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

Aim: To determine the effects of a developed interactive e-book featuring various clinical scenarios based on the ARCS (attention, relevance, confidence and satisfaction) model of motivation on the learning motivation, self-efficacy and FHR interpretation skills of nursing students. Background: This study fills the digital gap in teaching foetal heart rate interpretation and will help expand obstetric nursing education for on-site and distance education. Design: A randomised controlled trial was conducted of nursing students assigned to the experimental group (n = 41) and control group (n = 39). Methods: The experimental group used the developed e-book to learn about FHR interpretation, while those in the control group watched an instructional video and their learning outcomes were measured at baseline, immediately after the intervention and two weeks after the intervention. Results: Generalised estimating equations were applied to conduct the analyses revealing that the experimental group scored significantly higher than the control group in the immediate and two-week post-intervention tests on average regarding learning motivation and self-efficacy (p < .01). The experimental group also scored significantly higher in the immediate post-test for FHR interpretation skills (p < .001) and the significance lasted for two weeks after the intervention (p < .01). Conclusions: The developed interactive e-book can effectively improve the learning motivation, self-efficacy and FHR interpretation skills of nursing students, confirming the potential of multimedia and interactive elements in digital learning, particularly regarding complex obstetric nursing concepts. This study provided empirical support for the use of interactive e-books in nursing education.