Background <p>Medication administration errors represent a major threat to pediatric patient safety, and insufficient pharmacological knowledge among nursing students contributes substantially to this risk. Given the complexity of intravenous medication care in children, educational approaches that actively support knowledge acquisition and safe medication practices during clinical training are needed.</p> Objective <p>This study aimed to evaluate the effect of problem-solving–based intravenous medication care training integrated into pediatric clinical education on pharmacological knowledge and medication error risk among nursing students.</p> Methods <p>This quasi-experimental pretest–posttest study was conducted in 2024 among sixth-semester nursing students undergoing pediatric clinical training at Hamadan University of Medical Sciences, Iran. Using a census approach, 54 eligible students were allocated to an experimental group (<i>n</i> = 27) or a control group (<i>n</i> = 27) based on predefined clinical group assignments. Both groups received routine clinical training, while the experimental group additionally participated in structured problem-solving–based intravenous medication care training delivered through daily clinical scenarios over nine consecutive days. Data were collected using a demographic questionnaire, a researcher-developed pharmacological knowledge questionnaire, and an observational medication error risk checklist. Data were analyzed using appropriate parametric and non-parametric statistical tests, including repeated-measures analysis, with effect sizes reported.</p> Results <p>At baseline, no significant differences were observed between groups in demographic characteristics, pharmacological knowledge, or medication error risk (<i>P</i> &gt; 0.05). Following the intervention, pharmacological knowledge increased significantly in both groups; however, the improvement was significantly greater in the experimental group, which achieved higher post-intervention knowledge scores compared with the control group (<i>P</i> &lt; 0.001; Cohen’s d = 1.22). Medication error risk decreased significantly over time in both groups, but the reduction was significantly greater in the experimental group, with a significant time-by-group interaction effect (<i>P</i> &lt; 0.001).</p> Conclusion <p>Integrating problem-solving–based intravenous medication care training into pediatric clinical education was associated with greater improvements in pharmacological knowledge and a larger reduction in medication error risk compared with routine clinical training alone. Embedding structured scenario-based learning within clinical practice may support medication safety during undergraduate pediatric nursing education.</p> Clinical trial number <p>Not applicable.</p>