Gamification Versus E-Learning for Electrocardiogram Education

June 9, 2026 updated by: Hsiao-Yen Hsieh, DNP, RN, APN, Taiwan Municipal An-Nan Hospital-China Medical University

Comparing the Effectiveness of Gamification Educational Method and E-learning Educational Method

This randomized controlled study aims to compare the effectiveness of a gamification educational method and an e-learning educational method for electrocardiogram (ECG) education. Nursing students and novice nurses are randomly assigned to either a gamified learning group or an e-learning group. The study evaluates whether the gamification approach improves ECG knowledge, learning confidence, and learning satisfaction compared with conventional e-learning instruction.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Electrocardiogram (ECG) interpretation is an essential competency for nursing students and novice nurses. Traditional educational approaches, including lecture-based and self-directed e-learning methods, may not fully engage learners or promote active participation. Gamification has emerged as an innovative educational strategy that incorporates game elements into learning activities to enhance motivation, engagement, and knowledge acquisition.

This randomized controlled study was conducted to compare the effectiveness of a gamification educational method with a conventional e-learning educational method for ECG education. Participants were assigned to either a gamification group or an e-learning group. The gamification intervention incorporated interactive learning activities designed to facilitate active participation and reinforce ECG learning concepts, whereas the comparison group received self-directed e-learning instruction.

The study was designed to evaluate whether gamification could improve learning outcomes and provide evidence for the application of innovative educational strategies in nursing education and clinical training programs.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
297

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Taiwan
    • Taiwan
      • Tainan, Taiwan, Taiwan, 709
        • Tainan Municipal An-Nan Hospital, China Medical University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Nursing students who completed medical-surgical nursing coursework
  • Newly graduated nurses undergoing clinical orientation
  • Able to understand study procedures
  • Willing to provide informed consent

Exclusion Criteria:

  • Previous participation in the study
  • Failure to complete study questionnaires
  • Declined participation

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Other
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Gamified ECG Education
Participants received electrocardiogram education through a gamification educational method that incorporated game-based learning activities designed to enhance learner engagement and participation.
Behavioral: Gamification Educational Method
Participants received electrocardiogram education through a self-directed e-learning educational method using online educational materials and instructional content.
Active Comparator: E-learning ECG Education
Participants received electrocardiogram education through a self-directed e-learning educational method using online instructional materials.
Behavioral: E-learning Educational Method
Participants received electrocardiogram education through a self-directed e-learning educational method using online educational materials and instructional content.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Electrocardiogram Knowledge Questionnaire Score
Time Frame: Immediately before and immediately after the intervention
Measured using a 20-item electrocardiogram knowledge questionnaire. Scores range from 0 to 20, with higher scores indicating greater ECG knowledge.
Immediately before and immediately after the intervention

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Learning Confidence Scale Score
Time Frame: Baseline and immediately after completion of the educational intervention
The Learning Confidence Score Scale consists of 5 questions, designed to measure a participant's confidence in interpreting ECGs and applying them clinically after completing an ECG course. A 0-100mm line is divided into 100 divisions, marked with a scale from 1 to 100, where 0 represents no confidence and 100 represents full confidence. The test subject quantifies their self-perceived visual score from 0 to 100.
Baseline and immediately after completion of the educational intervention
Learning Satisfaction Questionnaire Score
Time Frame: Immediately after completion of the educational intervention
This questionnaire includes key evaluation points for teaching effectiveness, such as lesson planning, teaching material presentation, teaching strategies, teaching assessment, and teaching atmosphere. It comprises 13 questions and uses a Likert scale, with 1 point for "very dissatisfied" and 5 points for "very satisfied." The total score ranges from 13 to 65 points, with higher scores indicating higher course satisfaction.
Immediately after completion of the educational intervention

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Taiwan Municipal An-Nan Hospital-China Medical University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
July 14, 2020

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
December 23, 2020

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 23, 2020

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
June 3, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
June 9, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
June 12, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
June 12, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
June 9, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
June 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • TMANH109-REC001(CR-1)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data will not be made available to protect participant confidentiality and because data sharing was not specified in the original study protocol and informed consent documents.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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