Evaluating the effectiveness of disaster nursing programs based on Bloom’s taxonomy: a meta-analysis

Abstract

Background: Effective disaster response demands rapid decision-making and high-quality nursing care. To establish and sustain disaster nursing competencies, structured education and training are indispensable. This study systematically evaluated the effectiveness of disaster nursing programs based on Bloom’s taxonomy of educational objectives. Methods: A comprehensive literature search was conducted using the keywords “disaster,” “nursing,” “education,” “training,” and “program,” covering publications from January 1, 1900, to August 6, 2024. A total of 12,076 articles were initially identified. After excluding non-interventional studies, books, posters, and studies without calculable effect sizes, 18 articles met the inclusion criteria. Data were analyzed using R version 4.4.2 to compute effect sizes, assess heterogeneity, and evaluate publication bias. Results: The overall effect size of disaster nursing programs for nurses and nursing students was large (Hedges’ g = 1.12, 95% CI [0.48, 1.77]). By Bloom’s taxonomy domains, the effect sizes were as follows: cognitive domain, g = 0.92 (95% CI [−0.30, 2.14]); affective domain, g = 0.86 (95% CI [0.21, 1.51]); and psychomotor domain, g = 1.19 (95% CI [0.49, 1.89]). For integrated outcomes combining knowledge, attitudes, and skills (other domain), the effect size was g = 0.89 (95% CI [−0.30, 4.08]). Conclusion: Disaster nursing programs demonstrated the greatest effectiveness in enhancing psychomotor skills, reflecting improvements in practical performance. Strengthening disaster nursing competencies requires comprehensive educational strategies that integrate cognitive, affective, and psychomotor domains while fostering higher-order thinking. These findings highlight the necessity of systematic curriculum design, evidence-based instructional methods, and rigorous evaluation frameworks to advance disaster nursing education.