Guess it (SVUAL): An app designed to help nursing students acquire and retain knowledge about basic and advanced life support techniques

Mobile applications in nursing science education: A scoping review with snowballing method

OBJECTIVES

To review the available evidence on the use and effectiveness of mobile applications to assist nursing students in comprehending, utilising, and applying specialised language and knowledge terminologies when learning the language of biosciences.

DESIGN

A scoping review.

DATA SOURCES

The databases CINAHL Complete, ERIC, EMCare, MEDLINE, PubMed, the OVID scholarly interface and the web search engine Google Scholar were searched.

REVIEW METHODS

Peer-reviewed literature published in English during the period 2010-2023 was reviewed. Snowballing methods saw the reference lists of all included articles searched, and a secondary search of the Scopus ranked top ten nursing journals. Articles were included if they reported on any app or digital resource used when teaching undergraduate nursing students biosciences/science language skills, concepts, or terminology. Studies were excluded if the participants were non-nursing student cohorts or content did not meet the inclusion criteria.

RESULTS

Mobile applications generally contribute positively to nursing students' education. These applications are deemed valuable tools, offering structured content in easily digestible formats. Some applications also foster teamwork and collaboration during clinical placements, promoting peer learning, and a sense of community. User internet access and preparation for learning were the only noted barriers. A range of science-based concepts were taught using applications, including diabetes mellitus, medical terminology, asthma, and cardiac conditions. Despite the promise shown by using mobile applications to teach nurse sciences, few are dedicated to bioscience language and scientific terminology. Recognising the challenging nature of teaching these concepts, developing specialised applications could substantially improve the educational experience for nursing students.

CONCLUSION

Nurse educators are encouraged to teach with applications given their reported effectiveness in knowledge gains for students learning science concepts. Rigorous interventional study designs are warranted to extend suggestions that using applications enhances student understanding of challenging scientific concepts and support quality in clinical learning.

Gamified learning for resuscitation education: A systematic review

Aim

To systematically review published literature to evaluate the impact of gamified learning on educational and clinical outcomes during life support education.

Methods

This systematic review was conducted as part of the continuous evidence evaluation process of the International Liaison Committee on Resuscitation (ILCOR). A search of PubMed, Embase, and Cochrane was conducted from inception until February 12, 2024. Studies examining incorporation of gamified learning were eligible for inclusion. Reviewers independently extracted data on study design and outcomes; appropriate risk of bias assessment tools were used across all outcomes.

Results

2261 articles were identified and screened, yielding sixteen articles (seven randomized trials, nine observational studies) which comprised the final review. No meta-analyses were conducted due to significant heterogeneity of intervention, population, and outcome. Only one study was found to have a low risk of bias; the remaining studies were found to have moderate to high risk. Fourteen studies were in healthcare providers and two were in laypersons. Most studies (11 of 16) examined the impact of a digital platform (computer or smartphone). Most (15 of 16) studies found a positive effect on at least one educational domain; one study found no effect. No included study found a negative effect on any educational domain.

Conclusion

This systematic review found a very heterogeneous group of studies with low certainty evidence, all but one of which demonstrated a positive effect on one or more educational domains. Future studies should examine the underlying causes of improved learning with gamification and assess the resource requirements with implementation and dissemination of gamified learning.

Effectiveness of "Escape Room" Educational Technology in Nurses' Education: A Systematic Review

Escape room games are educational gamification technologies that consist of introducing a team of players into a physical or digital space in search of clues to answer puzzles, riddles or enigmas and solve a mystery or problem. This study aims to determine the effectiveness of escape room games on the training of nursing students in an international context. A systematic review was carried out in MEDLINE, WOS, SCOPUS, CINAHL and LILACS databases using the MeSH terms "Education, Nursing" and "Educational Technology", and the free term "Escape room", combined with Boolean operators AND/OR. Intervention studies in Spanish, English and Portuguese were included, without limitation for the year of publication. Selection and critical appraisal were conducted by two independent reviewers. A total of n = 13 interventional studies were included (n = 2 Randomized Clinical Trials and n = 11 quasi-experimental design). Escape rooms are a recent and growing educational methodology, increasingly used in academia and in the training of nurses and nursing students. However, it is necessary to expand their use and the quality of the studies in a greater number of contexts. Furthermore, it is necessary to homogenize and standardize validated instruments to evaluate the effectiveness of escape rooms in the nursing education area.

