Perceived contribution of a hybrid serious game to the development of collaborative problem solving among undergraduate nursing students: A mixed method design

Community health nurses collaborate in teams to address client care, organize services, and conduct preventive activities. Hence, it is crucial for students in this work context, to practise and enhance their collaborative problem-solving (CPS) skills. To facilitate this, a hybrid serious game called "Carion" was developed, immersing second-year nursing students in a semester-long experience of working as district nurses in self-managed teams. The game challenges them to collectively tackle authentic and fictional problems. However, the extent and manner in which this hybrid serious game contributes to students' CPS skill development is unknown. The aim of this study is to explore how students perceive the development of CPS by doing assignments carried out in the learning context of the hybrid serious game Carion. Two teams each consisting of five second-year nursing students, were selected for the qualitative case study. Two lecturers acting as team coaches also participated in this study. 110 (response rate 61%) second-year students participated in the quantitative survey at the beginning of the semester, 109 students at the end of the semester. The study is a mixed method design. The qualitative component involves a case study while the quantitative component consists of an online survey. Qualitative and quantitative data regarding collaborative problem solving was collected at different time points using focus group interviews, one-on-one interviews, digital logbooks and an online self-assessment tool. Qualitative analysis revealed insights into three key themes: 1) Collaboration, encompassing consulting with each other, and capitalising on each other’s qualities and strengths; 2) Problem solving, encompassing quicker and easier problem solving, allocating assignments, coming to a joint solution, and problem-solving method; and 3) Learning from each other, encompassing learning from each other’s knowledge and experience, and from each other’s ideas. No growth in collaborative problem-solving development was statistically shown in the group. This study gives an ambiguous view on students' perception of their CPS development through involvement in various Carion assignments. Based on this exploratory investigation, prematurely labelling Carion as a potential educational environment for developing CPS among undergraduate nursing students in community healthcare would be unwarranted. Further research is needed, particularly in scrutinizing the interplay between CPS and diverse learning activities, assignments and learning outcomes within this specific hybrid serious game context.