Animation-Based Orotracheal Suction Training for Expert Nurses

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.

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.

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.