The Effects of Serious Games on Cardiopulmonary Resuscitation Training and Education: Systematic Review With Meta-Analysis of Randomized Controlled Trials

BACKGROUND

Serious games have emerged as an innovative educational strategy with the potential to significantly enhance the quality and effectiveness of cardiopulmonary resuscitation (CPR) training. Despite their promise, there remains a degree of controversy when comparing the advantages of serious games with traditional CPR training methods. This study seeks to provide a comprehensive assessment of the impact of serious games on CPR training and education by systematically analyzing the results of previous research.

OBJECTIVE

This study aimed to assess the effect of serious games on CPR training and education by summarizing and pooling the results of previous studies.

METHODS

We conducted a thorough and systematic search across 9 prominent web-based databases, encompassing the period from the inception of these databases until April 1, 2023. The databases included in our search were PubMed, Cochrane Library, Wiley Online Library, EBSCO (PsycInfo), SpringerLink, Chinese Biology Medicine Disc, Vip Journal Integration Platform, Wanfang Database, and Chinese National Knowledge Infrastructure. The studies selected adhered to the following criteria: (1) being a randomized controlled trial comparing serious games and traditional methods for CPR training; (2) having participants aged 12 years or older in CPR; (3) having an experimental group using serious games and a control group using nongame methods for CPR instruction; and (4) having outcomes including theoretical and skill assessments, compression depth, and rate. The Cochrane risk of bias assessment tool was used to evaluate the risk of bias. Data analysis was performed using RevMan (version 5.3; Cochrane Training), and mean differences (MDs) and standardized mean differences (SMDs) with 95% CIs were used to calculate continuous variables.

RESULTS

A total of 9 articles were included, involving 791 study participants, of whom 395 in the experimental group taught CPR training using serious games and 396 in the control group taught CPR training using traditional methods. The results of our meta-analysis indicate that the use of serious games in CPR training yields outcomes that are comparable in effectiveness to traditional training methods across several key areas. Specifically, serious games demonstrated equivalence to traditional formats in theory assessment (SMD -0.22, 95% CI - 0.96 to 0.51; P=.55), skill assessment (SMD -0.49, 95% CI -1.52 to 0.55; P=.36), compression depth (MD -3.17, 95% CI -0.18 to 6.53; P=.06), and compression rate (MD -0.20, 95% CI -7.29 to 6.89; P=.96).

CONCLUSIONS

In summary, serious games offer a viable and effective CPR education approach, yielding results comparable to traditional formats. This modality is a valuable addition to CPR training methodologies. However, caution is warranted in interpreting these findings due to limited controlled trials, small sample sizes, and low-quality meta-analyzed evidence.

Nurses' Roles in mHealth App Development: Scoping Review

BACKGROUND

Although mobile health (mHealth) apps for both health consumers and health care providers are increasingly common, their implementation is frequently unsuccessful when there is a misalignment between the needs of the user and the app's functionality. Nurses are well positioned to help address this challenge. However, nurses' engagement in mHealth app development remains unclear.

OBJECTIVE

This scoping review aims to determine the extent of the evidence of the role of nurses in app development, delineate developmental phases in which nurses are involved, and to characterize the type of mHealth apps nurses are involved in developing.

