# Effect of problem-based learning approach program on meta-cognitive thinking skills and cooperative learning attitude among nursing students: quasi experimental study

## TL;DR

A study found that problem-based learning improves critical thinking and teamwork skills in nursing students.

## Contribution

The study demonstrates that problem-based learning significantly enhances meta-cognitive and cooperative learning skills in nursing students.

## Key findings

- Problem-based learning significantly improved meta-cognitive thinking skills (F = 904.39; p < 0.001).
- There was a significant improvement in cooperative learning attitudes (F = 822.74; p < 0.001).

## Abstract

This study aimed to evaluate the effect of problem-based learning approach program on meta -cognitive thinking skills and cooperative learning attitude among nursing students.

Nursing students encounter numerous challenges and obstacles that can hinder their academic performance. The problem-based learning approach is designed to enhance metacognitive thinking skills and cooperative learning attitude. These elements lead to master, directed and adaptable to the problems occurring within the academic and practical environment.

The intervention commenced in the period started from 28 September 2023 to 28 October 2023 through workshop with a preparatory phase at the beginning of the study, A quasi-experimental design was employed at the Faculty of Nursing in Port Said, Egypt. The study involved 207 nursing students enrolled in the first and incoming second academic levels for the 2023–2024 academic year. Data were collected by the Problem-Based Learning Approach Knowledge Questionnaire, the Metacognition Self-Assessment Scale, and the Students’ Cooperative Learning Attitude Questionnaire. The data analysis procedures which the study employed version 27.0 of the Statistical Package for Social Sciences (SPSS) for data analysis using Shapiro–Wilk test and single-factor (time) repeated measures analysis of variance (ANOVA) with Greenhouse–Geisser correction.

The findings illustrated significant improvements in participants’ meta-cognitive thinking skills over time (F = 904.39; p < 0.001). Additionally, there was a notable significant change over time in participants’ cooperative learning attitudes (F = 822.74; p < 0.001).

The problem-based learning program effectively enabled nursing students to develop mastery in meta-cognitive thinking skills and improved cooperative learning attitudes.

The study offers several important implications for nursing education practice and policy. These skills are critical for the practice of nursing. Educational policymakers and curriculum developers should consider integrating problem-based learning strategies more comprehensively within nursing programs to foster essential skills in critical thinking, problem-solving, and collaboration.

The study protocol was approved by the Research Ethics Committee of the Faculty of Nursing, Port Said University (code number: NUR 7/5/2023 (25)).

The online version contains supplementary material available at 10.1186/s12912-025-03485-z.