Busca Erica, Caristia Silvia, Bidone Sara Palmira, Bolamperti Alessia, Campagna Sara, Cattaneo Arianna, Lea Rosaria, Montani Doriana, Scalogna Antonio, Bassi Erika, Dal Molin Alberto
Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.
Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy.
JMIR Serious Games. 2024 Nov 26;12:e52644. doi: 10.2196/52644.
The use of serious games (SGs) in nursing education is increasing, with the COVID-19 pandemic significantly accelerating their development. A key feature of SGs is their flexibility, allowing students to train at any place and time as needed. Recently, there has been a shift from developing disease-specific SGs to games focused on broader health issues. However, there has been a lack of proposals to enhance nursing interventions in home and frail care settings. The REACtion project developed a SG to improve students' understanding and clinical reasoning in caring for home-dwelling older adults.
This study aims to describe the development of "REACtion Game" (RG) and explore its validity as an educational tool. A multidisciplinary team created a SG that simulates the assessment process of older adults in home settings by nurses. It features web-based scenarios, clickable objects, and a menu with tools, and medical records to enhance nursing students' knowledge and clinical reasoning skills.
A prospective, observational study was conducted using the Dutch Society for Simulation in Healthcare's framework to validate the game. Further, 5 experts in home health care nursing evaluated content validity, while 30 students assessed construct validity, face validity, concurrent validity (by comparing game scores with those from the Nursing Clinical Reasoning Scale), game quality, and usability. Data were collected through self-administered web-based questionnaires and the debriefings of each match played. The students were enrolled in 2 postgraduate nursing programs: a master of science in nursing degree and a first-level continuing education in family and community nursing.
Experts rated the content validity highly after revisions (universal agreement calculation method of scale-level content validity index=0.97). The sample consisted of 30 students, predominantly women (n=20, 67%) and aged younger than 45 years (n=23, 77%) with no prior experience in SG. Almost all students had a positive impression of RG as an attractive and useful method for learning new knowledge. Participants found the cases, scenarios, and dialogues realistic (face validity) and of high quality, though usability aspects such as instructions clarity and intelligibility of game progression were less favored. Construct validity showed general agreement on the game's educational value, with family and community nursing students reporting more consistent alignment with educational goals. Overall, RG scores correlated positively with time spent playing but showed limited correlation with Nursing Clinical Reasoning Scale scores.
This study developed and validated a nursing education game, especially valuable as simulation is underused in some curricula. Created during the pandemic, it offered a digital learning environment. Although the game shows potential, further testing is needed for usability, concurrent validity, and functional improvements. Future research should involve larger samples to fully validate the game and assess its impact on academic achievement.
严肃游戏（SGs）在护理教育中的应用正在增加，新冠疫情显著加速了其发展。严肃游戏的一个关键特性是其灵活性，使学生能够根据需要在任何时间和地点进行训练。最近，已从开发针对特定疾病的严肃游戏转向关注更广泛健康问题的游戏。然而，缺乏关于加强家庭和脆弱护理环境中护理干预的建议。REACtion项目开发了一款严肃游戏，以提高学生在照顾居家老年人方面的理解和临床推理能力。
本研究旨在描述“REACtion游戏”（RG）的开发过程，并探讨其作为一种教育工具的有效性。一个多学科团队创建了一款模拟护士在家庭环境中对老年人进行评估过程的严肃游戏。它具有基于网络的场景、可点击对象以及带有工具和病历的菜单，以增强护理专业学生的知识和临床推理技能。
采用荷兰医疗保健模拟协会的框架进行了一项前瞻性观察研究，以验证该游戏。此外，5名家庭健康护理专家评估了内容效度，30名学生评估了结构效度、表面效度、同时效度（通过将游戏得分与护理临床推理量表得分进行比较）、游戏质量和可用性。数据通过基于网络的自填问卷和每场游戏后的汇报收集。这些学生参加了两个研究生护理项目：护理学硕士学位项目和家庭与社区护理一级继续教育项目。
经过修订后，专家对内容效度给予了高度评价（量表级内容效度指数的通用一致性计算方法 = 0.97）。样本包括30名学生，主要为女性（n = 20，67%），年龄小于45岁（n = 23，77%），之前没有严肃游戏经验。几乎所有学生都对RG留下了积极印象，认为它是学习新知识的一种有吸引力且有用的方法。参与者认为案例、场景和对话逼真（表面效度）且质量很高，不过诸如说明清晰度和游戏进程易懂性等可用性方面不太受青睐。结构效度表明对该游戏的教育价值普遍达成共识，家庭与社区护理专业的学生报告与教育目标的一致性更高。总体而言，RG得分与游戏时长呈正相关，但与护理临床推理量表得分的相关性有限。
本研究开发并验证了一款护理教育游戏，鉴于模拟在某些课程中未得到充分利用，该游戏具有特别的价值。它是在疫情期间创建的，提供了一个数字学习环境。尽管该游戏显示出潜力，但在可用性、同时效度和功能改进方面还需要进一步测试。未来的研究应纳入更大的样本，以充分验证该游戏并评估其对学业成绩的影响。
