Enhancing undergraduate nursing informatics literacy through design-based learning: a mixed-methods participatory action research study

Abstract Background Rapid advances in healthcare technologies and hospital informatization have prompted the need for enhanced nursing informatics literacy among undergraduate nursing students. Traditional nursing curricula often lack authentic, design-oriented learning experiences that integrate nursing, computer science, and information technology. Aim This four-year participatory action research study aimed to explore the effectiveness of a Design-Based Learning (DBL) approach in improving undergraduate nursing students’ informatics literacies within a “Nursing Informatics” course. Methods This study adopted a participatory action research design with a convergent mixed-methods approach. From 2020 to 2024, a total of 622 undergraduate nursing students at a comprehensive university in China were recruited through total population sampling from an iterative, DBL-enhanced “Nursing Informatics” course. Students tackled real-world clinical informatics problems through iterative cycles of investigation, design, and redesign. Pre- and post-course informatics literacy scores were measured using a validated 28-item, 5-point Likert scale questionnaire (total score range: 28–140). Paired t-tests and Bayesian modeling assessed improvements over time, while focus group interviews provided qualitative insights into students’ learning experiences. Results Across all four cohorts, informatics literacy scores improved significantly (p