The increasing complexity of modern healthcare demands that nurses possess robust clinical reasoning and problem-solving skills to ensure patient safety and effective care, forming an essential component of nursing competence (Karam et al., 2021, Zaitoun et al., 2023). Clinical reasoning is recognized as a holistic, recursive cognitive process necessary to meet the challenges of patients' complex needs and to "think like a nurse". However, equipping nursing students with these essential higher-order competencies remains a significant pedagogical challenge, particularly in resource-constrained environments.

To develop the core competencies, nursing education employs a blend of methods, from traditional lectures to simulation-based training (Park et al., 2024). Traditional lectures efficiently disseminate foundational knowledge but often promote passive learning, which can hinder the development of critical thinking and clinical judgment (Hafeez, 2021, Sharofat and Ruxsora, 2021). In response, active-learning strategies such as problem-based learning (PBL), case-based learning, and collaborative exercises have been widely adopted to foster engagement and applied thinking. While these methods promote deeper processing than passive lectures, their effectiveness can be inconsistent; they may not fully replicate the pressured, sequential decision-making of clinical practice and can be limited by variable group dynamics or a lack of standardized feedback (Wong, 2020).

Simulation-based education has therefore become a cornerstone for bridging theory and practice by offering controlled, experiential learning. High-fidelity patient simulation (HFPS) is valuable for developing clinical judgment through immersive experience but is often prohibitively resource-intensive, limiting its accessibility and scalability (Wong et al., 2023). Conversely, low-fidelity simulation (LFPS) is more accessible but may lack the contextual complexity and realism needed to consistently advance higher-order clinical reasoning (Hill et al., 2023, Konlan et al., 2024, Wong, 2020, Wong and Kan, 2022, Zhang et al., 2022). This disparity highlights a critical gap for a pressing need for innovative, scalable pedagogical approaches that can effectively develop clinical reasoning and problem-solving by integrating the strengths of various approaches, such as the structured reflection of active learning and the experiential fidelity of simulation, without being solely dependent on resource-intensive HFPS (Li et al., 2021, Wong and Wong, 2023).

In response, this study introduces and evaluates the StepUp Learning tool, a structured pedagogical framework designed to bridge this gap. Its contribution lies not in inventing new teaching techniques, but in the deliberate integration and sequencing of established, scalable methods, including interactive lectures, self-assessments via e-learning and short questions, preparatory video scenarios with feedback, and culminating simulation, within a scaffolded model grounded in experiential learning theory. This design is informed by pedagogical principles emphasizing active learning, student-centered methods, and the importance of structured reflection and feedback. The framework is designed to transition learners systematically from foundational knowledge acquisition to complex clinical application, aiming to replicate the co-construction of knowledge involving students and instructors that is deemed most effective. By providing a cost-effective, adaptable, and logically sequenced learning experience, the StepUp Learning tool aims to enhance clinical reasoning and problem-solving abilities in nursing students.

This study aimed to evaluate the effectiveness of the StepUp Learning tool which is a structured pedagogical framework designed around three sequential learning stages (foundational knowledge, application & reflection, and integration & experimentation), for optimizing education outcomes across diverse institutional settings in enhancing first-year nursing students’ problem-solving and clinical reasoning skills, compared with a standard curriculum.