to protect personal data, the data is not available for sharing.

Publications

Jeong, H., Kim, S., & Park, Y. (2023a). Effectiveness of ARCS-based simulation on nursing students' communication competence. Nurse Education Today, 124, 105690. https://doi.org/10.1016/j.nedt.2023.105690
Erden Y, Uludag E, Albayrak O. Examining the effects of ARCS-based urinary catheter education on first-year nursing students' learning motivation, self-efficacy and clinical skill levels. Nurse Educ Pract. 2025 Nov;89:104598. doi: 10.1016/j.nepr.2025.104598. Epub 2025 Oct 30.
PubMed 41175787
Chen PJ, Liou WK, Chen MJ. Effects of an ARCS-based interactive e-book featuring clinical scenarios on the learning motivation, self-efficacy and practical competence of nursing students in foetal heart rate interpretation. Nurse Educ Pract. 2025 Feb;83:104261. doi: 10.1016/j.nepr.2025.104261. Epub 2025 Jan 18.
PubMed 39855069
Chao HM, Chen SW, Chao SM. Effects of mobile learning applications for physical examination among nurse students: Use of the cardiovascular system. Nurse Educ Pract. 2025 Nov;89:104620. doi: 10.1016/j.nepr.2025.104620. Epub 2025 Oct 31.
PubMed 41192101
Chang, C. C., Lee, T. H., & Tseng, H. H. (2024). Applying the ARCS model to enhance student motivation and engagement in distance education. Interactive Learning Environments, 32(1), 45-62. https://doi.org/10.1080/10494820.2022.2045721
Cai, Y., Xie, X., & Zhang, L. (2022). Enhancing nursing students' critical thinking and self-directed learning via ARCS-based blended teaching. BMC Nursing, 21(1), 1-9. https://doi.org/10.1186/s12912-022-00842-5
Andrade IRC, Queiroz JC, Farias MS, Maia NPDS, Silva LFD. Clinical simulation in the teaching of cardiovascular physical examination with nursing students: a systematic review. Rev Bras Enferm. 2025 Mar 10;78(1):e20230429. doi: 10.1590/0034-7167-2023-0429. eCollection 2025.
PubMed 40072983
Althubaiti A. Sample size determination: A practical guide for health researchers. J Gen Fam Med. 2022 Dec 14;24(2):72-78. doi: 10.1002/jgf2.600. eCollection 2023 Mar.
PubMed 36909790
Alharbi, M., Kang, H., & Noh, H. (2021). The effects of ARCS-based e-learning on learners' motivation and learning achievement in a medical informatics course. International Journal of Emerging Technologies in Learning (iJET), 16(9), 203-214. https://doi.org/10.3991/ijet.v16i09.21459
Ajemba, M. N., Ikwe, C., & Iroanya, J. C. (2024). Effectiveness of simulation-based training in medical education: assessing the impact of simulation-based training on clinical skills acquisition and retention: a systematic review. World Journal of Advanced Research and Reviews, 21(1), 1833-1843. https://doi.org/10.30574/wjarr.2024.21.1.0163
Kavak HK, Kazanc S. The effect of ARCS motivational model-based education on nursing students' communication skills, learning motivation, and self-efficacy: a mixed-methods randomized controlled intervention study. BMC Med Educ. 2026 Feb 7;26(1):525. doi: 10.1186/s12909-026-08724-8.
PubMed 41654826
Bozkurt T, Nacak UA, Karakas E, Ciftci B. The effect of stoma care teaching based on the ARCS motivation model on nursing students' learning motivation, self-efficacy and knowledge levels. Nurse Educ Pract. 2025 Jan;82:104207. doi: 10.1016/j.nepr.2024.104207. Epub 2024 Dec 2.
PubMed 39647174

Study at a glance

From the registry record, last updated by the sponsor on 29 Jul 2026. Recruitment status is as the sponsor reported it: confirm with the study team.

Official title: Examining the Effects of ARCS-Based Education on Cardiovascular System Physical Examination Skills, Motivation, and Self-Efficacy Levels in Nursing Students: A Randomized Controlled Experimental Study
ClinicalTrials.gov ID: NCT07733479
Acronym / sponsor ID: TOGU SBF
Conditions: Assessment of Physical Examination Skills for the Cardiovascular System, Determining Levels of Academic Self-Efficacy, Determining Motivation Levels, Evaluation of the Effectiveness of the ARCS Intervention
Keywords: Physical Examination, Motivation, Nursing Education, ARCS
Study type: Interventional
Recruitment status: Completed
Enrolment: 100 participants (actual)
Lead sponsor: Cumhuriyet UniversityUniversity, hospital or other
Study start: 7 May 2026 (actual)
Primary completion: 15 May 2026 (actual)
Study completion: 15 Jun 2026 (actual)
First posted: 29 Jul 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.

