Impact of an advanced trauma life support (ATLS) simulation program on nursing students’ clinical decision-making in trauma care: a quasi-experimental study

Abstract

Background and objective: Trauma is one of the leading causes of mortality worldwide, especially in developing countries. Accurate clinical decision-making ability among nurses plays a crucial role in reducing trauma-related mortality and complications. Strengthening such skills during nursing education can better prepare students to effectively address clinical challenges they may face in real-world trauma care. This study aimed to determine the effect of an Advanced Trauma Life Support (ATLS) simulation program on the clinical decision-making abilities of nursing students. Methods: This quasi-experimental study with a pre-test/post-test control group design was conducted in 2025 on 66 final-year nursing students at Shahid Beheshti University of Medical Sciences. Participants were assigned to intervention (n = 31) and control (n = 35) groups. The intervention group received advanced trauma life support simulation training. Data were collected using a validated clinical decision-making questionnaire and analyzed with paired t-tests, repeated measures ANOVA, and interaction effects tests. Results: The mean clinical decision-making score in the intervention group increased from 40.81 ± 3.22 before the intervention to 52.24 ± 2.04 after the intervention. In the control group, the mean scores were 39.06 ± 2.27 before and 48.09 ± 1.97 after the study period. Repeated measures ANOVA indicated that time (F = 601.08, p < 0.001), group (F = 47.26, p < 0.001), and the interaction of time and group (F = 8.23, p = 0.006) had significant effects on clinical decision-making ability. The improvement in the intervention group was significantly greater than in the control group. Conclusions: These findings suggest that ATLS-based simulation programs can significantly improve nursing students’ readiness for real-life trauma situations and should be integrated into nursing curricula.