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Development of a Mobile Learning Application to Enhance Nursing Students’
Clinical Reasoning and Self-directed Learning Abilities

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C. Cheng, Y. Hung, C. Hung, and S. Liou 1
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Chang Gung University of Science and Technology, Chinese Taipei, and General Education Center,
Feng Chia University, Chinese Taipei

Background: In alignment with the learning patterns of Generation Z, mobile educational applications
offer significant benefits for students.

Objective: This study aimed to integrate an unfolding case study into a mobile application and pilot
test its effectiveness in enhancing nursing students’ clinical reasoning and self-directed learning
abilities.

Methods: The mobile app was developed using Thunkable, with the user interface designed in Adobe XD.
It includes micro-courses, case scenarios, tests, and resource modules. The micro-courses are publicly
available on YouTube, with links embedded in the app. The case study is divided into four segments, each
containing patient information, scenario videos, focus questions, and student tasks. Students complete the
case study through Edpuzzle, accessible via the app. Five clinical nurses and teachers evaluated the app’s
content, ease of use, fluency, and interface appearance. Subsequently, the app was tested by 34 nursing
students who had completed medical-surgical nursing and internships. Students filled out the Nurses
Clinical Reasoning Scale (NCRS) and Self-Directed Learning Instrument (SDLI) before and after using the
app. Twenty-seven students participated in a focus group discussion. Wilcoxon signed-rank tests and
Spearman correlation were used to analyze the scale scores, while qualitative data were analyzed using
content analysis.

Results: The NCRS and SDLI scores showed significant increases from pretest to posttest. NCRS was
positively correlated with SDLI. Most students (87.5%) expressed satisfaction, finding the mobile app
Poster Presentation Abstracts
helpful or very helpful for learning. The experience of using the app was described as fostering
“autonomy and flexibility in learning,” “developing comprehensive nursing competency,” “improving
critical thinking,” and promoting “enhanced and reflective learning.”

Conclusion: The mobile app has the potential to revolutionize nursing education, enhancing the overall
learning experience by providing flexibility, personalized learning, and autonomy, thereby making
education more accessible and enjoyable. Video-based simulations, developed from unfolding case study
scenarios, offer students a holistic approach to developing nursing competencies.

Keywords: clinical reasoning, mobile learning application, self-directed learning, unfolding case study

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Correspondence: Ching-Yu Cheng, Chang Gung University of Science and Technology, Chinese Taipei
E-mail: cycheng@mail.cgust.edu.tw

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