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.

De-identified individual participant data underlying the results reported in this study will be made available upon reasonable request to the corresponding author. Data will be available beginning 6 months and ending 5 years following publication. Requests will be reviewed by the principal investigator, and access will be granted for scientifically sound research purposes after approval and signing of a data access agreement.

Individual participant data and supporting materials will be available beginning 6 months following publication and ending 5 years after publication.

De-identified individual participant data, study protocol, statistical analysis plan, and analytic code will be made available upon reasonable request to the corresponding author. Data will be shared with researchers who provide a methodologically sound proposal for achieving the aims of the approved proposal. Access will be granted after review and approval by the principal investigator and completion of a data access agreement.