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Interactive e-books and traditional education show comparable effectiveness for foundational cancer sleep management nurse trainingStudy compares e-book and traditional training for nurses on cancer sleep management

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Key Takeaway
Consider interactive e-books as a scalable alternative for foundational nurse training when traditional education is impractical.

A cluster randomized controlled trial compared interactive e-books to traditional education for foundational cancer sleep management (BBTI) training among 142 clinical nurses from nine wards. Nurses were randomized to either interactive e-book training (n=75) or traditional education (n=67), with outcomes assessed one week post-intervention. Both groups showed significant confidence improvements (e-book: d=0.51; traditional: d=0.36), though the between-group difference was not statistically significant (p=0.263). Knowledge gains were modest and non-significant in both groups. Learning satisfaction was high in both groups (83% vs. 81% of maximum score, p=0.365), and confidence significantly mediated the relationship between knowledge and satisfaction (indirect effect=0.051, 95% CI [0.006-0.096]). No safety or tolerability data were reported. A key limitation is that limited knowledge gains suggest brief theoretical instruction alone may be insufficient for knowledge acquisition. The study had 100% retention. In practice, interactive e-books may offer a scalable alternative to traditional education for foundational training when logistical constraints exist, but neither method produced substantial knowledge gains in this brief format. The study measured educational outcomes in nurses, not patient health outcomes.

A study compared two ways to train nurses on helping cancer patients with sleep problems. One group of 142 nurses used an interactive e-book, while another group received traditional classroom education. Both methods taught the same foundational sleep management techniques.

The researchers found that both training methods worked similarly well. Nurses in both groups reported feeling more confident about using sleep management techniques and were highly satisfied with their training. However, neither group showed strong improvements in their actual knowledge of the material after just one week.

This study only measured how nurses felt about their training, not whether patients actually slept better. The limited knowledge gains suggest that brief training alone might not be enough for nurses to fully master this topic. The results show that interactive e-books could be a useful alternative when traditional training isn't practical, but more research is needed to understand how this affects patient care.

What this means for you:
Interactive e-books may train nurses on sleep management as well as traditional methods, but more study is needed.

Study Details

Study typeRct
EvidenceLevel 2
PublishedApr 2026
View Original Abstract ↓
PURPOSE: Sleep disturbances affect approximately 60% of cancer patients, with significant impacts on quality of life and treatment outcomes. While Brief Behavioral Treatment for Insomnia (BBTI) offers evidence-based management, implementation requires foundational training for oncology nurses. This study compared interactive e-books with traditional education for cancer sleep management training. The purpose of this study was to evaluate knowledge acquisition, confidence enhancement, and learning satisfaction between formats, and examine confidence as a mediator. METHODS: Cluster randomized controlled trial with 142 clinical nurses from nine wards assigned to interactive e-book (n = 75) or traditional education (n = 67) groups. Outcomes assessed at baseline and one-week post-intervention using validated instruments (Cronbach's α = 0.862-0.980). Structural equation modeling examined mediation effects, controlling for baseline differences. RESULTS: Both groups showed significant confidence improvements (e-book: d = 0.51; traditional: d = 0.36) with no between-group difference (p = 0.263). Knowledge gains were modest and non-significant in both groups. Learning satisfaction was high in both groups (83% vs. 81% of maximum score, p = 0.365). Confidence significantly mediated the knowledge-satisfaction relationship (indirect effect = 0.051, 95% CI [0.006-0.096]), accounting for 24.5% of the total effect. Feasibility indicators were favorable with 100% retention. CONCLUSIONS: Interactive e-books and traditional methods showed comparable effectiveness for foundational BBTI training. Limited knowledge gains suggest brief theoretical instruction alone is insufficient, supporting multi-component training programs. Confidence emerged as a key mediator, indicating educational programs should incorporate explicit confidence-building strategies. Interactive e-books offer scalable alternatives when traditional training is impractical.
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