Virtual Game Simulation and Virtual Reality-Based Learning

The Effect of Virtual Game Simulation and Virtual Reality-Based Learning Tool on Nursing Students' Thoracic and Lung Physical Examination Knowledge and Satisfaction: A Randomized Controlled Trial

The purpose of this study is to determine the effects of a virtual game simulation and a virtual reality-based learning tool on nursing students' knowledge and satisfaction with thoracic and lung physical examinations. Two different teaching methods involving technology will be used in the study. No studies have been found that have examined the thoracic and lung physical examination knowledge of nursing students using a virtual game simulation and a virtual reality-based student tool. The study will utilize a three-group (two interventions (virtual game simulation (Intervention-I) - virtual reality-based learning tool (Intervention-II) - one control) pretest-posttest randomized controlled trial design. The population will consist of 119 students enrolled in the second year of nursing at Gazi University Faculty of Nursing in the 2025-2026 Fall Semester and taking the elective course "Health Assessment" coded HEM 205. The sample will consist of 60 students (20 Intervention-I, 20 Intervention-II, 20 control) who met the inclusion criteria and agreed to participate in the study. Data will be collected using a "Descriptive Characteristics Form," a "Thoracic and Lung Physical Examination Knowledge Test," and a "Satisfaction with Education Methods Survey." First, all students will receive a one-hour theoretical training on thoracic and lung physical examination. Following the training, all students will receive a one-hour laboratory demonstration on thoracic and pulmonary physical examinations. All students will then be briefed, and a pretest will be administered the following week. The study will be implemented one week after the pretest. Students will be randomly assigned to three groups. The first group will play a virtual game simulation on thoracic and pulmonary physical examinations. The second group will experience a virtual reality-based learning tool. The third group, consisting of the control and excluded students, will be evaluated in a classroom environment using question-and-answer sessions. All students will then be informed that a posttest will be administered. The posttest will be administered one week later. After the posttest, all students will be provided with hands-on experience with technology-based learning methods.

Study Overview

• Status: Completed
• Conditions: Satisfaction, Personal; Knowledge
• Intervention / Treatment: Other: Virtual game simulation; Other: Virtual reality-based learning tool; Other: Control

Detailed Description

One of the teaching methods that incorporates technology in nursing education is virtual game simulation, a two-dimensional (2D) virtual computer game featuring simulated people that allows students to actively participate in a clinical scenario. Virtual game simulations are a pedagogical method that allows students to practice critical thinking and decision-making skills by using simulated patients in scenarios involving different clinical environments. Studies using virtual game simulations have been conducted with nursing students in the fields of obstetrics, pediatrics, geriatrics, mental health, surgery, respiratory diseases, emergency health, and the nursing process. These studies indicate that virtual game simulations increase students' knowledge, feedback, interaction, participation, self-confidence, self-efficacy, satisfaction, critical thinking, decision-making skills, learning, and psychomotor skills. This study is expected to make significant contributions to the literature by evaluating the effectiveness of providing thoracic and lung examination training to nursing students through virtual game simulation.

Virtual reality is another method that incorporates technology in nursing education. Virtual reality is the user's active interaction with a computer-generated world through realistic scenarios. Virtual reality technology offers students an active learning environment independent of time and space. Virtual reality technology offers students a safe, motivating learning experience, and providing physical assessment training on a virtual patient is seen as an efficient alternative that will make future healthcare professionals more competent and equipped. A limited number of studies teaching physical assessment skills using virtual reality-based learning tools have found that the emphasis is on teaching inspection and auscultation skills. This study is expected to contribute significantly to the literature by evaluating the effectiveness of virtual reality-based thoracic and lung examination training for nursing students. This study is the first to use two different and innovative learning technologies in teaching thoracic and pulmonary examinations to nursing students, a field that has received limited research. No studies have been found in the literature examining the effectiveness of virtual game simulation and virtual reality technology on nursing students' learning. Therefore, the study is unique in its field. Therefore, the results of this study are expected to provide important information regarding teaching thoracic and pulmonary physical examinations to nursing students and to improve student satisfaction with both learning methods.

• Study Type: Interventional
• Enrollment (Actual): 60
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Ankara, Turkey (Türkiye)
    • Gazi University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• The student must be taking the HEM 205 "Health Assessment" course for the first time.
• Students must not have any eye conditions that affect depth perception, such as amblyopia (lazy eye), anisometropia (differences in refraction between the two eyes), or strabismus (crossed eyes).
• Students must have no problems speaking and understanding Turkish.
• They must be willing to participate in the research.

Exclusion Criteria:

• Having a high school, associate's degree, or bachelor's degree in a health-related field;
• Taking the HEM 205 "Health Assessment" course as a secondary course;
• Not attending the thoracic and lung physical examination theoretical course;
• Not participating in laboratory exercises;
• Not participating in one of the research steps (pre-test, virtual game simulation, virtual reality-based learning tool, post-test);
• Completing and/or incomplete data collection forms;
• Wanting to withdraw from the research.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Virtual game simulation; Students in this class will play the Virtual Game Simulation for Thorax and Lung Physical Examination located at https://nursinggames.net/tr/.	Other: Virtual game simulation; The virtual game simulation was prepared for nursing students to learn thoracic and lung physical examination.
Experimental: Virtual reality-based learning tool; Students in this class will experience the Thoracic and Lung Physical Examination featured in a virtual reality-based learning tool.	Other: Virtual reality-based learning tool; The virtual reality-based learning tool was designed for nursing students to experience thoracic and lung physical examination skills on a virtual patient in a life-like environment.
Active Comparator: Control; Students in this class will learn Thoracic and Lung Physical Examination using traditional learning methods (theory, question and answer, discussion).	Other: Control; Traditional teaching method (question-answer, lecture, discussion) will be used.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Knowlegde	Thorax and Lung Physical Examination Knowledge Test	Up to 1 month
Personal satisfaction	Satisfaction Survey with Training Methods	Up to 1 month

Collaborators and Investigators

• Sponsor: Necmettin Erbakan University
• Collaborators: Gazi University
• Investigators: Study Director: Nurcan Çalışkan, PhD, Gazi University Faculty of Nursing

Study record dates

Study Major Dates

• Study Start (Actual): November 4, 2025
• Primary Completion (Actual): November 25, 2025
• Study Completion (Actual): December 2, 2025

Study Registration Dates

• First Submitted: September 27, 2025
• First Submitted That Met QC Criteria: November 19, 2025
• First Posted (Estimated): November 20, 2025

Study Record Updates

• Last Update Posted (Estimated): December 4, 2025
• Last Update Submitted That Met QC Criteria: December 3, 2025
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Behavior; Personal Satisfaction
• Other Study ID Numbers: Physical examination

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

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