This randomized controlled mixed-methods study evaluated the effect of creative drama education on nursing students' reflective thinking and clinical decision-making skills. Participants were randomly assigned to either an experimental group receiving creative drama education (n = 40) or a control group participating in case-based discussion sessions (n = 37). Quantitative data were collected before and after the intervention using validated measurement instruments. Following completion of the intervention, qualitative interviews were conducted with participants from the experimental group to explore their learning experiences and provide a deeper explanation of the quantitative findings.