Effect of using gamification and augmented reality in mechanical ventilation unit of critical care nursing on nurse students' knowledge, motivation, and self-efficacy: A randomized controlled trial

Background: Gamification and augmented reality (AR) are innovative teaching modalities. Research on the effects of combining these two strategies in nursing education is scarce.

Objectives: To examine the effect of the combined use of gamification and AR in teaching mechanical ventilation (MV) on nurse students' knowledge, motivation, self-efficacy, and satisfaction.

Design: Randomized controlled trial.

Setting: A conveniently selected faculty of nursing in Egypt.

Participants: A total of 410 nurse students.

Methods: Participants were randomly assigned to the intervention or control group (205 in each). Kahoot games and AR were used in the intervention group, whereas a traditional lecture was applied in the control group. The outcomes included levels of students' knowledge, learning motivation, self-efficacy, and satisfaction.

Results: Mixed design repeated-measures ANOVA test revealed a statistically significant difference in knowledge test scores within-subject over time (p-value [effect size]: <0.001 [0.515]), between-subject due to the main effect of interventions (<0.001 [0.146]), and within-between interaction effect of group and time (<0.001 [0.515]). After using Kahoot and AR, the total mean self-efficacy score was significantly higher in the intervention group than in the control group (<0.001 [0.662]). The total median motivation score was significantly higher for the Kahoot and the AR groups compared with the traditional lecture (<0.001 [0.558]).

Conclusion: Kahoot games and AR significantly increased nurse students' knowledge, motivation, and self-efficacy compared with traditional MV learning classes. Nursing educators need to incorporate Kahoot and AR in their pedagogies to enhance nurse students' satisfaction and development.