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Completed

NCT Number: NCT06751446

Improving Critical Thinking and Clinical Reasoning in Nursing Students Through Post-Operative Scenario-Based Simulation

The goal of this clinical trial is to determine whether scenario-based simulation training can effectively enhance critical thinking and clinical reasoning skills in nursing students in Bangladesh, focusing on postoperative nursing management.

The main questions it aims to answer are:

1. Does scenario-based simulation training improve critical thinking and clinical reasoning skills in postoperative nursing management? 2. Is scenario-based simulation training more effective than traditional skills training in enhancing these skills?

Researchers will compare an intervention group (receiving scenario-based simulation training) to a control group (receiving traditional skills training) to see if the intervention leads to greater improvements in critical thinking and clinical reasoning abilities.

Participants will:

* Attend lectures on postoperative nursing care, take a pre-test, and be randomly assigned to either the intervention or control group. * The intervention group will undergo scenario-based simulation training, while the control group will receive traditional skills training. * Both groups will engage in individual practice and complete post-training evaluations to assess critical thinking, clinical reasoning, and overall competency

This study aims to identify an effective teaching strategy for nursing students, enhancing their ability to handle complex clinical situations and improving patient care quality.

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Key information

Conditions

Nursing Education Teaching Method

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Grameen Caledonian College of Nursing

Dhaka, Turag, Dhaka-1230, Bangladesh

About this study

This study, titled "Enhancing the Ability of Critical Thinking and Clinical Reasoning among Nursing Students on Post-operative Management through Scenario-Based Simulation," evaluates the impact of scenario-based simulation training on developing critical thinking and clinical reasoning skills in 2nd-year Bachelor of Science in Nursing (BSN) students at the Grameen Caledonian College of Nursing (GCCN), Bangladesh.

Design and Methodology:

The research employs a prospective, open-label, randomised controlled trial (RCT) with a 1:1 parallel design and block randomization. The study consists of 57 participants, split into an intervention group (scenario-based simulation training) and a control group (traditional skills training).

  • Study Duration: 11 months from November 2024 to September 2025, including preparation, intervention (3 months), and analysis.
  • Educational Context: Participants will have no prior exposure to postoperative nursing theory or practice before this intervention.

Intervention Protocol

  • One week ( Both for intervention group and control group)
  • Two lectures on postoperative nursing management, critical thinking, and clinical reasoning.
  • Pre-test to assess baseline knowledge and randomise participants.
  • One to two weeks ( Based on the school schedule)

Training:

  • Intervention Group: scenario-based simulation, including group activities with realistic clinical cases, guided debriefing, and individual practice.
  • Control Group: Traditional skills training with standard demonstrations and hands-on practice.

Independent Practice:

  • Individual practice in skill labs to reinforce learning.

Evaluation:

  • Skills and knowledge assessments using a standardised checklist and post-tests.
  • Participant reflections were collected for qualitative insights.

Evaluation Metrics

Primary Outcome:

Development of critical thinking and clinical reasoning, assessed using a customised checklist that evaluates domains such as analysis, inference, and evaluation.

Secondary Outcomes:

  • Knowledge improvement through pre- and post-tests.
  • Practical skills in postoperative management.
  • Qualitative insights from participant reflections.

Technical Aspects

Randomisation:

Block randomisation is based on pre-test scores, ensuring balanced baseline knowledge across groups.

Assessment Tools:

  • Knowledge Test: A 25-item multiple-choice questionnaire assessing theoretical understanding.
  • Critical Thinking and Clinical Reasoning Checklist: Developed based on a theoretical framework by Facione and validated by Hiroshima University nursing faculty.
  • Skills Evaluation: Measures ability in critical and practical components of postoperative nursing care.

Ethical and Data Management

  • Ethical approval is secured from GCCN's Institutional Review Board (IRB).
  • Participants' data are anonymised, securely stored on a cloud system, and will be deleted after five years.
  • Participation is voluntary, with informed consent required, and withdrawal allowed without penalties.

