Gamification in nursing education: Challenges and effects on skill acquisition

Background Gamification has recently demonstrated effectiveness in shifting nursing education from lecture-based models to learner-centred approaches. While it enhances skill acquisition, instructional methods for developing procedural skills remain diverse and inconsistent. Aim This study examined the effects of gamification-based educational materials on students' understanding and application of nursing skills, knowledge, and procedures. Design A descriptive qualitative design was employed. Participants Eleven fourth-year nursing students from University A in Japan. Methods Participants were recruited through network sampling. They first completed a pre-game questionnaire on procedures and nursing techniques for position changes and feeding assistance. They then engaged in a game in which they cared for a simulated patient with paraplegia and hemiplegia, adjusting posture and assisting in feeding. After the game, they provided care to simulated patients using the same game scenario and completed a post-game questionnaire. Analysis was conducted using qualitative inductive reasoning. Changes in the students' perception before and after the game were analysed to determine their understanding of the 51 care points outlined in the game scenario. Results Students reported improvement in skills such as observing the patient's condition, judgement regarding appropriate timing, and understanding the treatment rationale. Additionally, the procedural points reported by students after the game were more detailed than those before the game, and students understood and retained the content. Conclusion Combining game-based teaching material with simulation experiences was effective in improving students' understanding of nursing implications related to learning nursing skills and their rationales.