Başer Aysel, Anil Murat
Faculty of Medicine, Department of Medical Education, Izmir Democracy University, Izmir, Turkey.
Faculty of Medicine, Department of Paediatric, Izmir Democracy University, Izmir, Turkey.
Nurs Crit Care. 2025 Jul;30(4):e13238. doi: 10.1111/nicc.13238. Epub 2025 Jan 6.
Paediatric emergency and critical care require skilled nurses, but they often face a lack of motivation during continuing professional development. Motivation-based, engaging activities in training programmes are essential to sustain interest and improve learning outcomes in these high-stress environments.
This study aims to develop, implement and evaluate the effectiveness of a Paediatric Emergency Course (PEC) using the ARCS (Attention, Relevance, Confidence, Satisfaction) Motivational Design Model to equip nurses with the knowledge and skills needed to manage paediatric patients in emergency and critical care settings.
The study employed a quasi-experimental pretest/post-test design. The PEC was conducted from 1 June to 31 December 2023, with the participation of 57 nurses working in emergency and critical care units. To evaluate the programme's effectiveness, a paired t-test was used for pre-test and post-test comparisons, and logistic regression analysis was conducted to determine the factors affecting course success (lecture test activities and motivational tactics).
Pre-lecture assessments averaged 9.55, significantly increasing to 16.88 post-lecture (out of 22), indicating a substantial improvement in knowledge after the lecture series (t = -20.26, df = 55, p < .001; 95% CI [-8.05, -6.60]). Similarly, pre-course scores rose from 7.21 to 17.14 post-course (out of 25), reflecting significant gains in overall understanding and competency (t = -20.83, df = 56, p < .001; 95% CI [-10.89, -8.97]). Logistic regression analysis demonstrated that a one-unit increase in post-lecture test scores increased the likelihood of course success by 22.5%, with an odds ratio of 1.225 (B = .203, SE = 0.092, p = .028; 95% CI [1.023, 1.468]). Additionally, motivational design significantly influenced course success, increasing the likelihood by 433.3%, with an odds ratio of 5.333 (B = 1.674, SE = 0.363, p < .001; 95% CI [3.134, 9.074]).
The PEC continuing education programme, developed using the ARCS Motivational Design Model to support the professional development of nurses in emergency and critical care, was successfully implemented. These results suggest that both knowledge acquisition and motivational factors play a substantial role in enhancing course success among participants. Significant improvements in pre- and post-test results, along with high scores on the motivational design scale, demonstrated the effectiveness of the programme.
The use of motivation-enhancing tactics and strategies in training has led to successful outcomes, demonstrating that structured programmes designed with these methods can significantly improve the clinical competencies, expertise, decision-making and patient safety of nurses working in paediatric emergency and critical care services in high-pressure environments.
儿科急诊与重症护理需要技术娴熟的护士，但他们在继续专业发展过程中常常缺乏动力。在培训项目中开展基于动机的、引人入胜的活动对于在这些高压力环境中维持兴趣并提高学习成果至关重要。
本研究旨在开发、实施并评估儿科急诊课程（PEC）的有效性，该课程采用ARCS（注意、相关性、信心、满意度）动机设计模型，使护士具备在急诊和重症护理环境中管理儿科患者所需的知识和技能。
本研究采用准实验前测/后测设计。PEC于2023年6月1日至12月31日开展，共有57名在急诊和重症监护病房工作的护士参与。为评估该项目的有效性，采用配对t检验进行前测和后测比较，并进行逻辑回归分析以确定影响课程成功的因素（讲座测试活动和动机策略）。
讲座前评估平均分为9.55分，讲座后显著提高至16.88分（满分22分），表明系列讲座后知识有显著提升（t = -20.26，自由度 = 55，p <.001；95%置信区间[-8.05，-6.60]）。同样，课程前得分从7.21分提高到课程后17.14分（满分25分），反映出整体理解和能力有显著提高（t = -20.83，自由度 = 56，p <.001；95%置信区间[-10.89，-8.97]）。逻辑回归分析表明，讲座后测试成绩每提高一个单位，课程成功的可能性增加22.5%，优势比为1.225（B =.203，标准误 = 0.092，p =.028；95%置信区间[1.023，1.468]）。此外，动机设计对课程成功有显著影响，可能性增加433.3%，优势比为5.333（B = 1.674，标准误 = 0.363，p <.001；95%置信区间[3.134，9.074]）。
采用ARCS动机设计模型开发的PEC继续教育项目成功实施，以支持急诊和重症护理护士的专业发展。这些结果表明，知识获取和动机因素在提高参与者课程成功率方面都发挥了重要作用。前测和后测结果的显著改善以及动机设计量表上的高分证明了该项目的有效性。
在培训中使用增强动机的策略和方法取得了成功结果，表明采用这些方法设计的结构化项目可以显著提高在高压环境下从事儿科急诊和重症护理服务的护士的临床能力、专业知识、决策能力和患者安全性。
