Thangavelu Dhivya P, Tan Apphia J Q, Cant Robyn, Chua Wei Ling, Liaw Sok Ying
National University Hospital, Singapore.
Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Nurse Educ Today. 2022 Jun;113:105357. doi: 10.1016/j.nedt.2022.105357. Epub 2022 Apr 6.
This review aimed to synthesise evidence from experimental studies of the application of digital serious games in developing nursing clinical competence.
Systematic review and meta-analysis.
Eight databases were searched for randomized controlled trials and quasi-experimental studies published in English from 2000 to 2021.
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were adopted in this review. Quality appraisal was conducted using Cochrane's Risk of Bias tool and the Joanna Brigg's Institute Critical Appraisal Tool for Quasi-Experimental Designs. A narrative synthesis of studies, and a meta-analysis and subgroup analysis, was performed on the study outcomes.
22 experimental studies including 13 randomized controlled trials and nine quasi-experimental studies were included. Of these, 19 studies examined nursing students and three examined qualified nurses. These studies applied serious games to develop nursing competencies in management of nursing care, clinical reasoning skills, procedural skills, legal practice and quality improvement. Compared with control groups, serious games improved knowledge (SMD = 1.30, 95% CI [0.75, 1.86]) and skills (SMD = 0.38, 95% CI [0.17, 0.60]). Subgroup analysis for both knowledge and skills outcomes demonstrated that serious games were more effective than control groups with either no intervention or other educational interventions. A large effect size (SMD = 1.13, 95% CI [0.91, 1.34]) was found in favour of serious games for improving knowledge scores in management of nursing care.
The reviewed studies identified a broad application of digital serious games for developing nursing competencies. The knowledge and skills performance outcomes supported the use of serious games, which were found to be superior to conventional educational interventions. More serious games are required to be incorporated into undergraduate and continuing nursing education for workplace training, with more rigorous studies examining the effect of serious games in improving the quality and safety of clinical nursing practice.
本综述旨在综合数字严肃游戏在培养护理临床能力方面的实验研究证据。
系统评价和荟萃分析。
检索了8个数据库，以查找2000年至2021年发表的英文随机对照试验和准实验研究。
本综述采用系统评价和荟萃分析的首选报告项目（PRISMA）指南。使用Cochrane偏倚风险工具和乔安娜·布里格斯研究所准实验设计批判性评价工具进行质量评估。对研究结果进行了叙述性综合分析、荟萃分析和亚组分析。
纳入了22项实验研究，包括13项随机对照试验和9项准实验研究。其中，19项研究针对护理专业学生，3项研究针对注册护士。这些研究应用严肃游戏来培养护理能力，包括护理管理、临床推理技能、操作技能、法律实践和质量改进。与对照组相比，严肃游戏提高了知识水平（标准化均数差[SMD]=1.30，95%置信区间[0.75，1.86]）和技能水平（SMD=0.38，95%置信区间[0.17，0.60]）。知识和技能结果的亚组分析表明，与无干预或其他教育干预的对照组相比，严肃游戏更有效。在护理管理知识得分方面，发现支持严肃游戏的效应量较大（SMD=1.13，95%置信区间[0.91，1.34]）。
综述研究确定了数字严肃游戏在培养护理能力方面的广泛应用。知识和技能表现结果支持使用严肃游戏，发现其优于传统教育干预。需要将更多的严肃游戏纳入本科和继续护理教育中，以进行职场培训，并开展更严格的研究来检验严肃游戏对提高临床护理实践质量和安全性的效果。
