Service-learning using the BOPPPS model in TCM nursing education: a mixed-methods study

Abstract

Background Service-learning is increasingly used in nursing education to connect classroom learning with authentic practice and community engagement. However, evidence on how instructional models can optimize service-learning in nursing education remains limited. This study aimed to examine the educational effects of service-learning using the BOPPPS model in an undergraduate traditional Chinese medicine (TCM) nursing course. Methods This mixed-methods study included a quasi-experimental quantitative component and a qualitative component using thematic analysis. Ninety-six undergraduate nursing students participated, including 49 in the experimental group and 47 in the control group. The experimental group received service-learning using the BOPPPS model, whereas the control group received conventional teaching. Quantitative outcomes included course scores, service-learning abilities, and course evaluation scores. Qualitative data were collected through final reflective reports and analyzed to explore students' learning experiences. Results Compared with the control group, the experimental group achieved better academic performance (87.69 ± 5.69 vs. 84.15 ± 8.35, P = 0.018), stronger service-learning abilities (288.76 ± 47.28 vs. 259.66 ± 46.51, P = 0.003), and more positive course evaluation scores (37.84 ± 3.85 vs. 34.81 ± 4.88, P = 0.001). Qualitative findings further showed that the intervention supported knowledge application in practice, strengthened communication and caring, and deepened students' understanding of the value of TCM nursing. Students also reported increased workload and time demands. Conclusion Service-learning using the BOPPPS model may be a valuable teaching approach in TCM nursing education. It may help students connect classroom learning with authentic care needs while fostering practical competence and humanistic awareness.