A quasi-experimental study of music-based instruction for cranial nerve learning in nursing students

Abstract

Learning neuroanatomy, particularly the twelve cranial nerves, presents considerable challenges for nursing students due to the abstract nature and sequential organization of the material. This study examined whether a music-based instructional package could enhance learning outcomes compared with conventional lecture-based instruction. A quasi-experimental pretest-posttest control group design was conducted with 65 s-semester nursing students in Bali, Indonesia. Two intact classes were assigned to serve as the experimental group ( n = 33) or control group ( n = 32); because pre-existing classes were used rather than individual randomisation, the groups were not equivalent at baseline. The experimental group learned cranial nerve content through educational songs presented in three musical styles (blues, rock, acoustic), with lyrics incorporating anatomical names, functions, and classifications. The control group received conventional lecture-based instruction. Cognitive achievement was assessed using a validated 20-item multiple-choice test. Although pretest scores differed substantially between groups (experimental M = 72.06, SD = 6.2; control M = 53.87, SD = 5.2), ANCOVA adjusting for baseline differences indicated that the music-based instructional package was associated with significantly higher adjusted posttest scores for the music-based group in two of the three sessions: Session I–IV (F(1,62) = 11.49, p = 0.001, partial η²=0.16; adjusted difference 6.82 points) and Session V–VIII (F(1,62) = 13.15, p = 0.001, partial η²=0.18; 6.29 points). In Session IX–XII the adjusted difference was smaller (2.87 points) and not statistically significant (F(1,62) = 2.71, p = 0.105). However, these adjusted differences should be interpreted cautiously given the substantial baseline imbalance, which introduces limitations that statistical adjustment alone cannot fully compensate for. Importantly, raw learning gains (posttest minus pretest scores) were comparable between groups across all sessions (control gain: 12.90–15.32 points; experimental gain: 11.64–15.00 points), indicating that both instructional approaches produced similar learning improvements from pretest to posttest. Students in the music-based group reported higher engagement and noted that the rhythmic structure helped them remember the sequence and functions of the cranial nerves. These findings suggest that incorporating musical elements into neuroanatomy instruction may support retention of sequentially organized anatomical information while maintaining student engagement, offering a practical alternative for teaching complex biomedical terminology in health science education.

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