Animation-Based Orotracheal Suction Training for Expert Nurses (ABOST-EN)

June 30, 2026 updated by: Makbule YILMAZ, Bartın Unıversity

Effect of Animation-Based Orotracheal Suction Training on Clinical Reasoning Competency and Knowledge Level of Expert Nurses: A Randomized Controlled Trial

This randomized controlled trial aimed to evaluate the effect of animation-based orotracheal suction training on the clinical reasoning competency and knowledge levels of expert pediatric nurses. Orotracheal suctioning is a complex and invasive nursing procedure requiring advanced clinical reasoning, rapid decision-making, and patient safety awareness. Although digital learning approaches are increasingly used in nursing education, evidence regarding their effectiveness among expert nurses remains limited.

A total of 66 pediatric nurses with at least five years of clinical experience and classified as expert nurses according to Patricia Benner's Novice-to-Expert Model were randomly assigned to either an intervention group receiving animation-based mobile training or a control group receiving PowerPoint-supported traditional training. Clinical reasoning competency and knowledge regarding orotracheal suctioning were assessed before and after the educational intervention.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Background:

Orotracheal suctioning is an essential but invasive nursing intervention frequently performed in pediatric clinical settings. Safe and effective implementation of this procedure requires advanced clinical reasoning skills, prioritization, rapid decision-making, and patient safety awareness. Expert nurses are expected to integrate experiential knowledge and clinical judgment during such complex procedures. However, traditional in-service educational approaches may not sufficiently support the development of clinical reasoning competencies.

Animation-based educational technologies provide opportunities for repeated observation, visualization of procedural steps, and reinforcement of clinical decision-making processes. Despite increasing interest in digital educational approaches, evidence regarding their effectiveness among expert nurses remains limited.

Objective:

This study aimed to examine the effect of animation-based orotracheal suction training on expert nurses' clinical reasoning competency and knowledge regarding orotracheal suctioning.

Methods:

This study was designed as a single-blind, parallel-group, pretest-posttest randomized controlled trial. The study was conducted between January and April 2026 in pediatric clinics of a city hospital in Istanbul, Türkiye.

Participants were pediatric nurses with at least five years of clinical nursing experience who met the expert-level criteria defined by Patricia Benner's Novice-to-Expert Model. Participants were randomly assigned to either the intervention group (animation-based mobile training) or the control group (PowerPoint-supported traditional training).

Data were collected using a Descriptive Characteristics Form, the Orotracheal Suction Knowledge Test, and the Clinical Reasoning Competency Scale for Nurses. Outcomes were evaluated before and after the intervention.

Primary Outcome:

Clinical reasoning competency measured by the Clinical Reasoning Competency Scale for Nurses.

Secondary Outcome:

Knowledge regarding orotracheal suctioning measured using the Orotracheal Suction Knowledge Test.

Significance:

The findings of this study are expected to contribute to the development of innovative, technology-enhanced educational strategies aimed at strengthening clinical reasoning, decision-making, and patient safety among expert nurses.

Study Type

Interventional

Enrollment (Actual)

66

Phase

  • 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

  • Turkey (Türkiye)
      • Istanbul, Turkey (Türkiye), 34083
        • Kartal Dr. Lutfi Kirdar City 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

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Registered nurses working in pediatric clinics.
  • Having at least five years of clinical nursing experience.
  • Meeting expert-level criteria according to Patricia Benner's Novice-to-Expert Model.
  • Willing to participate voluntarily in the study.
  • Providing written informed consent.
  • Having access to a smartphone or mobile device to access the educational materials.

Exclusion Criteria:

  • Having less than five years of clinical nursing experience.
  • Being on leave or absent during the study period.
  • Failing to complete the educational intervention or posttest assessments.
  • Withdrawing from the study at any stage.
  • Submitting incomplete questionnaires.

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: Other
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Animation-Based Training Group
Participants in this group received animation-based orotracheal suction training delivered through QR code-enabled mobile access. The educational intervention included animated visualization of procedural steps and clinical decision-making processes related to pediatric orotracheal suctioning.
Other: Animation-Based Orotracheal Suction Training
A mobile-supported animation-based educational intervention designed to improve expert nurses' clinical reasoning competency and knowledge regarding pediatric orotracheal suctioning. Participants accessed the educational content through QR code-enabled mobile devices.
Other: Traditional Training Group
Participants in this group received PowerPoint-supported traditional training on pediatric orotracheal suctioning delivered through conventional face-to-face educational methods.
Other: PowerPoint-Supported Traditional Training
Traditional educational training delivered using PowerPoint presentations covering pediatric orotracheal suctioning procedures and related theoretical content.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Clinical Reasoning Competency
Time Frame: Baseline and immediately after completion of the educational intervention (approximately 2 weeks)
Clinical reasoning competency will be assessed using the Clinical Reasoning Competency Scale for Nurses. Higher scores indicate higher levels of clinical reasoning competency.
Baseline and immediately after completion of the educational intervention (approximately 2 weeks)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Orotracheal Suction Knowledge Level
Time Frame: Baseline and immediately after completion of the educational intervention (approximately 2 weeks)
Knowledge regarding pediatric orotracheal suctioning will be assessed using the Orotracheal Suction Knowledge Test. Higher scores indicate greater knowledge regarding evidence-based orotracheal suction practices.
Baseline and immediately after completion of the educational intervention (approximately 2 weeks)

Collaborators and Investigators

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

Sponsor

Bartın Unıversity

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

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)

January 1, 2026

Primary Completion (Actual)

April 30, 2026

Study Completion (Actual)

April 30, 2026

Study Registration Dates

First Submitted

June 30, 2026

First Submitted That Met QC Criteria

June 30, 2026

First Posted (Actual)

July 7, 2026

Study Record Updates

Last Update Posted (Actual)

July 7, 2026

Last Update Submitted That Met QC Criteria

June 30, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • BARU-OTOA-2026

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

De-identified individual participant data underlying the results reported in this study will be made available upon reasonable request to the corresponding author. Data will be available beginning 6 months and ending 5 years following publication. Requests will be reviewed by the principal investigator, and access will be granted for scientifically sound research purposes after approval and signing of a data access agreement.

IPD Sharing Time Frame

Individual participant data and supporting materials will be available beginning 6 months following publication and ending 5 years after publication.

IPD Sharing Access Criteria

De-identified individual participant data, study protocol, statistical analysis plan, and analytic code will be made available upon reasonable request to the corresponding author. Data will be shared with researchers who provide a methodologically sound proposal for achieving the aims of the approved proposal. Access will be granted after review and approval by the principal investigator and completion of a data access agreement.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP
  • ANALYTIC_CODE

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

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.

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