Effectiveness of TPACK-based instruction on nursing students’ knowledge of pressure injury prevention: A quasi-experimental study
Year: 2026
Type: article
Study design: Clinical Trial
Abstract: Nursing students’ knowledge of pressure injury (PI) prevention in northern Morocco is notably low, highlighting the need for evidence-based curriculum design practices. In this context, the Technological Pedagogical and Content Knowledge (TPACK) framework was used to guide the design of an evidence-based instructional intervention. This study aimed to assess the effectiveness of TPACK-based instruction in improving nursing students’ knowledge of PI prevention. A single-group quasiexperimental pre–post design was conducted among first-year nursing students (N = 52) enrolled in a Fundamentals of Nursing course. Students participated in a three-week distance learning intervention consisting of 13 TPACK-based instructional videos delivered via the Edpuzzle® platform. Knowledge of PI prevention was assessed before and after the intervention using the French version of the Pressure Ulcer Knowledge Assessment Tool (PUKAT-Fr). The tool consisted of six domains and 25 items. An additional questionnaire was administered to collect data on participants’ demographic characteristics and their access to and familiarity with educational technologies. Data were analyzed using descriptive statistics and the Wilcoxon signed-rank test. Students’ overall knowledge of PI prevention improved significantly following the intervention, with notable gains observed across all six knowledge domains, particularly in risk assessment (83.5%) and etiology (80.8%). However, two knowledge domains and nine items did not reach the predefined 60% threshold. In addition, two items showed no improvement and even declined. These findings suggest that the TPACK model enhances nursing students’ knowledge of PI prevention, although gaps persist in certain domains and items. Pedagogical constraints such as curriculum overload and limited opportunities for application, as well as technological resource and access limitations, remain important challenges. Considering pedagogical requirements and addressing technological barriers are essential to improve nursing students’ PI prevention knowledge acquisition and transfer in future instructional designs.
Institution: Abdelmalek Essaâdi University
Language: English
Subfield: Dermatology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7208825322