Comparison of The Effect of Team-Based Learning and Jigsaw on The Knowledge And Self-Efficacy of Nursing Students in Palliative Care

The study aims to compare the effects of Jigsaw and Team-Based Learning methods on nursing students’ knowledge, self-efficacy, and satisfaction in palliative care.

A randomized, parallel group, controlled, semi-experimental clinical trial in phase 2. A total of 48 undergraduate nursing students were randomly assigned into three equal groups: Jigsaw education group, Team-Based Learning group, and control group with no intervention. Stratified randomization was performed using the RAND function in Microsoft Excel.

This semi-experimental study with a parallel-group design and stratified randomization will be conducted at the Faculty of Nursing and Midwifery, Islamic Azad University, Karaj. Forty-eight nursing students will be randomly assigned to Jigsaw, Team-Based Learning, or control groups. Both intervention groups will receive four sessions of identical palliative care content. Data will be collected through self-report questionnaires at three time points. The data analyst will be blinded to group allocation.

Inclusion criteria: Nursing students from semesters 3 to 6; at least one term of clinical experience; signed informed consent; no prior palliative care training. Exclusion criteria: Incomplete questionnaires; absence in more than one session; withdrawal at any stage.

The first group receives education using the Jigsaw method; The second group receives education using the Team-Based Learning method; The third group serves as the control group and receives no educational intervention. Both intervention groups are trained over four sessions with identical content related to palliative care.

Knowledge; self-efficacy; satisfaction with educational methods in palliative care at three time points: before, after, and one month post-intervention.

Stratified randomization will be used to ensure balanced distribution of background variables such as academic semester, GPA, and gender across the study groups. The unit of randomization is the individual student. Participants will be first categorized into strata based on their semester, GPA, and gender. Within each stratum, random allocation to one of the three groups—Jigsaw, Team-Based Learning, or Control—will be performed. The random sequence will be generated using statistical software (e.g., SPSS or R). Allocation concealment will be ensured by having an independent person, not involved in the implementation of the intervention, manage the randomization list. The allocation sequence will be stored in a secured file and only accessed after participant enrollment to prevent selection bias.

In this study, due to the educational nature of the interventions, participants were aware of the group they were assigned to (Jigsaw, Team-Based Learning, or Control). The researcher, intervention instructors, and outcome assessors were also aware of the intervention type. However, in order to reduce bias in data interpretation, the data analyst was blinded to the group assignments, and statistical analysis was conducted using anonymized, coded datasets. No Data Safety and Monitoring Board (DSMB) was established for this study. While participants were not blinded, the presence of blinding at the data analysis level provides a single level of blinding in the study.

De-identified individual participant data related to the primary outcome variables, including knowledge, self-efficacy, and satisfaction scores. These data will be shared in Excel format upon written request and approval by the ethics committee. Additional documents such as the full study protocol and statistical analysis plan will also be available upon request.

Access to the data will begin three months after publication of the main study results and will remain available for a period of two years to qualified researchers with a valid written request.

Access to the data will be granted to researchers affiliated with universities, academic institutions, and research centers. Requests must be accompanied by an official letter of introduction and approval from the applicant’s institutional ethics committee.

The data may only be used for scientific and research purposes; commercial use is not permitted. Analyses must align with the original objectives of the study, and misleading or unrelated analyses are not allowed. Applicants must submit a research proposal, an official letter of introduction, and ethics committee approval from their institution. Data use will be subject to signing a data sharing agreement.

Applicants seeking access to the study data or documents may contact the principal investigator, Ms. Sharareh Zeyghami Mohammadi, via email. The request must include a research proposal, an official letter of introduction, and ethics committee approval. Contact Person: Sharareh Zeyghami Mohammadi Position: Faculty Member, Faculty of Nursing and Midwifery, Islamic Azad University, Karaj Branch Postal Address: Faculty of Nursing and Midwifery, Islamic Azad University, Moazen Boulevard, Rajaei Shahr, Karaj, Postal Code: 3149968111 Email: sharareh.zeyghami@iau.ac.ir Phone: +98 26 34203590

After submitting a written request including a research proposal, an official letter of introduction, and ethics committee approval from the applicant’s institution, the request will be reviewed by the research team within 2 weeks. If approved, a data sharing agreement will be sent to the applicant for signature. Once the signed agreement is received, the requested data or documents will be shared via email or a secure cloud platform within a maximum of 2 weeks. The entire process typically takes 3 to 4 weeks.