Application of an interactive eBook with video feedback to promote nurses’ electrocardiography learning achievement: A repeated-measure design

AIM To evaluate the effect of an interactive eBook combined with video-based feedback on nurses' electrocardiogram (ECG) interpretation competence, confidence and learning satisfaction. BACKGROUND Studies have suggested that an additional feedback mechanism should be provided, in combination with eBooks, to maximize learning effects. However, the feedback mechanism and its potential impact remain unclear. DESIGN A two-group, repeated-measures design with cluster randomization. METHOD Seventy-five nurses from six medical units in a medical center in southern Taiwan participated; 38 in the experimental group and 37 in the control group. Their ECG conceptualization, waveform interpretation and confidence were measured three times at two-month intervals. Data were analyzed using repeated-measures analysis of variance and qualitative content analysis. RESULTS The experimental group demonstrated significantly higher levels of ECG conceptualization and confidence at both post-intervention and follow-up assessments, as well as superior waveform interpretation skills at the follow-up. They also expressed satisfaction with the integration of the interactive eBook and video feedback. Three qualitative themes emerged: clear focus, self-paced convenience and applicability. CONCLUSION Digital learning with a dual-component model, using interactive eBooks and video-based feedback, can enhance nurses' ECG interpretation competence and confidence. The better the ECG conceptual learning, the better the retention of ECG waveform interpretation. It is recommended to incorporate an interactive eBook with clinical scenarios to enhance the application of knowledge in clinical practice, alongside well-structured video-based feedback that addresses common mistakes and provides logical explanations to facilitate a deeper conceptual understanding.