Content area
Aim
The aim of this study was to examine randomized controlled trials in nursing education using bibliometric analysis.
MethodsDescriptive and bibliometric analyses were used. Web of Science database was used to determine the most frequently cited studies of nursing education randomised controlled trials, the most influential journals in this field, trends and trends of studies. Bibliometric analysis and visualisation were performed using VOSviewer and Bibliometrix Package in R software.
ResultsIn the study, a total of 141 publications were published in 29 different sources between 2007 and 2025. The most influential journal where the studies were published was Nurse Education Today (n = 53). In the studies, 405 author keywords belonging to 623 authors were found. The most frequently used author keywords were ‘simulation (n = 18)’, ‘knowledge (n = 8)’, ‘simulation training (n = 8)’, ‘learning (n = 7)’ and ‘anxiety (n = 6)’. It was found that the most frequently used trend topics in the early years were ‘attitudes’, while in recent years, trend topics such as ‘simulation’, ‘knowledge’ and ‘skills’ have become popular.
ConclusionThe number of randomized controlled trials in nursing education has been on the rise in recent years. The findings of this study will contribute to the advancement of nursing education literature and inform future scientific studies by addressing existing gaps in knowledge in this field.
Nursing research is expected to include experiments that produce information that can be generalised to real life with high explanatory power rather than descriptive to evaluate the effectiveness of nursing interventions. Nursing should base its practice on the best available scientific evidence, as recommended by the evidence-based practice (EB) model ( Melnyk Fineout-Overholt, 2023). Randomised controlled trials (RCTs) are important for nursing research. These studies offer a rigorous and controlled approach to assess the safety and effectiveness of interventions. This makes them the most reliable method for evaluating the effectiveness of interventions used by nurses ( Melnyk and Fineout-Overholt, 2018). The design of RCTs is structured to minimise bias ( Akın and Koçoğlu, 2017). It is therefore considered that the results of this study represent the gold standard in medical research, with effects on medical care that are unique compared with other study designs. It is also considered second-tier evidence and is the main source for systematic reviews and meta-analyses, which are considered first-tier evidence ( Melnyk & Fineout-Overholt, 2018). Mantzoukas (2009) stated that experimental methodology including randomisation was used in a small number of studies (6 %) in nursing. Baldi et al. (2014) reported that experimental studies published in the field of nursing have increased in the last 20 years and more than half of them (67 %) were RCTs. Medina-Aedo et al. (2024) analysed 47 nursing RCTs published between 2005 and 2022 in their study on RCTs in the field of nursing in Latin America and reported that an average of three RCTs were published per year and RCT publications showed a general increasing trend.
Scholars engage in bibliometric analysis for a variety of reasons, including the identification of emerging trends in article and journal performance, the investigation of patterns of collaboration and research components and the examination of the intellectual structure of a given field as reflected in the extant literature ( Donthu et al., 2021). The utility of bibliometric analysis lies in its capacity to elucidate and delineate the cumulative scientific knowledge and evolutionary nuances of established fields. This is achieved by making sense of large volumes of unstructured data in a rigorous manner. Consequently, the implementation of well-designed bibliometric studies can facilitate the advancement of a field in novel and meaningful ways ( Mukherjee et al., 2022). A review of the nursing literature reveals a growing trend in the use of bibliometrics, as evidenced by the increasing number of studies employing this method ( Wang et al., 2022; Cant et al., 2022). This increase is believed to be attributable to three key factors: the growing trend towards evidence-based nursing, the rising number and accessibility of digitally stored research articles and enhancements in the availability of user-friendly bibliometric tools ( Kokol & Blažun Vošner, 2019). This trend aligns with the broader rise in the application of bibliometrics in scientific output.
