ArticleFrontiers in medicine2026
Designing a rheumatology and immunology nursing training model for resource-limited settings: application of the Medical Research Council framework.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Inadequate training has intensified the shortage of specialized rheumatology and immunology nurses, particularly in resource-limited settings. To address this gap, a theory-driven and evidence-based training model was developed to strengthen nurses' core competencies and professional capacity. Methods: The model was developed in two sequential phases following the updated Medical Research Council (MRC) framework for complex interventions. Phase 1 focused on evidence identification through five activities: evidence synthesis, stakeholder engagement, program theory development, contextual analysis, and economic evaluation. Phase 2 involved a two-stage modeling process, including the construction of a hierarchical case library and the design of a tiered Case-Based Learning (CBL) model incorporating progressive levels of complexity (basic, intermediate, and advanced). Results: Evidence synthesis identified CBL as the most effective educational strategy for enhancing nursing competencies, with progressive implementation showing particular promise. Stakeholder engagement revealed low trainee confidence and dissatisfaction with current unsystematic programs, while trainers emphasized the need for structured CBL, laboratory test interpretation, medication management, and communication skills. The program theory, grounded in the Zone of Proximal Development, supported a staged learning pathway from foundational to advanced levels. Contextual analysis outlined key barriers and six design elements to address them, and the economic evaluation confirmed the feasibility and cost-effectiveness of a localized training model. The final product was a hierarchical case library constructed from authentic clinical records and a three-tiered CBL model ensuring continuity through a spiral progression of knowledge and skills. Conclusion: This study developed a theory-driven, evidence-based nursing training model using the MRC framework and tailored to local needs in resource-limited hospitals. The model offers a structured and scalable approach to strengthening competencies in rheumatology and immunology nursing and provides a methodological reference for developing complex educational interventions in similar settings. A pilot cluster-randomized controlled trial has been conducted to further evaluate its feasibility and effectiveness.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.