Abstract:

While web-based learning platforms address diverse educational needs, limited customization and adaptability remain major shortcomings. Adaptive learning tailors content, instructional strategies, and assessments to individual learners using advanced technologies. This approach is particularly valuable in fields requiring critical thinking and evidence-based practice, including Nursing education. Although studies emphasize adaptive learning’s role in improving reasoning and decision-making in clinical nursing, a research gap remains regarding its application in this field. To address this gap, the present study introduces an adaptive learning system designed to support nursing professionals in applying the ‘Advanced Nursing Process,’ an internationally recognized approach to evidence‑based in cardiac care.

The system was developed as a web-based platform with four architectural components: domain model, learner model, tutoring model, and user interface. The domain model organizes knowledge through hierarchical prerequisite and semantic links to present content on the the subject domain. The learner model records and updates learner information. The tutoring model applies 15 conditional IF–THEN rules to provide adaptive strategies, while the user interface offers multimodal resources, interactive clinical scenarios, and a question bank aligned with learner preferences.

The learning process begins with initial profiling assessing prior knowledge, learning style, and activity patterns. Based on this, the system generates a personalized learning path. During learning, the tutoring model adapts content presentation, feedback, and navigation according to performance, while the learner model is continuously updated. The course concludes with a post-test and a personalized summary supporting self-assessment and knowledge retention without educator involvement.

A semi quasi experimental study was conducted with nursing staff (n = 31) from the Cardiac Care Units of two affiliated hospitals of Tehran and Shiraz Universities of Medical Sciences, Iran, using convenience sampling. Participants completed the course within two weeks. System usability, learner knowledge, and satisfaction were evaluated. Knowledge was assessed using a 35 item test administered before and after the course and analyzed with a paired t test. Learner satisfaction was measured using an e learning quality questionnaire, and system usability was evaluated by 12 domain experts using an e learning usability perception questionnaire.

Thirty-one nurses completed the program. Knowledge scores increased significantly from a pre-test mean of 43.20 (13.52) to a post-test mean of 68.70 (18.16) out of 122, as shown by a paired t-test (α = 0.05). Learner satisfaction ratings were high: overall course evaluation 4.84 (0.15), course support 4.55 (0.40), and material usefulness 3.93 (0.21) out of 5. Expert usability ratings were acceptable, with mean (SD) scores as follows: navigation support 4.76 (0.27); visual design 4.60 (0.55); learning support 3.68 (0.55); content 4.29 (0.95); accessibility 4.16 (0.36); interactivity 4.03 (0.23); self-assessment and learnability 4.45 (0.32); motivational usability 4.37 (0.59) out of 5.

The system effectively enhanced the nursing professionals’ knowledge and received high learner satisfaction and the expert usability ratings. These findings highlight its potential to advance technology-enhanced, individualized professional education in healthcare.

Keywords:

Adaptive learning, Personalized learning, Nursing education, Technology-enhanced learning, Intelligent Tutoring system.