Effectiveness of Scenario-Based Online Simulation in Chest Trauma in Nurses

March 24, 2025 updated by: tygh backup

The Effectiveness of a "CARE I DECIDE！" Scenario-Based Online Simulation Training Program in Chest Trauma Care Knowledge and Clinical Reasoning Ability Among Nurses

Methods This randomized controlled trial evaluated teaching strategies for chest trauma education. The course was promoted via posters and conducted over two days, with two sessions per day. Sessions were randomly assigned to the control or experimental group via a lottery system before the course. This process was repeated on day two. A total of 67 participants per group were recruited, ensuring 50% random allocation. Control Group Participants received traditional classroom instruction with case discussions. Pretest: Collected demographic data and assessed baseline knowledge using the Chest Trauma Knowledge Scale (CTKS) and Nursing Clinical Decision-Making Scale (NCDMS). First posttest (1-week follow-up): Measured CTKS, NCDMS, and Learning Engagement Scale (LES). Second posttest (3-month follow-up): Assessed CTKS and Confidence in Nursing Clinical Reasoning Scale (CNCRS). Experimental Group Participants received traditional instruction plus "CARE! I-DECIDE" online simulation. Pretest: Same as the control group. First posttest (1-week follow-up): Measured CTKS, NCDMS, and LES. Second posttest (3-month follow-up): Assessed CTKS and CNCRS. Assessments were completed via Google Forms or paper-based questionnaires. This study compared traditional teaching with blended learning using online simulation, evaluating immediate and delayed outcomes.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Background In Taiwan, accidental injuries remain a major cause of death, with thoracic trauma being a significant contributor to severe cases. Nurses must develop rapid assessment, management, and clinical reasoning skills to improve trauma care. However, trauma training is often limited by spatial and financial constraints, restricting ongoing education. The "Care I Decide!" online simulation-assisted teaching provides a flexible, accessible solution for continuous thoracic trauma training, enhancing nurses' knowledge and clinical reasoning skills.

Purpose This study assessed the effectiveness of "Care I Decide!" in improving nurses' thoracic trauma knowledge and clinical reasoning skills.

Method This randomized controlled trial (RCT) used a two-group, repeated-measures design with 95 ER and surgical nurses from a regional teaching hospital in Northern Taiwan.

  • Experimental group (n=49): Received classroom teaching + "Care I Decide!" online simulation.
  • Control group (n=46): Received classroom teaching + case sharing.

Participants completed:

  • Pre-test (before intervention)
  • First post-test (1 week after intervention)
  • Second post-test (12 weeks after intervention)

Instruments used:

  • Thoracic Trauma Knowledge Scale (TTKS)
  • Clinical Reasoning Skills Scale (CRSS)
  • Learning Engagement Scale (LES) Results Pre-test scores showed no significant differences between groups.

After the intervention:

  • The experimental group had higher thoracic trauma knowledge in both post-tests (p < .01).
  • Their clinical reasoning skills improved significantly in the second post-test (p < .05).
  • High learning engagement was observed in both groups but was not statistically significant (p > .05).

Conclusion and Recommendations Both approaches improved nurses' knowledge and clinical reasoning skills. The "Care I Decide!" online simulation provided flexible training without time or location constraints. Scenario-based exercises enhanced clinical reasoning and decision-making, offering real-time feedback for concept clarification.

Additionally, interactive videos strengthened knowledge retention and clinical judgment by allowing nurses to apply reasoning in patient scenarios. This method is recommended for continuing education and could be expanded to other trauma scenarios for ongoing clinical training.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
95

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Taiwan
      • Taoyuan, Taiwan, 330
        • TaoYuan General Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Professional Setting:

Nurses working in emergency departments or specific surgical specialties, including thoracic surgery, neurosurgery, general surgery, and orthopedics.

Willingness to Participate:

Nurses who voluntarily agree to participate in this study.

Exclusion Criteria:

  • Non-Surgical Nurses:

Nurses from non-surgical departments or those not meeting the inclusion criteria within other surgical specialties.

Non-Frontline Care Providers:

Nurses not directly involved in the clinical care of chest trauma patients, such as outpatient nurses or case managers.

Incomplete Participation:

Nurses who do not complete the full course of the study program.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Experimental Group

The experimental group received "Care I Decide!" online simulation-assisted teaching following the classroom-based instruction.

