Effectiveness of online simulation with decision-based branching video learning on nurses' knowledge and clinical reasoning in chest trauma: A randomized controlled trial.

BACKGROUND

Accidental injuries, especially thoracic trauma, are a leading cause of death worldwide. Nurses need systematic training to improve trauma care competency. Traditional approaches limit instructor involvement and learner participation. Integrating online simulation with decision-branch may enhance clinical reasoning and improve learning outcomes.

OBJECTIVE

This study aimed to evaluate the effectiveness of an online simulation-based learning approach with decision-branching videos (Online SimuBranch) in enhancing nurses' knowledge of thoracic trauma care and clinical reasoning ability.

DESIGN

Randomized controlled trial with two-group repeated measures design was used.

METHODS

A convenience sample of 95 nurses from a regional hospital in Taiwan was randomly assigned to either experimental (n = 49). or control group (n = 46). The experimental group received a thoracic trauma care course using Online SimuBranch, while the control group received traditional lecture-based instruction. Data were collected at pre-intervention, one-week post-intervention and twelve-week post-intervention. Instruments used were a demographic information sheet, Thoracic Trauma Knowledge Scale and Clinical Reasoning Ability Scale. Results were analyzed using Generalized Estimating Equations (GEE).

RESULTS

The experimental group showed a significant improvement in thoracic trauma knowledge (p < .001), sustained for twelve weeks. Their clinical reasoning scores were higher than the control group but not statistically significant (p > .05).

CONCLUSION

This study found that the Online SimuBranch enhances thoracic trauma knowledge. Although not statistically significant, the intervention enhanced nurses' reasoning ability and confidence in trauma care. Future initiatives are recommended to incorporate Online SimuBranch into continuous education to strengthen the connection between knowledge and practice.