This randomized controlled trial aims to evaluate the effectiveness of a serious game in improving targeted temperature management (TTM) knowledge and situational awareness among critical care nurses. A total of 120 nurses from adult intensive care units will be randomly assigned to either a control group receiving traditional lecture-based teaching or an experimental group receiving lecture-based teaching combined with a digital serious game. Outcomes will be measured using a TTM knowledge test, a situational awareness scale, and a system usability scale. The findings will provide evidence for the use of serious games as an innovative educational strategy to enhance post-resuscitation care quality and patient safety.

Targeted temperature management (TTM) is an evidence-based neuroprotective strategy recommended for patients resuscitated after cardiac arrest. Despite its clinical importance, critical care nurses often lack sufficient knowledge and situational awareness to effectively implement TTM, due to limited exposure to relevant cases and time constraints in training. Conventional teaching methods, while beneficial, face challenges such as limited resources, time, and opportunities for repeated practice.

Serious games, which integrate educational content with interactive digital game elements, offer a flexible and engaging learning tool that enables repeated practice in a safe, simulated environment. Previous studies have shown that serious games can enhance learners' motivation, knowledge retention, and decision-making skills.

This study will develop and implement a serious game specifically designed for TTM education. The randomized controlled trial will enroll 120 intensive care unit nurses, randomly allocated into two groups: the control group will receive lecture-based teaching with case discussion, while the experimental group will receive the same content supplemented with the serious game for additional practice. All participants will complete a pre-test, a post-test one week after the intervention, and a follow-up test at six weeks.

The primary outcome will be the improvement in TTM knowledge, and secondary outcomes will include situational awareness and system usability (experimental group only). The study is expected to provide evidence that serious games are an effective and scalable strategy for enhancing TTM-related knowledge and situational awareness, thereby supporting better quality of post-resuscitation care and patient safety.

Inclusion Criteria:

• Registered nurses currently working in adult intensive care units (medical, surgical, or mixed ICUs).
• Able to read and understand Chinese.
• Willing to participate and provide informed consent.
• Available to complete pre-test, post-test, and follow-up assessments.

Exclusion Criteria:

• Nurses working in pediatric or neonatal ICUs.
• Nurses holding administrative or supervisory positions (non-clinical).
• Nurses currently participating in other TTM-related educational or research programs.
• Individuals unable to complete the intervention or evaluation schedule.

Participants are blinded to group assignment until the intervention begins. Investigators are aware of allocation to deliver the assigned teaching method.