Randomized controlled trials are regarded as a valuable means of generating evidence that can inform the nursing literature. Consequently, there is a consistent emphasis on the production and dissemination of such trials. Nevertheless, the trends of these studies as publication outputs in nursing journals have rarely been assessed thus far ( Gonella et al., 2019). The first bibliometric analysis of RCTs in nursing was conducted by Baldi et al. in 2014. In this bibliometric study, it was found that publications were mostly published in the Northern USA and Europe between 1991 and 2011 ( Baldi et al., 2014). During the same period, Di Giulio et al. (2014) conducted a comprehensive review of 227 experimental and quasi-experimental studies published in six prominent nursing journals between 2009 and 2013. They reported that the most studied topics were evaluating the effectiveness of educational, supportive interventions and clinical interventions. Gonella et al. (2019) examined 340 RCTs and quasi-experimental studies published between 2009 and 2016 in nursing journals with a 5-year impact factor > 1.5 according to Thomson's Journal Citation Reports. In the study, it was found that approximately 40 experimental studies were published each year, education and supportive interventions were the most frequently researched topics and especially the sample group included cancer patients and the elderly. In the nursing literature, it is seen that strong methods such as meta-analysis and systematic review are performed for RCTs ( Li et al., 2018; Hu et al., 2018; Gonella et al., 2019; Munday et al., 2020; Eckert et al., 2023; Medina-Aedo et al., 2024; Demircan et al., 2024). It can be said that some of these studies focus on specific topics and methods. Whereas traditional literature reviews typically examine a limited number of studies in considerable depth, bibliometric research often engages with a vast and diverse array of studies, often numbering in the hundreds or even thousands ( Zupic and Čater, 2015). Databases allow bibliometric analysis to be performed by allowing studies representing the field of study to be downloaded collectively into a dataset. Consequently, the resulting dataset in bibliometric research is more comprehensive ( Şimşir, 2022).
Nursing education consists of theoretical, laboratory and clinical components, aiming to develop students’ cognitive, affective and psychomotor skills ( Ngozika Ugwu et al., 2023). To deliver individualized and holistic care in complex clinical settings, students must be equipped with competence and confidence ( Mannino et al., 2021). Traditional teaching methods have been shown to be inadequate in developing these skills ( Benner et al., 2009) because they fail to address the changing needs and challenges of society.Therefore, nursing faculties must adopt and enhance evidence-based educational strategies ( Billings & Halstead, 2019; Khalili et al., 2015). Basic teaching strategies such as simulation applications, simulated patients, serious games, problem-based learning, themed game learning and web-based learning are used by educators as pedagogical approaches in nursing education. However, it appears that most of the studies conducted on the effectiveness of these teaching strategies have not been conducted as RCTs. Because in nursing education intervention studies, most study designs are non-randomized designs that limit the applicability of random distribution due to the inherent complexity of educational environments ( Jin et al., 2023). Given the absence of reviews on RCTs in the field of nursing education, this study used the bibliometric analysis method. Another reason for choosing the bibliometric analysis method is the current situation, trends, important points in randomised controlled trials in the field of nursing education and to guide future research and to provide recommendations on the adoption and implementation of randomised controlled trials. The objective of this study is to provide researchers with a comprehensive overview of the current state of research in this field and to offer new insights into the potential of RCTs in nursing education. Accordingly, this study used bibliometric analysis and visualization techniques to examine the landscape of RCTs publications in nursing education.
Considering the above context, our research questions are as follows:
1)What is the number of RCT studies in nursing education?
2)Which are the 10 most frequently cited RCT studies in nursing education?
3)Which journals publish RCT research in nursing education?
4)Which sources are most effective in terms of number of publications and citation analysis?
5)What is the thematic map of the keywords of randomised controlled trials in nursing education?
6)What are the trending topic keywords in randomised controlled trials in nursing education?
7)What does the thematic evolution of keywords in randomised controlled trials in nursing education indicate?
2 MethodA bibliometric analysis was performed to evaluate the current state of randomized controlled trials conducted within the purview of nursing education.
