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.