Basic Trauma Training Programme for Newly Graduated Nurses in Saudi Trauma Centres

Overview

New nurses often find it difficult to adjust when they start working in fast-paced, high-pressure trauma units, and many leave their jobs within the first two years. This study looks at whether a two-day training programme, called Basic Trauma Training (BTT), helps newly graduated nurses in Saudi trauma hospitals feel more confident, satisfied and engaged in their work, and more likely to stay in the nursing profession. The study takes place at two trauma hospitals in Saudi Arabia. Because it is not practical to randomly assign nurses to groups in this real-world hospital setting, the study compares an earlier group of new nurses, who receive standard hospital orientation only, with a later group, who receive standard orientation plus the two-day BTT training. Both groups complete questionnaires before and after their orientation or training period, answering questions about job satisfaction, engagement, stress and their plans to stay in the role. The study also looks at actual staff retention using hospital employment records at 6 and 12 months. Nurses in the comparison group are offered the BTT training later, once their part of the study is complete, so that everyone has the chance to take part in the training.

This is a two-site, non-equivalent comparison-group quasi-experimental study using a pre-test/post-test design. Allocation is non-random and determined by intake cohort within each participating site: an earlier intake of eligible newly graduated nurses forms the comparator group, and a subsequent intake forms the intervention group, so that study arm is not confounded with site. The intervention, Basic Trauma Training (BTT), is a structured two-day (14 contact-hour) educational programme developed in alignment with Saudi Commission for Health Specialties (SCFHS) Specialised Professional Programme accreditation standards. It comprises five modules: trauma systems and primary survey principles; advanced trauma assessment and clinical reasoning; critical trauma interventions and patient safety; interprofessional communication and team leadership; and psychological preparedness, peer support and self-care. Delivery combines didactic teaching, high-fidelity simulation using the PEARLS debriefing framework, and facilitated reflective discussion. The comparator condition is standard institutional orientation (approximately five days of general clinical induction without trauma-specific structured training). Comparator-arm participants are offered BTT, with the same continuing professional development credit, after their follow-up assessment (waitlist design). Individual-level randomisation was not adopted due to contamination risk between nurses working on the same unit, and because staffing and rostering decisions are governed by institutional service demand rather than research allocation. Contamination is managed through scheduling separation, controlled distribution of training materials, and a two-item contamination check at follow-up. The primary outcome is workforce sustainability, a formative composite index of four equally weighted, standardised components: job satisfaction (MOAQ-JSS), work engagement (UWES-9), personal burnout (CBI-PB, reverse scored), and retention intention. The primary analysis is a linear mixed-effects model with a time-by-arm interaction term, adjusting for site, prior trauma exposure, months since graduation, and delivery block. Secondary outcomes include the four composite components analysed individually, role transition stress (Rizzo Role Ambiguity and Role Conflict scales), trauma-care self-efficacy, general self-efficacy (GSE-10), and actual workforce retention from institutional HR records at 6 and 12 months. An exploratory mediation analysis examines whether role transition stress and self-efficacy mediate the effect of BTT on workforce sustainability. The study is reported in accordance with the SPIRIT 2025 statement for trial protocols and the TREND statement for non-randomised intervention evaluations, with intervention reporting following the TIDieR checklist.