2.1 Database and study collectionThe study data were collected from the Web of Science Core Collection (WoSCC) database. The WoSCC database was selected because it is more reliable and effective compared with Scopus and Google Scholar, its journal and citation archive is based on older years, it contains journals with higher impact values and it provides effective access to bibliographic data ( Zavadskas et al., 2014). Concurrently, the use of a solitary data source guaranteed data consistency and uniformity, thereby mitigating the potential complications that might arise from discrepancies in data formats and quality across disparate sources ( Linnenluecke et al., 2020). The search spanned the period from the database's inception until October 11, 2024. During the search, the keywords of (TITLE-ABS-KEY ("randomized controlled trial" AND TITLE-ABS-KEY AND(“nurs* education*” OR “nurs* training” OR “nurs* learning” OR “informatic* nurs*” OR “nurs* study” OR “nurs* teaching” OR “nurs* student” OR “pupil nurs*” OR “nurs* academic” OR “nurs* educator” OR “nurs* teacher” OR “nurs* course*” OR “nurs* degree”)) were used.
2.2 Eligibility criteriaInclusion criteria: (1) articles written in English, (2) SSCI or SCI indexed articles and (3) studies related to the nursing education research theme with randomised controlled designs.
The exclusion criteria: (1) articles not written in English, (2) duplicate publications with incomplete information, (3) early published articles, reviews, letters, conference abstracts, book chapters, retracted studies, (4) non-nursing categories.
2.3 Selection processIn the process of data selection and analysis, the SALSA method was used to generate unbiased datasets and achieve the research objectives, which included the steps of search, evaluation, synthesis and analysis ( Fig. 1; Mengist, Soromessa and Legese, 2020). The search was conducted on 11 October 2024 and identified 488 publications. Arabic (n = 1) and Russian (n = 1) articles not written in English were excluded. Only papers published in SSCI or SCI journals between 1982 and 2024 were included in the study. Although the Web of Science index of one article appeared as AHCI, it was determined that the journal was mislabelled ( Supplementary material 1). As a result of the analysis, articles with ESCI index (n = 46) and Proceedings Paper (n = 2) were excluded. Then, early published articles (n = 3), reviews (n = 47), editorial material (n = 1), corrected manuscripts (n = 1) and withdrawn studies (n = 1) that did not meet the inclusion criteria were excluded (n = 386). Then, the category was filtered as ‘Nursing’ in the WoS database and a total of 239 articles were included. For the purposes of this study, an RCT was defined as a true experimental study where participants were randomly allocated to two or more groups for the purpose of testing the efficacy or effectiveness of any intervention (educational, pharmacological, dietary, or other) ( Smith et al., 2008). Non-experimental studies were discarded. In this context, 239 articles were reviewed by the researchers and studies with nursing interventions on patients who did not meet the inclusion criteria, such as ‘A home-based, nurse-led health programme for postoperative patients with early-stage cervical cancer: A randomised controlled trial’, mislabelled articles e.g. “Insufficient evidence: the problems of evidence-based nursing” or the abstract is not appropriate for the content of the article e.g. ’Factors affecting health-promoting behaviors in nursing students: A structural equation modelling approach’, 98 articles were excluded. Based on the citation counts, 141 articles met the inclusion criteria. Finally, all bibliographic data were transferred from the WoS database into an Excel spreadsheet (‘savedrecs.xls’).
2.4 Validity and reliability and rigourTo maintain the validity and reliability of bibliometric studies, it is essential that the process of selecting studies is transparent and reproducible. In this study, the SALSA methodology was used to ensure the attainment of validity and reliability (see Fig. 1). Moreover, a member of the research team evaluated a random sample of 30 articles from the dataset to confirm that the articles were correctly classified according to the specified review types. No labeling errors were identified. Most of the articles had randomised controlled trial in the title, for example, ‘Effectiveness of music therapy and progressive muscle relaxation in reducing stress before exams and improving academic performance in Nursing students: A randomised trial’ However, for the studies that did not, the abstract was checked, for example, ’Effects of mindfulness-based stress reduction on depression, anxiety, stress and mindfulness in Korean nursing students - Design: Randomised controlled trial.
