Digital Transformation in Nursing Education: Evaluating a Video-Supported PBL Model on Clinical Competency and Critical Thinking

Abstract

This study engages with the ongoing theoretical debate between the technological solutionism prevalent in digital education (Morozov, 2013) and critical pedagogical perspectives that question the socio-technical implications of technology integration (Fenwick et al., 2015). In nursing education, this manifests as a tension between evidence-based advocacy for digital tools, such as instructional videos, and the imperative to foster pedagogical depth that cultivates critical thinking and clinical reasoning. However, scant research has systematically examined how the structured fusion of a robust pedagogical model such as Problem-Based Learning (PBL) with video-based scaffolding reconfigures the learning ecology, thereby affecting both procedural competency and learner agency. This article addresses this gap by asking: How does a systematically developed Video-Supported PBL model influence nursing students’ clinical skill acquisition and critical thinking? Using a design-based research (DBR) approach, the study developed, validated, and empirically tested the “MEDIFA” model, integrating expert validation and pretest/posttest analyses with 30 students. The findings demonstrate significant quantitative gains in clinical competency (N-Gain = 0.76) and reveal a qualitative shift toward self-regulated learning, in which students strategically used on-demand videos for mastery while engaging in collaborative problem-solving. The analysis further shows a reconfiguration of the instructor’s role from primary demonstrator to facilitator of reasoning, mediated by the digital scaffold. The article argues that this integration creates a synergistic learning system where cognitive load management via video enables deeper participation in situated, practice-based communities (Lave & Wenger, 1991), thereby bridging a key conceptual divide in the literature. It contributes a validated instructional model and a refined theoretical synthesis, offering a more nuanced framework for designing and evaluating technology-enhanced learning in competency-based professional education.