The effect of digital-based educational methods on learning outcomes ın nursing students: An integrative review proposing a conceptual framework.
BACKGROUND In response to the increasingly demanding needs of healthcare today, the integration of digital technologies into nursing education has accelerated. Digital approaches such as simulation, virtual learning environments, and AI-supported applications have become widely used to improve clinical competence. However, the mechanisms by which they affect learning and their effectiveness in cognitive, psychosocial, and psychomotor domains have not been sufficiently conceptualized. OBJECTIVE To integrate the effects of digital-based educational methods on nursing students' learning experiences and to develop a conceptual framework. DESIGN An integrative review. METHOD This review was conducted in accordance with the Whittemore and Knafl framework. A total of 54 studies published between January 2021 and January 2026, using qualitative, quantitative, and mixed methods, were included in the study. The methodological quality of the study was evaluated using the Mixed Methods Assessment Tool. Data were synthesized through inductive content analysis. RESULTS Digital-based intervention results significantly improved psychomotor skill performance, clinical decision-making ability, self-learning, motivation, and professional identity. The findings explain a shift from passive to active learning in the learning process, i.e., digital autonomy. A "Holistic Transformation Model of Digital Clinical Learning" encompassing safe learning spaces, digital autonomy, psychosocial transformation, and hybrid learning ecosystems has been developed. CONCLUSION Digital-based training methods represent a transformative pedagogical change in nursing education. Promoting digital autonomy and hybrid learning ecosystems is essential for achieving sustainable clinical competence in contemporary healthcare settings.