Background: One of the participatory learning approaches is the puzzle teaching method. Depending on the nature of the subject and the type of learners, this strategy can produce a variety of outcomes. The purpose of this study was to see how well the puzzle teaching style worked in the undergraduate nursing program's home nursing care course.Methods: This is a three-year evaluation study utilizing a qualitative methodology that took place between 2016 and 2019. The teaching technique was employed for a number of sessions of a home nursing care course during the first phase, and an evaluation was conducted at the end of the course using purposive sampling and focus group interviews with 11 students. The results of the first phase's evaluation led to changes in the procedure in the second phase, and at the end of that course, the evaluation was repeated with the 13 students. Further modifications to the teaching style were made, and a re-evaluation with ten students was conducted. MAXQDA10 software was used to conduct traditional content analysis on the data. Results The benefits of the puzzle method were confirmed by participants, but the findings of the first two phases of evaluation revealed obstacles such as "ineffective involvement," "inadequate teacher supervision," "offering unnecessary content," and "lack of final summarization" by the faculty member, "ineffective involvement", "crowded classroom", "the need for evaluation “and "piece learning" . Except for "ineffective involvement," the third phase's evaluation findings suggested that all flaws and obstacles had been addressed. Conclusion: The majority of the obstacles to implementing the puzzle teaching approach can be overcome by changing a few stages and procedures. However, ineffective involvement remains a significant roadblock. To overcome this stumbling block, more research is required.