Puzzle-based pedagogic activity to address rote learning of antibiotic classes in clinical pharmacology course for undergraduate nursing students

Abstract

Objective: We aimed to evaluate the impact of an active learning strategy, the Puzzle technique, on nursing students’ knowledge acquisition and engagement in Clinical Pharmacology, focusing on antibiotics. Background: Absenteeism and low motivation among university students pose significant challenges in higher education. Traditional rote learning methods often lead to disengagement, particularly in content-heavy subjects such as Clinical Pharmacology. Within this field, learning antibiotic classes requires extensive memorization, which may hinder students’ performance and retention of knowledge. Given the increasing role of nurses in antibiotic prescription, enhancing their pharmacological training is essential. Design: Educational intervention study with three intervention groups and two control groups, including within-group pre-post assessments. Methods: A total of 330 second-year nursing students from the University of Barcelona participated. Three groups (A, B, and C) engaged in the Puzzle intervention, while two groups (D and E) served as controls, thereby receiving only the standard theoretical instruction without any additional activity. The intervention consisted of a peer-to-peer collaborative activity where students were assigned specific antibiotic topics to teach their peers. Learning outcomes were assessed through a quiz, midterm, and final exams. Results: Intervention groups demonstrated significantly higher accuracy in quiz (p< 0.001) and exam accuracy percentages (p< 0.001) compared to controls. Among the intervention groups, students who participated in the activity outperformed their intra-group controls. Additionally, students reported high satisfaction and perceived applicability in learning consolidation. Conclusions: Our findings specifically pertain to undergraduate nursing students and undergraduate nursing education. The Puzzle technique effectively enhanced knowledge retention of antibiotic drug classes within Clinical Pharmacology. This peer-to-peer approach may serve as a valuable pedagogical tool for improving learning outcomes in nursing education, particularly in complex pharmacological subjects.