2.5 Data analysisThe data analysis and visualization were conducted using R Studio 4.3.1 ( Aria and Cuccurullo, 2017) and VOSviewer 1.6.18 ( van Eck and Waltman, 2010). In addition, the open-source software packages Bibliometrix and Biblioshiny running in R language environment were used to obtain important bibliometric analyses such as (1) the total number of studies published in randomised controlled trials; (2) the ten most frequently cited articles; (3) the top ten journals with the most significant impact, the total number of publications of the journals and the number of citations. The authors applied Bradford's Law to obtain active journals in randomised controlled trials in the field of nursing education ( Alvarado, 2016). Keyword analysis is a crucial element of academic research, facilitating the synthesis of study topics in specific fields and the investigation of current trends and emerging areas of inquiry. For this reason, to obtain more accurate results, some words, especially words such as ‘randomized controlled trial’, ‘nursing student’, ‘education’, ‘nursing student’, were excluded and the word list was transferred to a text file with txt extension and analysed ( Supplementary material 2). Thematic maps reveal the frequent use of keywords with each other and whether the words used with each other are central in the relevant literature and thematic maps, trend topics, thematic evolution and concurrency map analyses were used to identify research priorities, thematic trends and the evolution of studies ( Aria and Cuccurullo, 2017; Sedighi, 2016). Likewise, the text file with txt extension was also used in thematic map and evolution analysis.
2.6 Ethical considerationsAs this study does not entail any direct influence on humans or animals, it is not subject to approval by the board of ethics.
3 Results3.1 Preliminary data description
The data included 141 publications written by a total of 623 authors who met the inclusion criteria. Fig. 2 shows that the first randomised controlled trial on nursing education was conducted in 2007. In 2010 (n = 0), there were no publications and the first significant increase was in 2017 (n = 14). The most publications were made in 2021 (n = 20) and 2024 (n = 29).
3.2 The 10 most frequently cited studies (October 11 2024)Table 1 shows the 10 most frequently cited studies. Five of these studies were published in Nurse Education Today and these publications are among the top four most cited studies ( Table 1).
3.3 Source analysisThe studies were published in 29 different sources, as detailed in Table 2, which lists the 10 sources with the highest number of publications. Most of the studies were published in Nurse Education Today (n = 53), Nurse Education in Practice (n = 32), Journal of Advanced Nursing (n = 8). The Nurse Education Today source contained one third of the total number of publications and was therefore considered the main source according to Bradford's law ( Supplementary Figure 1).
Fig. 2, which is a supplementary figure, shows an analysis of the cumulative growth of sources with at least two publications. It can be seen that the number of articles in Nurse Education Today has increased continuously in comparison to all sources. Furthermore, there has also been significant growth in Nurse Education in Practice since 2013.
As indicated in Table 2, the most frequently cited source was Nurse Education Today (n = 1348). Fig. 3 presents a visual representation of the network of publications with at least two publications per source. The dataset consisted of 29 sources. The analysis yielded six distinct clusters. Cluster analysis revealed that the light green cluster was centered on Nurse Education Today (TLS = 13), the yellow cluster was centered on Nurse Education in Practice (TLS = 6) and the light blue cluster was centered on the Journal of Advanced Nursing (TLS = 4).
3.4 Keyword analysisIt was found that 405 author keywords belonging to 623 authors were used in randomised controlled trials conducted in nursing education. Fig. 4 illustrates the word cloud of the most frequently used author keywords. As the frequency of a given word increases, its font size in the word cloud is correspondingly larger. The most frequently used keywords were ‘simulation (n = 18)’, ‘knowledge (n = 8)’, ‘simulation training (n = 8)’, ‘learning (n = 7)’ and ‘anxiety (n = 6)’.
Thematic maps of randomized controlled trials in nursing education are presented in Fig. 5. The thematic map analysis comprises 405 words, with a minimum cluster frequency of 5 and a 1-level structure for each cluster ( Fig. 5).
Motor themes were positioned in the right upper quadrant, characterised by both higher intensity and higher centrality and consisted of 6 words: satisfaction, knowledge, simulation training, simulation, anxiety and patient.
In contrast, the upper left quadrant exhibits a lower centrality and higher density, contains niche themes and demonstrates a focus on specific topics within the domain of nursing education. Additionally, the identified niche themes are comprised of two-word phrases, namely "problem solving" and "Covid-19."
The lower right quadrant illustrates basic themes of lower intensity but higher centrality. These include the terms "learning" and "patient safety."