Significance This study addresses skill gaps in critical thinking and clinical reasoning among Bangladeshi nursing students. Findings will inform curriculum improvements and promote innovative teaching strategies, with broader implications for global nursing education.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • 2nd-year BSN students at GCCN who take "Adult medical & surgical nursing."
  • Students who provide informed consent to participate in the study.

Exclusion criteria

•Students who have completed theory class and clinical practice in the postoperative ward in any hospital.

Treatment and study plan

Scenario-based Simulation Skill Training

Other

Scenario-based simulation is an educational approach that immerses students in realistic clinical scenarios, allowing them to practice decision-making and problem-solving in a safe, controlled environment. It challenges students to assess patient data, identify priorities, and implement interventions. Through guided debriefing sessions, students reflect on their actions, justify their decisions, and explore alternative strategies.

Traditional Skill Training

Other

Traditional skill training in nursing education focuses on developing core technical skills through direct instruction, demonstrations, and hands-on practice. It emphasises mastery of essential tasks and conducting patient assessments. Students follow standardized protocols and procedures to ensure patient safety and accuracy in their practice

Primary outcomes

  1. Ability of critical thinking and clinical reasoning with skill

    Time frame: 6-7 weeks after baseline data collection

    The primary outcome, critical thinking and clinical reasoning skills, will be assessed using a validated checklist covering five domains: analysis, inference, evaluation, inductive reasoning, and deductive reasoning. Students' performance in simulations or traditional skill demonstrations will be scored based on practical skills, critical thinking, and clinical reasoning. Trained evaluators will observe and score students' ability to identify patient problems, make evidence-based decisions, and explain their reasoning during debriefing sessions, ensuring a comprehensive assessment of these skills.The postoperative skill evaluation checklist includes practical skills, critical thinking, and clinical reasoning. The overall total score is 100: 48 for postoperative skill, 32 for critical thinking ability, and 20 for clinical reasoning ability. This ranges from 0 - 100. Higher scores show higher skill & ability, and lower score indicates less skill and ability.

Secondary outcomes

  1. Critical Thinking Ability

    Time frame: 6-7 weeks after baseline data collection

    PI and the supervisor developed a questionnaire based on the theoretical model. Total score ranges from 0-32. A higher score shows higher ability, and a lower score indicates less ability.

  2. Clinical Reasoning Ability

    Time frame: 6-7 weeks after baseline data collection

    PI and the supervisor developed a questionnaire based on the theoretical model.Total score ranges from 0-20. A higher score shows higher ability, and a lower score indicates less ability.

  3. Post Operative Management Skill

    Time frame: 6-7 weeks after baseline data collection

    It was adapted from a questionnaire from the adult medical and surgical nursing department of Hiroshima University. The postoperative skill score ranges from 0 to 48. Higher scores show higher skill, and a lower score indicates less skill.

  4. Knowledge Test Score

    Time frame: 1 week after lecture session and 6-7 week after baseline data collection

    PI and the supervisor developed a questionnaire based on the medical & surgical nursing textbooks.The test will have a total score range of 0-25. A higher score indicates a higher level of knowledge, whereas a lower score indicates a lesser level of knowledge.

  5. Free Commnents

    Time frame: 6-7 weeks after baseline data collection

    The researcher developed a questionnaire. It has five comments.Free comments will undergo thematic analysis to identify key themes and patterns, with results presented as a narrative summary using illustrative quotes or making categories to describe their responses.

Sponsors and collaborators

Lead sponsor

Hiroshima University

Other

Registry information

Official study title

Enhancing the Ability of Critical Thinking and Clinical Reasoning Among Nursing Students on Post-operative Management Through Scenario-Based Simulation

Important dates

Study start
2025
Primary completion
2025
Study completion
2025
First posted
Dec 27, 2024
Registry last updated
Jun 15, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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