DOI: 10.12688/f1000research.182309.1 ISSN: 2046-1402

Integrating Video-Based Scaffolding into Problem-Based Learning for Nursing Skills Education: Development and Evaluation of the MEDIFA Model

Siti Fatimaha, Marini Agustin, Agus Sumarno, Misbah Fikrianto, Lukman Nulhakim
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Background The increasing integration of digital learning technologies in nursing education has created new opportunities for strengthening clinical skills instruction. Nevertheless, the educational contribution of instructional video depends not only on technological availability but also on how digital tools are pedagogically integrated within learning environments. Although problem-based learning (PBL) and video-assisted instruction have each demonstrated potential in nursing education, studies examining their systematic integration within competency-based clinical learning remain relatively limited. This study aimed to develop and evaluate a Video-Supported Problem-Based Learning (VS-PBL) model, referred to as the MEDIFA model, for undergraduate nursing skills education. Methods This study employed a design-based research (DBR)-informed approach involving instructional development, expert validation, formative evaluation, and field implementation. The MEDIFA model was developed by integrating video-based procedural scaffolding within a structured problem-based learning framework. Field implementation was conducted using a one-group quasi-experimental pre-test–post-test design involving 30 undergraduate nursing students. Quantitative data were analyzed using paired-sample t-tests, effect size analysis, and normalized gain (N-Gain) scores. Qualitative data obtained from interviews, open-ended questionnaires, and observational notes were analyzed thematically to explore students’ learning experiences during implementation. Results The findings demonstrated substantial improvement in students’ clinical competency following implementation of the MEDIFA model. Post-test scores increased significantly compared with baseline performance (p < 0.001), with an N-Gain score of 0.76 indicating high instructional effectiveness. Qualitative findings revealed three dominant themes: strengthened self-regulated learning, deeper procedural understanding through contextual problem-solving, and changes in instructional interaction patterns. Students reported using instructional videos repeatedly to support independent preparation and procedural confidence, while collaborative problem-based activities appeared to encourage reflective reasoning and contextual clinical understanding. Conclusions The study suggests that integrating video-based procedural scaffolding within a problem-based learning environment may support both clinical competency development and active learning engagement in undergraduate nursing education. The MEDIFA model contributes to ongoing discussions concerning pedagogically integrated digital learning in competency-based nursing instruction and offers a context-sensitive instructional framework for nursing skills education.

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