Furthermore, the lower left quadrant shows emergent and descending themes with lower centrality and lower intensity, especially involving nursing education, which suggests that problem-based learning, theme game and web-based learning have lower centrality and lower intensity in nursing education randomised controlled trials.
Fig. 6 illustrates the evolution of thematic keywords across three distinct phases. It depicts the correlation between the various themes and their progression over a 18-year period, divided into five phases: 2007–2012, 2013–2017, 2018–2021, 2022–2023 and 2024–2025. The most frequent keywords are ‘attitudes’ between 2007 and 2012; ‘care’ and ‘knowledge’ between 2013 and 2017; ‘simulation’ and ‘knowledge’ between 2018 and 2021; ‘simulation’ and ‘care’ between 2022 and 2023; and ‘knowledge’ and ‘skills’ in the last years ( Fig. 6).
4 DiscussionThe efficacy of proposed interventions must be substantiated by valid scientific studies prior to implementation. Evidence from randomised controlled trials (RCTs) is needed to assess whether an intervention is effective ( Melnyk, 2018). This study was conducted to describe in detail the trends, most frequently cited studies, most influential journals, thematic trends and evolution of RCTs in nursing education using a bibliometric analysis. The findings of this study will contribute to the advancement of nursing education literature and inform future scientific studies by identifying gaps in the existing literature in this field. In addition, this study is the first study to outline the scope review of randomised controlled trials in nursing education.
One significant gap in nursing education research is the lack of implementation of evidence-based educational approaches. Nursing education research is important to provide evidence-based teaching practices and inform curriculum and nursing program development ( Oermann, 2020). Although the term ‘randomised controlled trial’ was included in large databases such as MEDLINE and EMBASE in the 1990s, the first RCT in nursing education was published in 2007 ( Table 1). Mantzoukas (2009) emphasises that the reason for the limited number of RCTs in nursing may be related to lack of knowledge and anti-experimentation view. It is consistent with the knowledge that there is not enough experimental data for effective teaching and learning strategies in developing psychomotor skills of nursing students ( Staykova et al., 2017). In recent years, there has been a notable increase in investments in the field of nursing, which has led to an expansion in the number of studies designed and published, particularly those of an experimental nature ( Baldi et al., 2014; Di Giulio et al., 2014; Gonella et al., 2019; Medina-Aedo et al., 2024). The findings of this study similarly showed that the interest in randomised controlled trials in nursing education has increased ( Table 1). There is a downward trend in the number of publications in 2022 (n = 11) and this is thought to be due to the decrease in interventional practices due to the COVID-19 restrictions. It is seen that RCTs are generally on virtual simulation applications (Supplemantary material 1). In a recent study, Cant et al. (2022) employed a bibliometric analysis to examine the landscape of virtual simulation studies in nursing education and concluded that virtual simulation represents a novel field. These findings align with those of the current study. The increase in the number of publications again in 2023 is thought to be since the COVID-19 restrictions are no longer operating ( WHO, 2023). Baldi et al. (2014) found an increase in the number of experimental studies published in nursing, 67 % of which were RCTs. Medina-Aedo et al. (2024) reported that in Latin America alone, an average of three RCTs in nursing were published per year. A similar review reported a total of 188 nurse-led RCTs between 2000 and 2021 ( Eckert et al., 2023). The results of the study are in line with the literature and it can be said that interest in RCTs in nursing education has increased. However, this relative increase is not at the desired level and may highlight the need for support in designing, conducting and publishing RCTs in nursing-specific research.
