Evaluation of the effects of education with Jigsaw Technique on diabetic foot risk assessment knowledge and self-efficacy among nursing students: a randomised controlled trial

Innovative and active learning methods boost success by allowing students to actively participate in the learning process. Jigsaw Technique, one of these methods, delivers a learning experience in which students work in expert groups to develop knowledge on a specific sub-topic and then return to their home groups to share what they have learned with their peers. The aim of this study is to assess the effect of the Jigsaw Technique on the knowledge of diabetic foot risk identification and self-efficacy in nursing students. The study was planned and conducted in a randomised controlled design according to CONSORT guidelines. The sample of the study consisted of 68 first-year nursing students who took the course on health identification and physical examination techniques. The students were randomly divided into intervention ( n = 34) and control ( n = 34) groups. A descriptive information form for nursing students and the student self-efficacy scale (SSE) were completed in both groups at the initial evaluation. Afterwards, the intervention group was trained with Jigsaw Technique, and the control group was trained with the traditional learning method. The study was completed with 32 students in the intervention group and 30 students in the control group. The SSE scale was applied again in both groups in the final evaluation, and a knowledge test on the identification of diabetic foot risk assessment based on the “Clinical Oriented Reasoning Examination (CORE)” was applied. An independent-samples t-test was used to analyse the differences between the groups. At the beginning of the study, the socio-demographic data of the students and their SSE scale scores did not differ significantly between groups ( p > 0.05; intervention group: 28.79 ± 3.09, control group: 28.97 ± 3.34). After the intervention, SSE scale scores were significantly higher in the intervention group (30.68 ± 2.94) than in the control group (28.63 ± 4.13) ( p < 0.05). The CORE examination scores (intervention group: 68.93 ± 19.42, control group 74.73 ± 19.14) did not differ significantly between the groups ( p > 0.05). Education with Jigsaw Technique was associated with significantly higher self-efficacy scores compared with traditional teaching, but it did not produce a significantly greater increase in diabetic foot assessment knowledge. Jigsaw Technique may therefore be considered as an alternative method to support nursing students’ self-efficacy; its effect on knowledge acquisition requires further investigation. The study was registered at ClinicalTrials.gov (Number NCT06987006, Date 13/05/2025).