Study design

Primary purpose: Other
Allocation: Randomised
Intervention model: Parallel groups
Masking: Single blind (outcomes assessor)
Number of arms: 2

Arm	Type	Receives
ARCS Experimental Group	Experimental	Other: ARCS Model Education, Other: Structured Supplementary Training Based on the ARCS Motivation ModelARCS Model Training The experimental group received a total of two hours (120 minutes) of supplementary training, structured by the same instructor based on the ARCS (Attention, Relevance, Confidence, Satisfaction) Motivation Model. This training was conducted in accordance with the model's four components, using the following activities in sequence: Attention Component , Relevance Component , Confidence Component , Satisfaction Component
Control Group: Traditional Reinforcement Training	No intervention	–The control group received reinforcement training using the traditional question-and-answer method, conducted by the same instructor during the same time period (one week later). During this process, the instructor summarized and reviewed the topics covered in the four-hour basic training on cardiovascular system examination (history-taking, inspection, palpation, percussion, auscultation, heart sounds, peripheral pulse, and circulation assessment); the instructor verbally assessed the students' level of understanding by asking them questions in sequence. Based on the students' responses, any gaps or misunderstandings were verbally corrected; however, motivational and interactive activities-such as scenario-based exercises, role-playing, station-based activities, immediate feedback, or rewards-which were implemented in the experimental group, were not included. The control group's training was completed in the same amount of time (two hours) as the experimental group's but was conduct

Who may qualify

Sex: All
Healthy volunteers: Accepted
Age groups: Child, Adult, Older adult

Key inclusion criteria (3 listed)

Being a second-year nursing student (18-25 years old),
Taking the physical examination course for the first time
Voluntarily agreeing to participate in the study

Key exclusion criteria (4 listed)

Being a student transferring from another program,
Having difficulty understanding and speaking Turkish
Having graduated from a Health Vocational High School
Currently participating in any training related to physical examination in nursing; Not having taken courses related to physical examination of the cardiovascular system Withdrawing from the study or revoking consent during the research,

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
ARCS Model EducationThe experimental group received a total of two hours (120 minutes) of supplementary training, structured by the same instructor based on the ARCS (Attention, Relevance, Confidence, Satisfaction) Motivation Model. This training was conducted in accordance with the model's four components, using the following activities in sequence:	Other	ARCS Experimental Group
Structured Supplementary Training Based on the ARCS Motivation ModelThe experimental group received a total of two hours (120 minutes) of supplementary training, structured by the same instructor based on the ARCS (Attention, Relevance, Confidence, Satisfaction) Motivation Model. This training was conducted in accordance with the model's four components, using the following activities in sequence:	Other	ARCS Experimental Group

Primary outcome

Motivation Scale for Instructional Material
Time frame: The assessment will be conducted in two separate time periods. The first assessment will be immediately before the training, and the second assessment will be two weeks after the training (post-training test).
It is assessed using a 5-point Likert-type scale, and the total score range is between 33 and 165 point; an increase in score is interpreted as an increase in motivation. an increase in score is interpreted as an increase in motivation. The lower and upper score ranges are categorized as very low (33-37) and very high (161-165), respectively.
Academic Self-Efficacy Scale:
Time frame: The assessment will be conducted in two separate time periods. The first assessment will be immediately before the training, and the second assessment will be two weeks after the training (post-training test).
To assess academic self-efficacy, the "Academic Self-Efficacy Scale"-developed by Owen and Froman (1988) and adapted into Turkish by Ekici (2012) was used. It is noted that the scale consists of a total of 33 items and 3 dimensions, and that it can be used as a single-dimension scale. The scale is scored on a five-point Likert scale. The total score ranges from 33 to 165. The scale's subdimensions are listed as social status, cognitive applications, and technical skills. In the validity and reliability study of the Turkish version of the scale, the Cronbach's Alpha value was found to be 0.86 (Ekici, 2012). In this study, Cronbach's Alpha values were found to be 0.904 for the pretest and 0.963 for the posttest.
Cardiac and Circulatory System Examination Skills Assessment Form:
Time frame: The assessment will be conducted by OSCE two weeks after the training, during the students' practical applications.
A 54-item form covering the cardiovascular system examination-including taking a medical history, identifying key areas when auscultating heart sounds, and using inspection, palpation, and auscultation methods, as well as assessing the jugular vein, carotid artery, and capillary refill-has been developed in accordance with the literature (Özden, 2024; Yava and Koyuncu, 2017). This form was used as part of a post-education structured clinical examination (OSCE) to assess students' skills. Three categories were established for student evaluations, and the ability to perform the task described in the relevant item was scored as follows: Performed: 2 points; Incomplete/Incorrect: 1 point; Did Not Perform: 0 points. A maximum score of 0-108 points can be achieved on the skills form. A high score indicates good skill development.

