Currently submitted to: JMIR Nursing
Date Submitted: Jun 28, 2026
Open Peer Review Period: Jun 30, 2026 - Aug 25, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Evaluation a Digital SAHAR Model in Training Nurses' Clinical Decision-Making for Physical Trauma Cases in the Emergency Department: A Quasi-Experimental Study
ABSTRACT
Background:
Clinical decision-making is a crucial competency for nurses in the Emergency Department (ED), especially in managing patients with physical trauma. However, limitations in critical thinking and clinical reasoning can affect the quality of patient care. The digital SAHAR Model (Steps to Analysis of Hypothesis in Achieving Responsiveness) was developed as a structured framework to support nurses in making systematic and effective clinical decisions.
Objective:
This study aimed to evaluate the effectiveness of digital SAHAR Model training in improving nurses' knowledge, clinical behavior, and patient satisfaction in the ED.
Methods:
This quasi-experimental study design used a pretest–posttest non-equivalent control group design. The study was conducted in hospital Emergency Departments. Research instruments employed validated and reliable measurement tools to assess knowledge, clinical behavior, and patient satisfaction. The digital SAHAR Model and its associated tools underwent expert validation and readability testing prior to implementation. Data analysis used inferential statistics, including partial eta squared (η²) to measure effect size.
Results:
The digital SAHAR Model demonstrated significant effects on improving knowledge, nurse competencies, and patient satisfaction. The intervention group experienced improvements in knowledge, clinical behavior, and patient satisfaction, while the control group showed no significant changes.
Conclusions:
The digital SAHAR Model improved clinical decision-making competencies among ED nurses. The model has potential as a structured training framework and can be adapted in nursing education nationally and globally. Technology-based approaches, such as virtual reality, may enhance learning. Multi-center and longitudinal research is needed to strengthen the generalizability of findings.
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