METHODS

We conducted a scoping review following the 6-stage methodology. We searched 14 databases to identify publications on the role of nurses in mHealth app development and hand searched the reference lists of relevant publications. Two independent researchers performed all screening and data extraction, and a third reviewer resolved any discrepancies. Data were synthesized and grouped by the Software Development Life Cycle phase, and the app functionality was described using the IMS Institute for Healthcare Informatics functionality scoring system.

RESULTS

The screening process resulted in 157 publications being included in our analysis. Nurses were involved in mHealth app development across all stages of the Software Development Life Cycle but most frequently participated in design and prototyping, requirements gathering, and testing. Nurses most often played the role of evaluators, followed by subject matter experts. Nurses infrequently participated in software development or planning, and participation as patient advocates, research experts, or nurse informaticists was rare.

CONCLUSIONS

Although nurses were represented throughout the preimplementation development process, nurses' involvement was concentrated in specific phases and roles.

Gamification on Instagram: Nursing students' degree of satisfaction with and perception of learning in an educational game

BACKGROUND

Gamification has been shown to lead to greater motivation and participation among students. Currently, many teachers use social networks to share supplementary course materials and student work, but they have not incorporated gamified educational activities into social networking sites.

OBJECTIVE

To determine nursing students' satisfaction with an Instagram-based educational game and their perceptions of its effects on their learning.

DESIGN

We conducted a cross-sectional, descriptive, observational study.

PARTICIPANTS

First-year nursing students in the subject "Dietetics and Nutrition".

RESULTS

Of the total sample, 71.7 % agreed that gamification had helped them assimilate the content. Between 66 % and 70 % agreed that the experience had motivated them to keep up with the subject and learn more about the topic, that it had helped them to better understand certain concepts of the subject, that they would recommend the experience to other students, and that they enjoyed the experience of playing a game while learning. 71.7 % of them were in favour of increased use of gamification in other subjects.

CONCLUSIONS

The use of an Instagram-based educational game as a complement to in-class teaching was useful, enjoyable, and motivating for the acquisition of new knowledge.

The use and impact of game-based learning on the learning experience and knowledge retention of nursing undergraduate students: A systematic literature review

BACKGROUND

Active engagement of nursing students has deteriorated overtime, especially during the global pandemic. Therefore, there has been a widespread search for learning methods that incorporate digital technologies and active student participation in recent years. Game-based learning may be an option, as it uses game-design elements to enhance academic performance and learning. Its use in nursing education is, however, limited.

OBJECTIVES

The literature review aimed to explore student experience and learning when using game-based learning and to understand its uses in the nursing curriculum.

DESIGN

Systematic literature review using the Preferred Reporting Items for Systematic Reviews and Meta-analysis.

DATA SOURCES

ESBCO Discovery Service was used to search healthcare, science and education-related databases.

REVIEW METHODS

A comprehensive search of English language primary research published between 2017 and 2022 on the use of game-based learning in nursing undergraduate education was conducted. Data was analysed using thematic analysis.

RESULTS

Seventeen papers from 4 different countries were included. The studies explored interventions and subjects of increased teaching complexity that required increased levels of knowledge retention and critical thinking, such as nursing theory and complex clinical skills. Three themes emerged from the literature, including: approaches to game-based learning; student experience and engagement; impact of game-based learning on student learning and knowledge retention. Studies used a wide range of learning methods, such as quizzes, escape rooms and serious games. These methods were in general well-accepted by students, who endorsed its widespread use in the nursing curriculum. Most studies reported an increase in student experience and learning when using game-based learning, although time-limited games can often increase anxiety on students.

CONCLUSIONS

Game-based learning is an important alternative to traditional teaching methods. However, the recurrent use of game elements and its limited long-term effects may pose a limitation to its widespread use in nursing undergraduate education.

Usability Methods and Attributes Reported in Usability Studies of Mobile Apps for Health Care Education: Scoping Review

BACKGROUND

Mobile devices can provide extendable learning environments in higher education and motivate students to engage in adaptive and collaborative learning. Developers must design mobile apps that are practical, effective, and easy to use, and usability testing is essential for understanding how mobile apps meet users' needs. No previous reviews have investigated the usability of mobile apps developed for health care education.