Classroom-Based Teaching and Online Simulation-Assisted Instruction

Classroom-Based Instruction:

Participants were provided with a QR code to access the Moodle platform and download the electronic course materials.

The classroom instruction covered the following topics:

Mechanisms of trauma and prehospital assessment. Principles of major trauma activation and evaluation. Types of chest trauma and associated clinical signs. Principles of chest trauma care and recognition of changes in patient conditions.

"Care I Decide!" Online Simulation-Assisted Teaching:

A detailed explanation of the operational process for the "Care I Decide!" online simulation-assisted teaching materials was provided.

The session integrated classroom knowledge with the "Care I Decide!" online simulation. It presented clinical scenarios involving changes in vital signs and symptoms.
Other: Scenario-Based Online Simulation Training Program

Classroom-Based Teaching and Online Simulation-Assisted Instruction

Classroom-Based Instruction:

Participants were provided with a QR code to access the Moodle platform and download the electronic course materials.

The classroom instruction covered the following topics:

Mechanisms of trauma and prehospital assessment. Principles of major trauma activation and evaluation. Types of chest trauma and associated clinical signs. Principles of chest trauma care and recognition of changes in patient conditions.

"Care I Decide!" Online Simulation-Assisted Teaching:

A detailed explanation of the operational process for the "Care I Decide!" online simulation-assisted teaching materials was provided.

The session integrated classroom knowledge with the "Care I Decide!" online simulation. It presented clinical scenarios involving changes in vital signs and symptoms of chest trauma patients, guiding participants through clinical decision-making processes.
Other: Control Group

The control group received traditional case sharing following the classroom-based instruction.

Classroom-Based Teaching

Delivery of Course Materials:

Participants were provided with a QR code to access the Moodle platform, where they could download the electronic course handouts.

Classroom Instruction Content:

The classroom teaching session included the following topics:

Mechanisms of trauma and prehospital assessment. Principles of major trauma activation and evaluation. Types of chest trauma and associated clinical signs. Principles of chest trauma care and recognition of changes in patient conditions.

Chest Trauma Case Sharing

Case Presentation and Reflection:

Clinical cases involving chest trauma were presented to participants. They were guided to describe the case details, reflect on the management process, and receive constructive feedback.

Discussion and Problem Solving:

During the discussion, questions and uncertainties raised by participants were addressed
Other: Classroom-Based Teaching

Classroom-Based Teaching

Delivery of Course Materials:

Participants were provided with a QR code to access the Moodle platform, where they could download the electronic course handouts.

Classroom Instruction Content:

The classroom teaching session included the following topics:

Mechanisms of trauma and prehospital assessment. Principles of major trauma activation and evaluation. Types of chest trauma and associated clinical signs. Principles of chest trauma care and recognition of changes in patient conditions.

Chest Trauma Case Sharing

Case Presentation and Reflection:

Clinical cases involving chest trauma were presented to participants. They were guided to describe the case details, reflect on the management process, and receive constructive feedback.

Discussion and Problem Solving:

During the discussion, questions and uncertainties raised by participants were addressed to enhance understanding and clarify key concepts.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Chest Trauma Knowledge，Clinical Reasoning Scale
Time Frame: 6months
Primary Outcome Measures: Chest Trauma Care Knowledge Scale：Measures knowledge of chest trauma care.Time Points: Before the intervention, right after the intervention, and 12 weeks later.Clinical Reasoning Scale：Assesses clinical reasoning skills in chest trauma care.Time Points: Before the intervention, right after the intervention, and 12 weeks later.Learning Engagement Scale：Evaluates participants' engagement in the learning process.Time Point: Right after the intervention.Overall Study Time Frame: 6 months.
6months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
tygh backup

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
January 19, 2024

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
May 18, 2024

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
May 18, 2024

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
December 17, 2024

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
March 24, 2025

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
March 30, 2025

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
March 30, 2025

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
March 24, 2025

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
March 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • TYGH112053

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Clinical Trials on Nursing Education

Clinical Trials on Scenario-Based Online Simulation Training Program

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

Cookie Settings

We use cookies to ensure that we give you the best experience on our website. For more details carefully read our Privacy and Cookies Policy. ...>>>You can change your preferences or withdraw your consent at any time by deleting the cookies from your website or computer as described in the policy. Please accept it and choose your preferences by ticking the corresponding boxes in the "Manage Settings" section below. Please carefully read our Terms of Service before you proceed with using any part of this website.
«Manage Settings