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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:
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:
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.
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).
Intervention Protocol
One week ( Both for intervention group and control group)
One to two weeks ( Based on the school schedule)
Training:
Independent Practice:
• Individual practice in skill labs to reinforce learning.
Evaluation:
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:
Technical Aspects
Randomisation:
Block randomisation is based on pre-test scores, ensuring balanced baseline knowledge across groups.
Assessment Tools:
Ethical and Data Management
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Scenario-Based Simulation Training | Experimental | Students allocated to the intervention group through block randomisation will participate in scenario-based simulation training. The Principal Investigator (PI) and GCCN faculty will guide the students using PI-developed videos and scenarios. The training will incorporate cases that depict abnormal signs and symptoms, fostering active learning and challenging students to apply practical skills. Later, students will engage in group-based skills training for repeated practice and reinforcement. |
|
| Traditional Skills Training | Experimental | Students allocated to the control group through block randomisation will undergo traditional skills training. The Principal Investigator (PI) and GCCN faculty will demonstrate and train them in postoperative nursing management techniques. Later, students will practice independently in a skills lab under the guidance of the PI and GCCN faculty. Finally, all students will participate in a skills evaluation and knowledge post-test and provide free comments. To address potential ethical concerns, after the study's completion, the PI and GCCN faculty will provide the control group with training in scenario-based simulation and show them the developed videos on post-operative nursing management. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| 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. |
| Measure | Description | Time Frame |
|---|---|---|
| Ability of critical thinking and clinical reasoning with skill | 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. | 6-7 weeks after baseline data collection |
| Measure | Description | Time Frame |
|---|---|---|
| Critical Thinking Ability | 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. | 6-7 weeks after baseline data collection |
| Clinical Reasoning Ability |
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Inclusion Criteria:
Exclusion Criteria:
•Students who have completed theory class and clinical practice in the postoperative ward in any hospital.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Grameen Caledonian College of Nursing | Dhaka | Turag | Dhaka-1230 | Bangladesh |
Share according to request to the PI and Supervisor
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2025 - 2026
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Intervention Group Control Group
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| 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 |
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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. |
| 6-7 weeks after baseline data collection |
| Post Operative Management Skill | 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. | 6-7 weeks after baseline data collection |
| Knowledge Test Score | 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. | 1 week after lecture session and 6-7 week after baseline data collection |
| Free Commnents | 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. | 6-7 weeks after baseline data collection |