Introduction Clinical internship is a pivotal stage in nursing education, yet traditional cardiology preceptorship remains instructor-centered and lecture-based, inadequately fostering self-directed learning and clinical reasoning. Integrating the CDIO framework with Kolb's experiential learning theory into a blended online-to-offline model may offer a comprehensive solution. This study aimed to develop and evaluate this integrated model for cardiology nursing interns. Methods In this quasi-experimental study, 201 nursing interns were assigned to a control group (traditional lecture-based learning, n=100) or an experimental group (blended CDIO-experiential learning model, n=101). Self-directed learning, critical thinking, learning engagement, and clinical practice readiness were measured pre- and post-intervention, together with theoretical/skills examinations and teaching satisfaction. Results The experimental group significantly outperformed the control group on all outcomes: theoretical scores (d=0.81), skills scores (d=0.74), self-directed learning (d=3.53), critical thinking (d=4.59), learning engagement (d=4.02), clinical practice readiness (d=2.26), and teaching satisfaction (d=2.40) (all P<0.001); improvement magnitudes were also significantly greater (d=1.05–2.92). Skills scores (β=0.505) and critical thinking (β=0.280) independently predicted theoretical achievement. Discussion The blended CDIO-experiential learning model substantially enhances nursing interns' competencies and educational outcomes with large-to-very-large effect sizes, offering a transferable paradigm for clinical teaching reform. Long-term effects and generalizability require further multicenter validation.
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Zhao et al. (2026) studied this question.
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