The main purpose of nursing education is to train competent and confident nurses who have the knowledge, attitudes and skills necessary to maintain and improve nursing care ( Oermann, 2020). The most cited publication in the study is Song and Lindquist (2015) study, which examined the effects of mindfulness-based stress reduction on depression, anxiety, stress and mindfulness in Korean nursing students. In the study, it was found that the depression, anxiety and stress levels of the students in the intervention group decreased and their awareness increased more compared with the control group ( Song and Lindquist, 2015). It is noteworthy that the three most cited publications are aimed at reducing the anxiety of nursing students ( Table 1). Nursing science, which is one of the applied sciences, may be a source of anxiety for students. In general, it is seen that studies are aimed at increasing nursing students' skills such as knowledge, communication, self-efficacy, self-confidence, skills, empathy, critical thinking ( Table 1). It is stated that highly cited academic articles are associated with research quality in scientific fields ( Levitt and Thelwall, 2008). Furthermore, highly cited articles serve as exemplary research targets for literature reviews, focusing on a particular application area and research topic and exerting a profound influence on academic research ( Chigbu et al., 2023). The word cloud and trending topic analyses conducted within the scope of the current study show that these topics are still topical and maintain their importance in the research field ( Fig. 4). In the bibliometric analysis conducted by Oermann et al. (2024), it was determined that the second most studied topic was critical thinking. Because nursing students are expected to make informed decisions in clinical practice.
The research found that most studies were published in Nurse Education Today compared with all sources. It can be seen that the number of articles in Nurse Education Today is constantly increasing; Nurse Education in Practice has also reached a significant growth rate since 2013 ( Table 2). In the bibliometric study conducted on reviews of nursing education, it was found that the studies were mostly published in Nurse Education Today ( Oermann et al., 2024). In a similar vein, a bibliometric analysis of nursing education journals revealed that Nurse Education Today ( Chang et al., 2021; Cant et al., 2022; Oermann et al., 2024) was the journal with the highest number of publications and citations. The results of the study were found to be like the literature. Therefore, these two journals are of primary importance for randomised controlled trials in nursing education.
The most cited source in the study was identified as Nurse Education Today ( Table 2). When considering the number of publications, the higher TLS of high volume journals compared with other journals reflects the central role of these journals in the scientific literature and their strong links with other journals. This is likely to be due not only to the high number of publications of the journal, but also to the significant impact of these publications on the scientific community.
In his 1934 study, Bradford postulated that most articles on a specific topic are published by a limited number of specialized journals. These journals can be found on the periphery of the field, as well as those with a more expansive and general editorial scope. Consequently, the subset of journals in each field will exhibit a pattern of decreasing parentage over successive generations, with each subsequent generation becoming more numerous than the previous one. The practical application of Bradford's Law offers a means of selecting not only the most prolific journals in a given field, but also those that are most pertinent to the subject matter in question ( Alvarado, 2016). In this context, Supplementary Figure 1 can guide scholars interested in RCTs in nursing education in the selection of journals.
The term "hot topic" is used to describe a subject that is currently a focus of interest in a particular field of study. The identification of such topics allows researchers to gain insight into the current trends in their field ( Liu et al., 2021). Keyword analysis of author words revealed that the hot topics of RCTs in nursing education were 'simulation' ( Fig. 4). Studies also show that simulation is the most researched topic ( Shin et al., 2015; Chang et al., 2021; Oermann et al., 2024). For example, in the bibliometric analysis of nursing education reviews conducted by Oermann et al. (2024), simulation was found to be the most researched topic. The results of our study are consistent with the literature. In this direction, simulation studies on RCTs in nursing education can be a basic guide for new researchers towards this study design. Thus, a solid foundation for future research can be established by conducting in-depth studies on current trends in the field of research. For new researchers, it will be useful to follow these trends and understand the development of the field to make effective contributions.
With the expansion of nursing education research over time, educators and researchers engaged in this field have increasingly turned to systematic reviews as an invaluable source of insight to guide their understanding of student learning, identify optimal pedagogical approaches and pinpoint areas of knowledge that are currently under-researched, thereby shaping future research agendas ( Oermann, 2022). Thematic map analysis conducted as part of the review showed that the motor themes in RCTs of nursing education were satisfaction, knowledge, simulation training, simulation, anxiety and patient. The results demonstrated that the motor theme exhibited both higher density and centrality across studies. Furthermore, it manifested central and advanced themes ( Mumu et al., 2021). In this context, it can be said that these issues are a central concept and have been sufficiently developed. In other words, current studies focus on these themes and there is a need to work on different themes for the development of the field. The emerging and declining themes in the thematic map analysis indicate the low centrality and low density of problem-based learning, themed games and web-based learning in randomised controlled trials. The study conducted by Ma et al. (2021) revealed that theme game-based teaching demonstrated superior efficacy in developing disaster nursing competencies in nursing students when compared with scenario simulation. In addition, this is the first study in this area and further work is needed. Similarly, an integrated review conducted by McDonald et al. (2018) stated that e-based learning programmes in nursing assessment provide students with the opportunity to reflect on their actions and self-correct, but further research is needed. In this context, it is important for researchers and academics to develop innovative research methods by considering the gaps in the existing literature and developing trends. Focusing on these concepts in future studies will contribute to the development of RCTs in nursing education.