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 Jul 2026.
BackgroundJeong, H., Kim, S., & Park, Y. (2023a). Effectiveness of ARCS-based simulation on nursing students' communication competence. Nurse Education Today, 124, 105690. https://doi.org/10.1016/j.nedt.2023.105690
Background: PubMed 41175787Erden Y, Uludag E, Albayrak O. Examining the effects of ARCS-based urinary catheter education on first-year nursing students' learning motivation, self-efficacy and clinical skill levels. Nurse Educ Pract. 2025 Nov;89:104598. doi: 10.1016/j.nepr.2025.104598. Epub 2025 Oct 30.
Background: PubMed 39855069Chen PJ, Liou WK, Chen MJ. Effects of an ARCS-based interactive e-book featuring clinical scenarios on the learning motivation, self-efficacy and practical competence of nursing students in foetal heart rate interpretation. Nurse Educ Pract. 2025 Feb;83:104261. doi: 10.1016/j.nepr.2025.104261. Epub 2025 Jan 18.
Background: PubMed 41192101Chao HM, Chen SW, Chao SM. Effects of mobile learning applications for physical examination among nurse students: Use of the cardiovascular system. Nurse Educ Pract. 2025 Nov;89:104620. doi: 10.1016/j.nepr.2025.104620. Epub 2025 Oct 31.
BackgroundChang, C. C., Lee, T. H., & Tseng, H. H. (2024). Applying the ARCS model to enhance student motivation and engagement in distance education. Interactive Learning Environments, 32(1), 45-62. https://doi.org/10.1080/10494820.2022.2045721
BackgroundCai, Y., Xie, X., & Zhang, L. (2022). Enhancing nursing students' critical thinking and self-directed learning via ARCS-based blended teaching. BMC Nursing, 21(1), 1-9. https://doi.org/10.1186/s12912-022-00842-5
Background: PubMed 40072983Andrade IRC, Queiroz JC, Farias MS, Maia NPDS, Silva LFD. Clinical simulation in the teaching of cardiovascular physical examination with nursing students: a systematic review. Rev Bras Enferm. 2025 Mar 10;78(1):e20230429. doi: 10.1590/0034-7167-2023-0429. eCollection 2025.
Background: PubMed 36909790Althubaiti A. Sample size determination: A practical guide for health researchers. J Gen Fam Med. 2022 Dec 14;24(2):72-78. doi: 10.1002/jgf2.600. eCollection 2023 Mar.
BackgroundAlharbi, M., Kang, H., & Noh, H. (2021). The effects of ARCS-based e-learning on learners' motivation and learning achievement in a medical informatics course. International Journal of Emerging Technologies in Learning (iJET), 16(9), 203-214. https://doi.org/10.3991/ijet.v16i09.21459
BackgroundAjemba, M. N., Ikwe, C., & Iroanya, J. C. (2024). Effectiveness of simulation-based training in medical education: assessing the impact of simulation-based training on clinical skills acquisition and retention: a systematic review. World Journal of Advanced Research and Reviews, 21(1), 1833-1843. https://doi.org/10.30574/wjarr.2024.21.1.0163
Background: PubMed 41654826Kavak HK, Kazanc S. The effect of ARCS motivational model-based education on nursing students' communication skills, learning motivation, and self-efficacy: a mixed-methods randomized controlled intervention study. BMC Med Educ. 2026 Feb 7;26(1):525. doi: 10.1186/s12909-026-08724-8.
Background: PubMed 39647174Bozkurt T, Nacak UA, Karakas E, Ciftci B. The effect of stoma care teaching based on the ARCS motivation model on nursing students' learning motivation, self-efficacy and knowledge levels. Nurse Educ Pract. 2025 Jan;82:104207. doi: 10.1016/j.nepr.2024.104207. Epub 2024 Dec 2.
Individual participant dataSharing planned: No. In order to protect personal data, the data is not available for sharing.

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?

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 4 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 Jul 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?

Motivation Scale for Instructional Material (time frame: The assessment will be conducted in two separate time periods. The first assessment will be immediately before the training, and the second assessment will be two weeks after the training (post-training test).). 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 NCT07733479, which also lists 12 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 29 Jul 2026.