Digital Tools for Learning Diabetes: Combination of Animation and Gamification

COVID-19, a global epidemic that affects the world, has created significant changes in many areas, especially in the health system. One of the most affected areas is nursing education. The content of nursing education focuses on cognitive, psychomotor and affective areas. In order for nursing education to be successful, important initiatives should be provided in the education of these areas. However, difficulties were encountered in the distance education process.

This study was conducted to evaluate the delivery of diabetes education in nursing with animation and gamification.

Study Overview

• Status: Completed
• Conditions: Diabetes; Educational Problems
• Intervention / Treatment: Other: Traditional education; Device: Diabetes Education supported by digital tools

Detailed Description

This study was conducted with a randomized-controlled experimental design. This study was conducted between October and November 2020 in the Department of Nursing at the Faculty of Health Sciences in Turkey. The inclusion criteria were as follows: being 18 years old or over, studying in the second year, volunteering to take a diabetes course, not attending any course for diabetes before, have a remote access tool (internet connection, personel comuter eg.), not to be absent on the date when the data of the research will be collected. The second-year nursing students were selected for the study since participants have not taken diabetes nursing courses before.

In the randomization part of the study, the students were assigned to the experiment (n=35) and control (n=35) groups according to their number in the class list using the random numbers table.

Data were callacted with "Structured Student Identification Form", "Diabete Nursing Knowledge Test", "Instructional Materials Motivation Survey" and " Opinion Form on Diabetes Education Program supported by digital tools".

The Diabetes Nursing course is 2 hours per week fow 10 week. After students were assigned to groups with randomization, the application process of the research was explained to the students. The control group was taught with the traditional method and the experimental group was taught with learning activities based on animation and gamification.

Direct lecture, question-answer teaching methods were used through Microsoft Power Point presentation to the control group of Diabetes Nursing course. At the end of the lesson, "Diabete Nursing Knowledge Test" and "Instructional Materials Motivation Survey" were used in control group.

An animated video was watched at the beginning of each lesson in the experimental group. Later, lecture and question-answer teaching methods were used through Microsoft Power Point presentation. At the end of each lesson, Web 2.0 (Kahoot) application was used to reinforce students' knowledge.At the end of the lesson, "Diabete Nursing Knowledge Test", "Instructional Materials Motivation Survey" and " Opinion Form on Diabetes Education Program supported by digital tools"were used in intervention group.

• Study Type: Interventional
• Enrollment (Actual): 70
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey
  • Uskudar
    • Istanbul, Uskudar, Turkey
      • University of Health Sciences

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Over18 years old
• Being 2nd year student
• Volunteering to take a diabetes course
• Not attending any course for diabetes before
• Have a remote access tool (internet connection, personel comuter eg.)
• Not to be absent on the date when the data of the research will be collected.

Exclusion Criteria:

• Not being volunteer to participate in the study
• who have taken the course in previous years