The objective of educational institutions is to use innovative techniques to optimise the learning process and develop effective learning outcomes, thereby enhancing the quality of learning ( Oermann et al., 2024). In addition, nurse educators need to find effective teaching methods to ensure the successful transition of nursing students to clinical practice ( Staykova et al., 2017). Traditional teaching methods have been found to be ineffective in developing the cognitive, psychomotor and emotional skills of nursing students ( Benner et al., 2009). Simulation helps students to develop their clinical skills in a safe environment and be better prepared for real-life experiences ( Alanazi et al., 2017; Koukourikos et al., 2021). This approach is an important tool for increasing the effectiveness of nursing education. The thematic development of the study ( Fig. 6) is consistent with the findings in the literature. In the study by Oermann et al. (2024) it was found that most reviews were about simulation. The use of simulation in nursing and health education has seen a notable increase over time ( Bienstock and Heuer, 2022; Li et al., 2022). In this context, it can be posited that the effective implementation of simulation in the nursing education process has the potential to enhance students' knowledge and skills.
5 LimitationsThe limitation of our study is that the literature review is limited to data obtained from the WoS database and the study data is limited to journals in the nursing category, excluding journals in other categories. Therefore, some influential publications in databases such as Scopus, PubMed and Google Scholar may have been excluded from the study. The data presented in this study are limited to the time when the literature review was conducted. A replication of this study conducted in a different time may yield different results.
According to Lotka's Law, when considering the authors and articles related to the research topic; it was determined that 93.3 % of them were authors who contributed to the article ( Supplementary Figure 3). The fact that most authors had only one publication and the number of productive authors was much less than Lotka predicted indicates "weak compliance with Lotka's law". It should be noted that RCTs are time-consuming and costly due to the difficulties in the implementation phase. In addition, due to the complexity of educational environments, random distribution is often not applicable in nursing education research, which leads to the frequent use of non-random designs.
The strength of the study is that although the bibliometric analysis method is based on article titles, abstracts and keywords, both authors evaluated the articles in the raw data pool as full text. Mislabelled non-RCT articles were excluded.
6 ConclusionNursing faculties need to use evidence-based approaches to develop and implement educational strategies. This study provides important data on RCTs in nursing education and documents the increase in RCTs in nursing education, which is generally consistent with nursing research. The findings of the current study should help nurse educators to select effective and reliable educational methods, particularly simulation and to improve the quality of nursing education. They may also help researchers to develop nursing education strategies and adopt evidence-based approaches. In addition, there is a gap in the literature on RCTs of problem-based learning, themed games and web-based learning in nursing education. The contribution of researchers engaged in studies in these domains will prove beneficial for the advancement of nursing education literature.
CRediT authorship contribution statementKonal Korkmaz Ebru: Writing – review & editing, Visualization, Supervision, Software, Resources, Methodology, Investigation, Data curation, Conceptualization. Ateş Esin: Writing – original draft, Visualization, Supervision, Software, Resources, Methodology, Investigation, Data curation, Conceptualization.
Declaration of Competing InterestThe authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Appendix A Supporting informationSupplementary data associated with this article can be found in the online version at doi:10.1016/j.nepr.2025.104394.
