A Comparative Analysis of Blended, Video-Based and Face-to-Face Learning Modalities for Mechanism of Labor among Nursing Students of Sikkim, India
DOI:
https://doi.org/10.31674/mjn.2026.v17i04.017Abstract
Background: Effective teaching strategies are crucial for enhancing clinical competencies among nursing students. This study evaluated the effectiveness of blended learning, video-based learning, and face-to-face learning on the knowledge and skill acquisition related to the mechanism of labor among undergraduate nursing students. Methods: A quasi-experimental study with a pre-test and post-test design was conducted at Sikkim Manipal College of Nursing. Ninety-three third-year B.Sc. nursing students were selected through complete enumeration and randomly assigned to three groups (n=31 each): Group 1 (video-based learning), Group 2 (blended learning), and Group 3 (face-to-face learning as control). Knowledge was assessed using a structured questionnaire, and skill was evaluated using a rating scale. Post-tests were administered immediately after the intervention and on the 8th and 28th days. Data were analyzed using descriptive and inferential statistics, including ANOVA, paired t-tests, and chi-square tests. Results: All three teaching methods significantly improved students’ knowledge and skills (p < 0.001). The blended learning group showed the highest improvement in both knowledge (mean difference = 5.93) and skill scores (mean difference = 18.61), followed by face-to-face and video-based learning groups. No significant association was found between most demographic variables and post-test scores, except for age, which was significantly associated with skill performance in the blended group (p=0.020). Conclusion: Blended learning was the most effective teaching method for enhancing both theoretical knowledge and practical skills on the mechanism of labor among undergraduate nursing students. Integrating traditional and digital modalities offers superior educational outcomes and should be considered in nursing curricula.
Keywords:
Blended Learning;, Distance Learning;, Learning;, Literature Review;, Nurse Education;, Student EngagementDownloads
References
Abusabeib Z. A. (2025). Blended Learning in Bachelor's Nursing Education: Exploring Student Experiences, Satisfaction, and Knowledge. Advances in Medical Education and Practice, 16, 1197–1207. https://doi.org/10.2147/AMEP.S520500
Adinda, D., & Mohib, N. (2020). Teaching and instructional design approaches to enhance students’ self-directed learning in blended learning environments. Electronic Journal of eLearning, 18(2), 162-174. https://doi.org/10.34190/EJEL.20.18.2.005
Ahmed, A. A. E., Biswas, A., Bempong-Ahun, N., Perić, I., & O'Flynn, E. P. (2025). Barriers and Enablers to the Production of Open Access Medical Education Platforms: Scoping Review. JMIR Medical Education, 11, e65306. https://doi.org/10.2196/65306
Ashipala, D. O., Sapalo, E. M., & Shikulo, P. I. (2024). Blended learning: Exploring nurse educators' perspectives. Health SA = SA Gesondheid, 29, 2659. https://doi.org/10.4102/hsag.v29i0.2659
Balante, J., Candelaria, D., Perez, D., & Koo, F. (2023). Nursing students' experiences of using flipcharts as a learning tool during the COVID-19 pandemic. Nurse Education Today, 120, 105650. https://doi.org/10.1016/j.nedt.2022.105650
Button, D., Harrington, A., & Belan, I. (2014). E-learning & information communication technology (ICT) in nursing education: A review of the literature. Nurse Education Today, 34(10), 1311–1323. https://doi.org/10.1016/j.nedt.2013.05.002
Castro, R. (2019). Blended learning in higher education: Trends and capabilities. Education and Information Technologies, 24(4), 2523-2546. https://doi.org/10.1007/s10639-019-09886-3
Choi, H., Lee, U., & Gwon, T. (2021). Development of a computer simulation-based, interactive, communication education program for nursing students. Clinical Simulation in Nursing, 56, 1-9. https://doi.org/10.1016/j.ecns.2021.04.019
Dangwal, K. L. (2017). Blended learning: An innovative approach. Universal Journal of Educational Research, 5(1), 129-136. https://doi.org/10.13189/ujer.2017.050116
David, D., Kaur, S., Siddiqui, A., & Sarin, J. (2020). Efficacy of Lecture cum demonstration versus video-based teaching regarding active management of third stage of labor in terms of knowledge and skills of GNM students: An interventional study. Journal of Education and Health Promotion, 9, 243. https://doi.org/10.4103/jehp.jehp_236_20
Devi, B., Khandelwal, B., & Das, M. (2019). Comparison of the Effectiveness of Video-assisted Teaching Program and Traditional Demonstration on Nursing Students Learning Skills of Performing Obstetrical Palpation. Iranian Journal of Nursing and Midwifery Research, 24(2), 118–123. https://doi.org/10.4103/ijnmr.IJNMR_35_18
Field, A. (2024). Discovering statistics using IBM SPSS statistics. Sage publications limited. https://uk.sagepub.com/en-gb/eur/discovering-statistics-using-ibm-spss-statistics/book285130
Forbes, H., Oprescu, F. I., Downer, T., Phillips, N. M., McTier, L., Lord, B., Barr, N., Alla, K., Bright, P., Dayton, J., Simbag, V., & Visser, I. (2016). Use of videos to support teaching and learning of clinical skills in nursing education: A review. Nurse Education Today, 42, 53–56. https://doi.org/10.1016/j.nedt.2016.04.010
