Enhancing undergraduate nursing informatics literacy through design-based learning: a mixed-methods participatory...

Rapid advances in healthcare technologies and hospital informatization have prompted the need for enhanced nursing informatics literacy among undergraduate nursing students. Traditional nursing curricula often lack authentic, design-oriented learning experiences that integrate nursing, computer science, and information technology.

This four-year participatory action research study aimed to explore the effectiveness of a Design-Based Learning (DBL) approach in improving undergraduate nursing students' informatics literacies within a "Nursing Informatics" course.

This study adopted a participatory action research design with a convergent mixed-methods approach. From 2020 to 2024, a total of 622 undergraduate nursing students at a comprehensive university in China were recruited through total population sampling from an iterative, DBL-enhanced "Nursing Informatics" course. Students tackled real-world clinical informatics problems through iterative cycles of investigation, design, and redesign. Pre- and post-course informatics literacy scores were measured using a validated 28-item, 5-point Likert scale questionnaire (total score range: 28-140). Paired t-tests and Bayesian modeling assessed improvements over time, while focus group interviews provided qualitative insights into students' learning experiences.

Across all four cohorts, informatics literacy scores improved significantly (p < 0.001). The 2018 cohort's mean score increased from 73.13 ± 13.38 to 86.55 ± 12.21 (Cohen's d = 2.21), and by 2021 cohort, scores rose from 73.17 ± 15.15 to 92.47 ± 12.07 (Cohen's d = 3.07). Bayesian analysis confirmed that yearly improvements were credible, with posterior intervals excluding zero. Qualitative themes revealed enhanced interdisciplinary thinking, informatics skill mastery, stronger professional identity, and improved teamwork capabilities, suggesting that the observed quantitative gains represented meaningful, transformative learning experiences.

Implementing a DBL approach within the "Nursing Informatics" curriculum significantly enhanced undergraduate nursing students' informatics literacy and fostered deeper engagement, critical thinking, and interdisciplinary collaboration. These findings underscore the value of authentic, design-oriented instructional strategies in preparing future nurses for increasingly informatics-driven clinical environments. Further research is recommended to compare DBL with alternative pedagogical models and assess long-term impacts on professional practice.

Not applicable. This study did not involve a clinical trial.