The application of the Attention-Relevance-Confidence-Satisfaction motivation model-based instructional design in advanced nursing practice course: a mixed-methods study

Abstract

Background: The advanced nursing practice course is a core course for graduate nursing students, aimed at enhancing their comprehensive clinical competence and professionalism. The Attention-Relevance-Confidence-Satisfaction motivation model provides a theoretical framework for instructional innovation by using systematic strategies to stimulate and sustain learning motivation. Instructional design innovations play a crucial role in enhancing graduate nursing students’ learning motivation, self-learning ability, and critical thinking. Objective: The objective is to implement the instructional design based on the Attention-Relevance-Confidence-Satisfaction motivation model in the advanced nursing practice course and evaluate its influence on the learning motivation, self-learning ability, and critical thinking of graduate nursing students. Methods: This study employed a mixed-methods approach, combining a single-group pre-test/post-test quasi-experimental design with descriptive qualitative research. From March to May 2024, 31 first-year graduate nursing students received a 9-week Attention-Relevance-Confidence-Satisfaction model-based instructional reform. Quantitative methods were used to assess learning motivation, self-learning ability, critical thinking, and academic performance, with comparisons made using paired t-tests. The qualitative component included a descriptive qualitative study with semi-structured individual interviews. This mixed-methods study aimed to objectively measure effectiveness through quantitative data and gain in-depth insights into students’ experiences and benefits via qualitative data. Results: The learning motivation and self-learning ability, as well as critical thinking of students exposed to Attention-Relevance-Confidence-Satisfaction model, were all improved. In addition, students achieved better test scores, expressed recognition and satisfaction with the course, and improved professional value recognition. Conclusion: Applying the Attention-Relevance-Confidence-Satisfaction model-based motivational instructional design in advanced nursing practice course is feasible and has proved to be effective in increasing learning motivation, promoting self-learning ability, and cultivating critical thinking among graduate nursing students. In addition, the study found that the strategy had a positive effect on students’ learning gains, learning inspiration, and course feedback.