This study aims to evaluate the impact of a structured climate-resilient disaster preparedness education program on undergraduate nursing students' knowledge and practical skills. Climate change has intensified the frequency and severity of disasters, increasing the need for health professionals who are trained to respond effectively. Nursing students, as future frontline providers, must be equipped with both theoretical knowledge and hands-on competencies to manage disaster situations that are influenced by climate variability.

The study was conducted at Jouf University, Saudi Arabia, using a quasi-experimental design with intervention and control groups. A total of 160 undergraduate nursing students were recruited and randomly assigned at the class level (80 intervention, 80 control). The intervention group participated in a tailored disaster preparedness training program incorporating lectures, interactive workshops, and simulation-based exercises with a focus on climate-resilient responses. The control group continued with their standard nursing curriculum.

Outcomes were measured using validated instruments: a disaster preparedness knowledge questionnaire and an Objective Structured Clinical Examination (OSCE) for disaster management skills. Assessments were conducted at baseline, immediately post-intervention, and at a 4-week follow-up to evaluate retention.

The primary hypothesis is that students who receive the climate-resilient disaster preparedness education will demonstrate significantly greater improvement in knowledge and skills compared to those in the control group. Findings will provide evidence for integrating climate-resilient disaster preparedness into undergraduate nursing curricula to strengthen health workforce readiness for emerging global health challenges.

Disasters linked to climate change pose a growing challenge to health systems worldwide, with increased frequency of extreme weather events, floods, heatwaves, and pandemics. Nurses are among the largest sector of the health workforce and play a pivotal role in disaster preparedness and response. However, traditional nursing curricula often lack structured training in climate-resilient disaster preparedness. Addressing this educational gap is critical for building a workforce capable of protecting public health in the face of climate variability.

This quasi-experimental study was conducted at Jouf University, Saudi Arabia, to assess the effect of climate-resilient disaster preparedness education on nursing students' knowledge and clinical skills. The study enrolled 160 undergraduate nursing students (80 assigned to the intervention arm, 80 to the control arm). After accounting for attrition, 78 students in the intervention group and 79 in the control group completed the study.

Intervention:

The intervention group received a structured disaster preparedness training program designed in alignment with World Health Organization (WHO) and International Council of Nurses (ICN) recommendations. The program consisted of:

Didactic sessions covering disaster types, climate-related risk factors, and preparedness principles.

Interactive workshops emphasizing risk assessment, triage, evacuation, and communication during disasters.

Simulation-based exercises using Objective Structured Clinical Examination (OSCE) stations to practice disaster response in scenarios such as floods, heat emergencies, and mass casualty incidents.

The program was delivered over a 4-week period, totaling 20 contact hours. Faculty members with expertise in disaster nursing and climate health facilitated the sessions.

Control Group:

The control group continued with the standard nursing curriculum without additional disaster-specific training during the study period.

Outcomes:

Primary Outcome: Change in disaster preparedness knowledge (measured by a validated questionnaire, developed by Alim et al., adapted and validated into Arabic).

Secondary Outcome: Change in disaster preparedness skills (measured through OSCE checklists developed by the WHO and validated for reliability in this context).

Additional Outcome: Retention of knowledge and skills at 4 weeks post-training.

Data Collection and Analysis:

Data were collected at three time points: baseline (pre-test), immediately after the intervention (post-test), and 4 weeks later (follow-up). Statistical analysis included paired t-tests to assess within-group changes, independent t-tests and ANCOVA for between-group differences, and calculation of effect sizes (Cohen's d).

Ethical Considerations:

The study was approved by the Jouf University Institutional Review Board (IRB No. KFU-IRB-2025-NUR-014). Written informed consent was obtained from all participants. Participation was voluntary, and confidentiality was maintained throughout.

Significance:

This study addresses a critical gap in nursing education by integrating climate-resilient disaster preparedness into the curriculum. The findings are expected to contribute evidence for policy-makers, educators, and accreditation bodies to strengthen disaster preparedness competencies in nursing programs, ultimately enhancing workforce readiness to respond to climate-related emergencies.

Inclusion Criteria:

Undergraduate nursing students enrolled at Jouf University.

Aged between 18 and 30 years.

Registered in the second or third academic year at the time of study.

Willing to provide informed consent and participate voluntarily.

Able to attend all training sessions and complete pre-, post-, and follow-up assessments.

Exclusion Criteria:

Students who previously attended formal disaster preparedness or emergency management training outside the standard curriculum.

Students with physical or psychological conditions that may limit participation in simulation-based activities (e.g., mobility restrictions, severe anxiety disorders).

Final-year students due to scheduling conflicts with clinical placements.

Students who decline to provide written informed consent.

De-identified individual participant data (IPD) underlying the results reported in this study will be shared with other researchers upon reasonable request. Data will include demographic characteristics, pre- and post-test knowledge scores, skills (OSCE) scores, and follow-up outcomes.

Independent faculty assessors, who were not involved in delivering the intervention and unaware of group allocation, evaluated students' knowledge tests and OSCE checklists.