A COMPARATIVE STUDY TO ASSESS THE IMPACT OF FOUR COMPONENT INSTRUCTIONAL DESIGN (4C/ID) LEARNING MODEL ON KNOWLEDGE AND SKILLS REGARDING SAFE ADMINISTRATION OF INTRAVENOUS MEDICATION AMONG 3RD SEMESTER B.SC. NURSING STUDENTS
Keywords:
Medication administration safety is a critical component of nursing education. IV medication errors pose significant risks to patient safety, often resulting from inadequate knowledge and insufficient skill development among nursing students. The Four Component Instructional Design (4C/ID) model provides a structured approach to teaching complex clinical skills. Objective: To assess the effectiveness of the 4C/ID learning model in enhancing knowledge and skills regarding safe administration of intravenous medication among 3rd semester B.Sc. Nursing students. Methods: A quasi-experimental pre-test/post-test control group design was used among 70 B.Sc. Nursing students selected through purposive sampling. The experimental group received a 7-day 4C/ID-based educational intervention, while the control group underwent traditional teaching. A validated knowledge questionnaire and skill observation checklist were used. Data were analyzed using paired t-test, independent z-test, and Fisher’s exact test. Results: A total of 70 students (35 experimental, 35 control) completed the study. Baseline pre-test knowledge and skill scores showed no significant difference between groups (p > 0.05). After the 7-day intervention, the experimental group demonstrated a marked improvement in both knowledge and skill performance. The mean post-test knowledge score increased from 12.48 ± 3.15 to 24.62 ± 2.84, and the mean skill score increased from 6.14 ± 1.92 to 17.45 ± 1.33. In contrast, the control group showed only minimal improvement in knowledge (13.02 ± 3.41 to 15.88 ± 3.02) and skills (6.42 ± 1.86 to 8.21 ±1.77). Paired t-test and independent z-test revealed a highly significant difference between the experimental and control groups for both knowledge and skills (p < 0.001). The calculated effect size indicated a large educational impact of the 4C/ID model. No socio-demographic variables showed any significant association with baseline pre-test knowledge or skill levels. Conclusion: The 4C/ID instructional model effectively enhances IV medication safety competence among nursing students. Integration of this model into nursing education may reduce medication errors and improve patient safety outcomes.Abstract
Medication administration safety is a critical component of nursing education. IV medication
errors pose significant risks to patient safety, often resulting from inadequate knowledge and
insufficient skill development among nursing students. The Four Component Instructional
Design (4C/ID) model provides a structured approach to teaching complex clinical skills.
Objective: To assess the effectiveness of the 4C/ID learning model in enhancing knowledge
and skills regarding safe administration of intravenous medication among 3rd semester B.Sc.
Nursing students.
Methods: A quasi-experimental pre-test/post-test control group design was used among 70
B.Sc. Nursing students selected through purposive sampling. The experimental group received
a 7-day 4C/ID-based educational intervention, while the control group underwent traditional
teaching. A validated knowledge questionnaire and skill observation checklist were used. Data
were analyzed using paired t-test, independent z-test, and Fisher’s exact test.
Results: A total of 70 students (35 experimental, 35 control) completed the study. Baseline
pre-test knowledge and skill scores showed no significant difference between groups (p > 0.05).
After the 7-day intervention, the experimental group demonstrated a marked improvement in
both knowledge and skill performance. The mean post-test knowledge score increased from
12.48 ± 3.15 to 24.62 ± 2.84, and the mean skill score increased from 6.14 ± 1.92 to 17.45 ±
1.33. In contrast, the control group showed only minimal improvement in knowledge (13.02 ±
3.41
to
15.88
± 3.02) and skills (6.42 ± 1.86 to 8.21 ±1.77).
Paired t-test and independent z-test revealed a highly significant difference between the
experimental and control groups for both knowledge and skills (p < 0.001). The calculated
effect size indicated a large educational impact of the 4C/ID model. No socio-demographic
variables showed any significant association with baseline pre-test knowledge or skill levels.
Conclusion: The 4C/ID instructional model effectively enhances IV medication safety
competence among nursing students. Integration of this model into nursing education may
reduce medication errors and improve patient safety outcomes.
References
Lewis PJ, Dornan T, Taylor D, Tully MP, Wass V, Ashcroft DM. Prevalence, incidence
and nature of prescribing errors in hospital inpatients. Drug Saf. 2009;32(5):379–389.
Calabrese AD, Erstad BL, Brandl K, Barletta JF, Nightingale CH, Bates DW.
Medication administration errors in adult patients in the ICU. Am J Health Syst Pharm.
;58(19):1835–1841.
Jha AK, Larizgoitia I, Audera-Lopez C, Prasopa-Plaizier N, Waters H, Bates DW.
Medical errors and patient safety: A global issue. Health Aff. 2013;32(3):142–150.
Alghamdi AA, Keers RN, Sutherland A, Ashcroft DM. Medication safety competence
among nursing students: A systematic review. Nurse Educ Today. 2019;79:14–20.
van Merriënboer JJG, Clark RE, de Croock MB. Blueprints for complex learning: The
C/ID model. Educ Technol Res Dev. 2002;50(2):39–64.
van Merriënboer JJG, Kirschner P. Ten Steps to Complex Learning. 2nd ed. New York:
Routledge; 2018.
Vandewaetere M, Manhaeve D, Aertgeerts B, Clarebout G, Van Merriënboer JJG, Roex
A. Using the 4C/ID model in healthcare education improves competency development.
BMC Med Educ. 2015;15:235.
