The effect of pap-smear test application developed with augmented reality (AR) technology on nursing students' knowledge, attitudes and skills

Introduction: Cervical cancer is a significant health concern for women and, according to 2020 data, ranks as the fourth most common type of cancer. Its tendency to remain asymptomatic in early stages highlights the importance of screening programs. The Pap smear test is an effective method for the early detection of precancerous lesions. With technological advancements, the teaching of Pap smear procedures has improved, reducing errors in sample collection, technique, and storage. One of these innovations is the use of mobile Augmented Reality (AR) applications. Aim: The purpose of this study is to examine the effect of the Pap Smear Test application developed with Augmented Reality technology on nursing students' knowledge, skills, and attitudes. Method: This study employed a controlled quasi-experimental design and was conducted between November 2024 and April 2025 with a total of 91 nursing students—46 in the experimental group and 45 in the control group. Data were collected through face-to-face interviews using the Introductory Information Form, HPV Knowledge Scale, Turkish Version of the Cervical Cancer Knowledge Scale, HPV-DNA Sample Collection Skill Assessment Form, and the Attitude Scale for Augmented Reality Applications. These instruments were administered before the training, immediately after the training, and one month later to evaluate knowledge retention. Results: Within the scope of the study, the experimental and control groups showed similar characteristics in terms of age, academic performance, and use of digital tools. However, the gender distribution and prior experience with Augmented Reality (AR) technology differed between the groups. Participants in the experimental group demonstrated a significant increase in their knowledge of HPV and cervical cancer, their skills in collecting cervical HPV-DNA samples, and their attitudes toward AR applications. Although the experimental group had lower pre-training knowledge levels compared to the control group, they surpassed the control group in post-training and follow-up assessments. Furthermore, AR-supported education positively influenced participants' attitudes, leading to significant improvements in satisfaction, anxiety reduction, and willingness to use the technology. These findings indicate that AR-based education is effective in enhancing knowledge, skills, and attitudes. Conclusion:The Pap smear test application developed using Augmented Reality technology was found to have a positive impact on nursing students' knowledge, skills, and attitudes. September 2025, 147 pages. Keywords: Augmented reality, Papanicolaou test, Nursing education