Appendix A Supplementary materialSupplementary material
| No | Title | Authors | Year | Source | Total Citation |
| 1 | Effects of mindfulness-based stress reduction on depression, anxiety, stress and mindfulness in Korean nursing students | Yeoungsuk Song,
Ruth Lindquist | 2015 | Nurse Education Today 35 (1), pp.86–90 | 221 |
| 2 | Virtual versus face-to-face clinical simulation in relation to student knowledge, anxiety and self-confidence in maternal-newborn nursing: A randomized controlled trial | Shelley Cobbett,
Erna Snelgrove-Clarke | 2016 | Nurse Education Today 45(1), pp.179–184 | 112 |
| 3 | A randomized controlled trial of the effects of brief mindfulness meditation on anxiety symptoms and systolic blood pressure in Chinese nursing students | Yu Chen,
Xueling Yang, Liyuan Wang, Xiaoyuan Zhang | 2013 | Nurse Education Today
33(10), pp.1166–1172 | 112 |
| 4 | Designing and evaluating the effectiveness of a serious game for safe administration of blood transfusion: A randomized controlled trial | Apphia Jia Qi Tan,
Cindy Ching Siang Lee, Patrick Yongxing Lin, Simon Cooper, Lydia Siew Tiang Lau , Wei Ling Chua b , Sok Ying Liaw | 2017 | Nurse Education Today 55(1), pp.38–44 | 87 |
| 5 | The Effects of Scenario-Based Simulation Course Training on Nurses' Communication Competence and Self-Efficacy: A Randomized Controlled Trial | Li-Ling Hsu,
Wen-Hui Chang, Suh-Ing Hsieh | 2015 | Journal of Professional Nursing
31 (1), pp.37–49 | 77 |
| 6 | Effect of a game-based virtual reality phone application on tracheostomy care education for nursing students: A randomized controlled trial | Sule Biyik Bayram,
Nurcan Caliskan | 2019 | Nurse Education Today
79(1), pp. 25–31 | 72 |
| 7 | Effects of Simulation-Based Deliberate Practice on Nursing Students' Communication, Empathy and Self-Efficacy | Ju Li, Xue Li, Linlin Gu, Rui Zhang, Rongyan Zhao, Qiaoying Cai, Yanyan Lu, Hui Wang, Qinghui Meng, Holly Wei, | 2019 | Journal of Nursing Education 58(12), pp. 681–689 | 63 |
| 8 | Mobile-Based Video Learning Outcomes in Clinical Nursing Skill Education
A Randomized Controlled Trial | Lee, Nam-Ju, Chae, Sun-Mi, Kim, Haejin, Lee, Ji-Hye, Min, Hyojin Jennifer, Park, Da-Eun | 2016 | CIN: Computers, Informatics, Nursing 34(1):pp. 8–16, | 62 |
| 9 | The Effects of an Interactive Nursing Skills Mobile Application on Nursing Students' Knowledge, Self-efficacy and Skills Performance: A Randomized Controlled Trial | Hyunsun Kim, Eunyoung E. Suh | 2018 | Asian Nursing Research, Volume 12 (1), pp. 17–25 | 61 |
| 10 | Comparison of the effectiveness of two styles of case-based learning implemented in lectures for developing nursing students’ critical thinking ability: A randomized controlled trial | Shaohua Hong,
Ping Yu | 2017 | International Journal of Nursin Volume 68(1), pp.16–24 | 60 |
| Source (*) | Number of Articles | Total Citation | Average Citation | Quartiles (**) | JIF 2023 * * |
| Nurse Education Today | 53 | 1348 | 25.43 | Q1 | 3.6 |
| Nurse Education in Practice | 32 | 147 | 4.59 | Q1 | 3.3 |
| Journal of Advanced Nursing | 8 | 105 | 13.12 | Q1 | 3.8 |
| BMC Nursing | 4 | 6 | 1.5 | Q1 | 3.1 |
| International Journal of Nursing Studies | 4 | 190 | 47.5 | Q1 | 7.5 |
| Journal of Nursing Education | 4 | 89 | 22.25 | Q2 | 1.6 |
| Nurse Educator | 4 | 6 | 1.5 | Q1 | 2.7 |
| CIN-Computers Informatics Nursing | 3 | 69 | 23.0 | Q3 | 1.3 |
| Contemporary Nurse | 3 | 22 | 7.33 | Q3 | 1.2 |
| Applied Nursing Research | 2 | 44 | 22.0 | Q1 | 2.7 |
©2025. Elsevier Ltd