Introduction:
Traditional lecture-based learning (LBL) is commonly used in nursing education, but problem-based learning (PBL) offers potential advantages [1]. However, the effectiveness of PBL in addressing healthy and sustainable nutrition in nursing students remains understudied. This study assessed the effectiveness of PBL versus LBL in educating undergraduate nursing students about healthy and sustainable nutrition, focusing on knowledge construction, problem-solving, self-directed learning, motivation and group collaboration.

Methodology:
A quasi-experimental pre- and post-test study was conducted during the 2023/24 academic year among second-year nursing students at the University of the Basque Country UPV/EHU (Spain). Of 169 enrolled, 104 met eligibility criteria, and 72 completed the study. Participants were divided into PBL (n=36) and age- and sex-matched LBL (n=36). Both methods were applied over six sessions (April-May 2023) by the same instructor, focused on dietary recommendations and food sustainability. The PBL group used active learning techniques (mind mapping, jigsaw puzzle, 1-2-4 technique and poster presentation); whereas the LBL group followed traditional lectures. Data were collected using a validated online questionnaire on the perceived effectiveness of the teaching method that used a 5-point Likert scale response option [1]. This tool that had not been previously validated in languages other than English was translated into the local languages (Spanish and Basque) using the parallel translation/double translation method. Ethical approval was obtained from the Ethics Committee of the UPV/EHU. Statistical analyses included t-tests and mixed-design ANOVA, with p<0.05 considered significant.

Results:
Socio-economic characteristics were similar between groups. Both methods were equally effective in building professional knowledge (mean=4.2), but LBL was perceived as more effective in deepening nursing knowledge (t=-4.120, p<0.001). PBL improved over LBL in fostering problem-solving (t=2.303, p=0.027), self-directed learning (t=2.212, p=0.034), active participation (t=2.497, p=0.017) and overall motivation (t=2.749, p=0.009). PBL also enhanced group collaboration, particularly in encouraging open discussions (t=2.583, p=0.014). The total mean score across all five categories was similar results for both groups (PBL=4.0, LBL=3.9; t=1.725, p=0.093). PBL students achieved a higher mean grades (7.0±1.5) that LBL students (5.9 ± 2.0; p=0.025).

Conclusions:
While both LBL and PBL are valuable for integrating healthy and suitable nutrition into nursing curricula, PBL showed greater improvements in problem solving, self-directed learning, motivation, and collaboration. These findings highlight the potential of PBL as a valuable pedagogical approach in nursing education, particularly in fostering critical skills and sustainability awareness. Further research could explore PBL’s long-term impact on professional practice and its applicability to other nursing education areas, by conducting larger follow-up interventions.

Acknowledgements:
Supported by the Vice-Rectorate for Undergraduate and Educational Innovation UPV/EHU (code: i324-01).

References:
[1] S.Y. Hwang and M.J. Kim, "A comparison of problem-based learning and lecture-based learning in an adult health nursing course," Nurse Educ Today, vol. 26, no. 4, pp. 315-321, 2006. doi: 10.1016/j.nedt.2005.11.002.

Keywords: Problem-based learning, Lecture-based learning, Nursing education, Healthy and sustainable nutrition.