ArticlePloS one2026
Which digital education approaches most effectively enhance clinical reasoning in undergraduate nursing students: Protocol for a Network Meta-analysis.
Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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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.
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Corrections and comments
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Authors and funding
2 authors.
Funding
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Abstract
backgroundClinical reasoning is a core competency in nursing education, enabling students to make accurate and evidence-based clinical decisions. As digital-based learning expands, understanding the comparative effectiveness of different technology-enhanced educational approaches in improving clinical reasoning competence has become essential. However, existing evidence remains fragmented and inconsistent across the intervention types.
objectiveThis study aims to systematically evaluate and compare the effects of digital-based education interventions on clinical reasoning competence among undergraduate nursing students using a network meta-analysis.
methodsThis protocol describes a systematic review and network meta-analysis conducted in accordance with the PRISMA-P and Cochrane Handbook guidelines. Randomized controlled trials will be included and analyzed in separate networks. The primary outcome is clinical reasoning competence; secondary outcomes include critical thinking and problem-solving abilities. Searches will be conducted in PubMed, Embase, CINAHL, Web of Science, and CENTRAL from their inception to December 31, 2025. A frequentist network meta-analysis will be performed using R (version 4.1.0) with the netmeta package. Standardized mean differences with 95% confidence intervals will be calculated based on arm-level data. Transitivity and consistency will be assessed using global and local approaches. Intervention rankings will be estimated using P-scores. The certainty of evidence will be assessed using the CINeMA framework and GRADE.
conclusionsThis review will provide a comprehensive synthesis and comparative ranking of digital-based education interventions for improving clinical reasoning and related cognitive outcomes in nursing students. The findings will inform evidence-based decisions regarding the integration of effective digital educational strategies into nursing curricula.
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