The learning-by-teaching strategy represents an active learning model centered on the learner. In nursing education, where students must acquire diverse competencies and practical abilities, the use of dynamic, student-driven instructional approaches is crucial. This study aimed to evaluate how the learning-by-teaching method influences nursing students’ knowledge acquisition and skill performance during clinical skills training. A quasi-experimental study with no control group was conducted between November 2022 and February 2023, involving 206 senior nursing students. Participants underwent 14 weeks of instruction covering “intravenous catheter insertion and medication administration” and “intramuscular and subcutaneous injection techniques,” applying the learning-by-teaching approach through group-based activities. Throughout the program, students developed and delivered educational materials such as PowerPoint slides, posters, banners, instructional videos, and practical demonstrations. Knowledge assessments were administered before and three weeks after the training, and performance was measured using the Objective Structured Clinical Examination (OSCE). Participants had a mean age of 21.8 ± 1.31 years (range = 20–28), with 68.4% (n = 141) being female and an average GPA of 3.05 ± 0.27. All comparisons revealed statistically significant improvements between pre-test and post-test scores for both theoretical knowledge and practical skills across all groups (p < 0.05). The findings demonstrate that the learning-by-teaching model significantly enhances nursing students’ theoretical understanding and clinical skill proficiency across all evaluated topics, confirming its effectiveness as an active instructional method in nursing skills education.
