Reflective Islamic Spiritual Care Education and Nursing Students' IMAN Competencies: A Quasi-Experimental Pilot Study of the IneRISE-IMAN Model in a Muslim-Majority Setting

Abstract Objective: This pilot study aimed to assess the preliminary effectiveness of the IneRISE-IMAN model, delivered as Reflective Islamic Spiritual Care Education (RISE), in improving nursing students' spiritual care competencies (IMAN) within a Muslim-majority setting. It constitutes Phase III of a three-phase research program in which the model was previously content-validated by expert consensus and structurally validated using PLS-SEM . Methods: A quasi-experimental pilot design was employed, involving a non-randomized control group and pre–post testing. Eighty-two undergraduate nursing students were allocated to an intervention or a control group; complete pre- and post-test data were available for 81 (intervention n = 42; control n = 39). The intervention group participated in the IneRISE-IMAN model, which combines a flipped classroom with structured reflection and case-based learning in which the learning cases are co-constructed with students from their own experience of caring for Muslim patients, while the control group received traditional instruction. The study assessed outcomes such as knowledge, attitudes, skills, and IMAN competencies using validated tools. Analysis used Wilcoxon and Mann–Whitney tests, and ANCOVA controlling for pre-test score, age, gender, learning style, self-efficacy, and academic resilience . Results: The intervention group showed notable improvements in knowledge (p = 0.020), skills (p = 0.003), attitudes (p = 0.001), and overall competency (p = 0.006), whereas the control group exhibited no significant changes (p > 0.05). Between-group comparisons showed that the intervention group scored significantly higher on all post-tests (p < 0.001) with a large effect size (r = 0.61). ANCOVA confirmed a significant intervention effect after controlling for pre-test score, age, gender, learning style, self-efficacy, and academic resilience (F(1, 72) = 26.21, p < 0.001, partial η² = 0.267; adjusted mean difference 33.06, 95% CI 20.19 to 45.94) . Conclusions: These pilot findings suggest that the IneRISE-IMAN model, delivered through RISE, is a feasible and culturally appropriate approach to strengthening nursing students' Islamic spiritual care competencies. Given the non-randomized design, the modest sample and the baseline differences between groups, the results should be read as preliminary and require confirmation in a larger, multi-site randomized trial . Trial registration: Thai Clinical Trials Registry TCTR20260922003.