George, P. P., Papachristou, N., Belisario, J. M., Wang, W., Wark, P. A., Cotic, Z., Rasmussen, K., Sluiter, R., Riboli-Sasco, E., Tudor Car, L., Musulanov, E. M., Molina, J. A., Heng, B. H., Zhang, Y., Wheeler, E. L., Al Shorbaji, N., Majeed, A., & Car, J. (2014). Online eLearning for undergraduates in health professions: A systematic review of the impact on knowledge, skills, attitudes and satisfaction. Journal of Global Health, 4(1), 010406. https://doi.org/10.7189/jogh.04.010406
Government of India. (2020). National Education Policy 2020. Ministry of Human Resource Development. https://www.education.gov.in/sites/upload_files/mhrd/files/NEP_Final_English_0.pdf
Indian Nursing Council. (2021). Guidelines on blended learning in nursing education. New Delhi: INC. https://www.indiannursingcouncil.org/
Jowsey, T., Foster, G., Cooper-Ioelu, P., & Jacobs, S. (2020). Blended learning via distance in pre-registration nursing education: A scoping review. Nurse Education in Practice, 44, 102775. https://doi.org/10.1016/j.nepr.2020.102775
Kaveevivitchai, C., Chuengkriankrai, B., Luecha, Y., Thanooruk, R., Panijpan, B., & Ruenwongsa, P. (2009). Enhancing nursing students' skills in vital signs assessment by using multimedia computer-assisted learning with integrated content of anatomy and physiology. Nurse Education Today, 29(1), 65–72. https://doi.org/10.1016/j.nedt.2008.06.010
Leidl, D. M., Ritchie, L., & Moslemi, N. (2020). Blended learning in undergraduate nursing education - A scoping review. Nurse Education Today, 86, 104318. https://doi.org/10.1016/j.nedt.2019.104318
Li, M., Hong, Y., Wu, A., Ou, W., Yang, J., Lin, G., Ruan, Y., Chen, Z., Lin, C., & Liang, Y. (2025). The effectiveness of blended learning in nursing and medical education: An umbrella review. Nurse Education in Practice, 86, 104421. https://doi.org/10.1016/j.nepr.2025.104421
McCutcheon, K., Lohan, M., Traynor, M., & Martin, D. (2015). A systematic review evaluating the impact of online or blended learning vs. face-to-face learning of clinical skills in undergraduate nurse education. Journal of Advanced Nursing, 71(2), 255–270. https://doi.org/10.1111/jan.12509
Neville, V., Lam, M., & Gordon, C. J. (2015). The impact of eLearning on health professional educators' attitudes to information and communication technology. Journal of Multidisciplinary Healthcare, 8, 75–81. https://doi.org/10.2147/JMDH.S74974
Niu, Y., Xi, H., Liu, J., Sui, X., Li, F., Xu, H., Zhao, L., Li, Y., Zhang, S., & Guo, L. (2023). Effects of blended learning on undergraduate nursing students' knowledge, skills, critical thinking ability and mental health: A systematic review and meta-analysis. Nurse Education in Practice, 72, 103786. https://doi.org/10.1016/j.nepr.2023.103786
Polit, D. F., & Beck, C. T. (2008). Nursing Research: Generating and Assessing Evidence for Nursing Practice. Lippincott Williams & Wilkins. https://tinywebs.info/4RuEe9
Rajesh, S., & Swamy, A. A. (2014). Effectiveness of video assisted teaching programme on knowledge regarding non pharmacological pain relieving intervention for children among staff nurses in selected hospital. Asian Journal of Multidisciplinary Studies, 2(10), 122-33. https://doi.org/10.29322/IJSRP.15.07.2025.p16308
Regmi, K., & Jones, L. (2020). A systematic review of the factors - enablers and barriers - affecting e-learning in health sciences education. BMC Medical Education, 20(1), 91. https://doi.org/10.1186/s12909-020-02007-6
Wang, R., & Raman, A. (2025). Systematic literature review on the effects of blended learning in nursing education. Nurse Education in Practice, 82, 104238. https://doi.org/10.1016/j.nepr.2024.104238
Sáiz-Manzanares, M. C., Escolar-Llamazares, M. C., & Arnaiz González, Á. (2020). Effectiveness of Blended Learning in Nursing Education. International Journal of Environmental Research and Public Health, 17(5), 1589. https://doi.org/10.3390/ijerph17051589
Scaria, T. M., Valsaraj, P. B., & Pias, M. (2013). The effectiveness of video teaching over lecture cum demonstration in improving knowledge and skill, of nursing students on antenatal examination. International Journal of Nursing Education, 5(1), 228. https://doi.org/10.5958/j.0974-9357.5.1.026
Sharma, E., Dubey, A. K., Malhotra, S., Manocha, S., & Handu, S. (2017). Use of complementary and alternative medicines in Indian elderly patients. National Journal of Physiology, Pharmacy and Pharmacology, 7(9), 1. https://doi.org/10.5455/njppp.2017.7.0411401052017
Shorey, S., Kowitlawakul, Y., Devi, M. K., Chen, H. C., Soong, S. K. A., & Ang, E. (2018). Blended learning pedagogy designed for communication module among undergraduate nursing students: A quasi-experimental study. Nurse Education Today, 61, 120–126. https://doi.org/10.1016/j.nedt.2017.11.011
Wu, Y. L., Lai, M. C., Chang, W. P., & Lin, Y. H. (2025). Evaluating the effectiveness of illness script teaching on clinical reasoning skills in post-baccalaureate nursing students. Nurse Education Today, 144, 106401. https://doi.org/10.1016/j.nedt.2024.106401
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