OBJECTIVE

The aim of this scoping review is to identify usability methods and attributes in usability studies of mobile apps for health care education.

METHODS

A comprehensive search was carried out in 10 databases, reference lists, and gray literature. Studies were included if they dealt with health care students and usability of mobile apps for learning. Frequencies and percentages were used to present the nominal data, together with tables and graphical illustrations. Examples include a figure of the study selection process, an illustration of the frequency of inquiry usability evaluation and data collection methods, and an overview of the distribution of the identified usability attributes. We followed the Arksey and O'Malley framework for scoping reviews.

RESULTS

Our scoping review collated 88 articles involving 98 studies, mainly related to medical and nursing students. The studies were conducted from 22 countries and were published between 2008 and 2021. Field testing was the main usability experiment used, and the usability evaluation methods were either inquiry-based or based on user testing. Inquiry methods were predominantly used: 1-group design (46/98, 47%), control group design (12/98, 12%), randomized controlled trials (12/98, 12%), mixed methods (12/98, 12%), and qualitative methods (11/98, 11%). User testing methods applied were all think aloud (5/98, 5%). A total of 17 usability attributes were identified; of these, satisfaction, usefulness, ease of use, learning performance, and learnability were reported most frequently. The most frequently used data collection method was questionnaires (83/98, 85%), but only 19% (19/98) of studies used a psychometrically tested usability questionnaire. Other data collection methods included focus group interviews, knowledge and task performance testing, and user data collected from apps, interviews, written qualitative reflections, and observations. Most of the included studies used more than one data collection method.

CONCLUSIONS

Experimental designs were the most commonly used methods for evaluating usability, and most studies used field testing. Questionnaires were frequently used for data collection, although few studies used psychometrically tested questionnaires. The usability attributes identified most often were satisfaction, usefulness, and ease of use. The results indicate that combining different usability evaluation methods, incorporating both subjective and objective usability measures, and specifying which usability attributes to test seem advantageous. The results can support the planning and conduct of future usability studies for the advancement of mobile learning apps in health care education.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2196/19072.

How Gameful Experience Affects Public Knowledge, Attitudes, and Practices Regarding COVID-19 Among the Taiwanese Public: Cross-sectional Study

Background

In 2019, with the COVID-19 pandemic sweeping across the globe, public health systems worldwide faced severe challenges. Amid the pandemic, one simulation game, Plague Inc., has received substantial attention. This game has indirectly drawn greater public attention to public health issues by simulating pathogen transmission and disease symptoms.

Objective

Against this backdrop, this research investigates whether the gameful experience of Plague Inc. has indirectly affected public knowledge, attitudes, and practices (KAP) regarding COVID-19.

Methods

An online survey was conducted through social networking services in Taiwan from May 6-28, 2020.

Results

A total of 486 subjects participated in this study, of which 276 (56.8%) had played Plague Inc. This study had several findings. First, participants who had played Plague Inc. demonstrated higher levels of knowledge (P=.03, median 7, IQR 7-8) and attitudes (P=.007, median 8, IQR 7-8) than participants who had not played Plague Inc. (knowledge: median 7, IQR 6-8; attitude: median 7, IQR 6-8). Second, there was a significant correlation between creative thinking (ρ=.127, P=.04) and dominance (ρ=.122, P=.04) in attitude. Finally, there was a significant correlation between creative thinking (ρ=.126, P<.001) and dominance (ρ=.119, P=.049) in practice.

Conclusions

Serious games highlighting the theme of pathogen transmission may enhance public knowledge and attitudes regarding COVID-19. Furthermore, the creative thinking and dominance involved in gameful experiences may act as critical factors in public attitudes and practices regarding COVID-19. These findings should be further verified through experimental research in the future.