Skinner’s programmed instruction improves diabetes knowledge and skills of undergraduate nursing students: a randomised controlled trial

To evaluate whether Skinner’s programmed instruction approach is more effective than traditional lecture-based teaching in improving diabetes-related knowledge, technical skills, self-efficacy, and patient satisfaction among undergraduate nursing students. This randomised controlled trial was conducted at a tertiary teaching hospital in China. A total of 80 nursing students were randomly assigned to either a control group (traditional teaching, n = 40) or an experimental group (programmed instruction, n = 40). The intervention lasted 4 weeks. Outcomes were assessed across four domains: diabetes knowledge, technical skills (insulin injection and blood glucose monitoring), self-efficacy, and patient satisfaction. Composite scoring was used to estimate effect size and clinical relevance. Following the intervention, the experimental group demonstrated significantly higher scores than the control group in diabetes knowledge, insulin injection accuracy, and blood glucose monitoring skills (all P < 0.05). General Self-Efficacy Scale scores also improved significantly in the experimental group (P < 0.05). Patient satisfaction ratings were significantly higher in the experimental group across service attitude, technical ability, and health education guidance (P < 0.05). Programmed instruction can effectively enhance nursing students’ diabetes knowledge, technical skills, and self-efficacy, while also improving patient satisfaction. This teaching model shows promise for broader application in clinical nursing education.