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: Traditional diabetes education; The subjects and activities were applied to the control group, who received traditional diabetes education, between 8:00 and 10:00 with the classical method, which lasted 2 hours, for 10 weeks. The training was completed by the researcher with the verbal narration method. "Diabetes Achievement Assessment Test" with question and answer method was administered to the students at the beginning and end of the application. These questions were the same questions asked to the experimental group. Interaction of groups with each other was limited. Students were informed about this and their consent was taken.At the end of the course, students' opinions were taken through the form developed by the researchers. Instructional Materials Motivation Survey (IMMS) was used to measure to student' motivation levels.	Other: Traditional education; Diabetes education will be given by the trainer for 10 weeks, 2 hours of presentation.
Experimental: Diabetes Education supported by digital tools; The subjects included in the course content were given between 10:00-12:00 with the animation supported method, which lasted for 2 hours. The animations were created by the researchers to reflect all guidelines for diabetes. The scenario of the animation video was prepared in line with the training content. Storyboards in videos and animations were created with the collaboration of researchers and experts in their fields (software specialists, computer programmers). The animation video was voiced in Turkish by a professional actor. Animations are 2 minutes each and a total of 18 minutes long. The 'Kahoot' application, a Web 2.0 tool, was used to apply Diabetes Achievement Evaluation Test. At the end of the course, students' opinions were taken through the form developed by the researchers. Instructional Materials Motivation Survey (IMMS) was used to measure to student' motivation levels.	Device: Diabetes Education supported by digital tools; Diabetes education will be given for 10 weeks with 2-minute animations. At the end of the course, learners' knowledge was measured with a knowledge test using the Kahoot app.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Diabetes Nursing Course Knowledge Test, 10. week (after the course finished)	This knowledge test, which is prepared by submitting to expert opinion, consists of 40 multiple-choice questions. Each question is worth 2,5 points. The higher the test score, the higher the level of knowledge.	Through study completion, an average of 3 mounth
Instructional Materials Motivation Survey (IMMS), 10. week (after the course finished)	The scale was prepared in a 5-point Likert type, 36 items. The highest score that can be obtained from the entire scale is 165, and the lowest score is 33. The increase in the score obtained from the scale is interpreted as an increase in the motivation towards the teaching material.	Through study completion, an average of 3 mounth

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Opinion Form on Diabetes Education Program supported by digital tools, for only experimental group, 10. week (at the end of the course)	The form was prepared for the students in the experimental group to determine their views on education supported by animation and gamification. IThe form consisted of 4 open-ended questions containing opinions and suggestions about teaching method and digital education materials.	Through study completion, an average of 3 mounth

Collaborators and Investigators

• Sponsor: Saglik Bilimleri Universitesi
• Investigators: Study Chair: Ayşe Kabuk, Dr, Saglik Bilimleri Universitesi

Publications and helpful links

General Publications

• Liaw SY, Wong LF, Chan SW, Ho JT, Mordiffi SZ, Ang SB, Goh PS, Ang EN. Designing and evaluating an interactive multimedia Web-based simulation for developing nurses' competencies in acute nursing care: randomized controlled trial. J Med Internet Res. 2015 Jan 12;17(1):e5. doi: 10.2196/jmir.3853. Erratum In: J Med Internet Res. 2015 Mar 23;17(3):e75.
• Du S, Liu Z, Liu S, Yin H, Xu G, Zhang H, Wang A. Web-based distance learning for nurse education: a systematic review. Int Nurs Rev. 2013 Jun;60(2):167-77. doi: 10.1111/inr.12015. Epub 2013 Mar 25.
• Fayaz A, Mazahery A, Hosseinzadeh M, Yazdanpanah S. Video-based Learning Versus Traditional Method for Preclinical Course of Complete Denture Fabrication. J Dent (Shiraz). 2015 Mar;16(1 Suppl):21-8.
• Koch J, Andrew S, Salamonson Y, Everett B, Davidson PM. Nursing students' perception of a Web-based intervention to support learning. Nurse Educ Today. 2010 Aug;30(6):584-90. doi: 10.1016/j.nedt.2009.12.005. Epub 2010 Jan 4.

Helpful Links

• Federation of European Nurses in Diabetes

Study record dates

Study Major Dates

• Study Start (Actual): October 1, 2020
• Primary Completion (Actual): November 27, 2020
• Study Completion (Actual): November 30, 2020

Study Registration Dates

• First Submitted: August 6, 2021
• First Submitted That Met QC Criteria: August 16, 2021
• First Posted (Actual): August 20, 2021

Study Record Updates

• Last Update Posted (Actual): August 20, 2021
• Last Update Submitted That Met QC Criteria: August 16, 2021
• Last Verified: August 1, 2021

More Information

Terms related to this study

• Keywords: diabetes; distance learning; gamification; digital tools; animation
• Additional Relevant MeSH Terms: Glucose Metabolism Disorders; Metabolic Diseases; Endocrine System Diseases; Diabetes Mellitus
• Other Study ID Numbers: University of Health Sciences

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: If it is necessary for the ethical issue, we can share.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No