Comparison of Gamification Approaches in Midwifery Education

April 14, 2026 updated by: Rumeysa ÖZAYABAKAN, Agri Ibrahim Cecen University

Play to Learn: A Comparison of Puzzle-Based and Kahoot-Based Gamification in Midwifery Education

The aim of this study is to compare the effects of puzzle-solving and Kahoot-based learning methods on learning motivation and gaming experience among second-year midwifery students, and to evaluate students' satisfaction levels regarding these methods. The study is designed as a randomized controlled experimental research. It will be conducted between November and December 2025 with second-year students studying in the Department of Midwifery, Faculty of Health Sciences, Ağrı İbrahim Çeçen University.

The entire class will be randomly divided into two groups: Experiment 1 (Puzzle) and Experiment 2 (Kahoot). Data collection tools include the Learning Motivation Scale in Higher Education, the Gaming Experience Scale, a Satisfaction Questionnaire, Game (Kahoot-Puzzle) Achievement Test, and a Personal Information Form. For data analysis, paired-samples t-test, ANOVA, and independent-samples t-test will be used as appropriate.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

The lectures will be delivered by the instructor in three-week topic blocks. After each three-week block, the following procedures will be implemented:

Experiment 1 group: A 20-question puzzle prepared by the researchers and validated through expert opinions from 10 academic midwifery instructors using the Content Validity Index (CVI) will be distributed. Students will be given 10 minutes to complete the puzzle.

Experiment 2 group: The same questions will be answered via the Kahoot application.

The interventions will be conducted three times in total (e.g., during the 3rd, 6th, and 9th weeks). To prevent contamination, the groups will meet in separate classrooms, and students' phones will be collected at the entrance.

The Personal Information Form will be administered at the pre-test stage. The Learning Motivation Scale in Higher Education will also be applied as a pre-test and post-test. The Gaming Experience Scale will be administered after the first and last game sessions. The Satisfaction Scale and the Game (Kahoot-Puzzle) Achievement Test (scores obtained from the puzzle or Kahoot) will be completed after each game session.

Study Type

Interventional

Enrollment (Actual)

39

Phase

  • 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

  • Turkey (Türkiye)
    • Center
      • Ağrı, Center, Turkey (Türkiye), 04000
        • Ağrı İbrahim Çeçen Üniversitesi

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

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Being a second-year midwifery student
  • Enrolled in the prenatal care course
  • Owning a smartphone (for the Kahoot group)
  • Willingness to participate in the study
  • Regular attendance in the course

Exclusion Criteria:

  • Unwillingness to participate in the study
  • Presence of learning disorders such as dyslexia
  • Insufficient attendance in the course
  • Previous participation in a similar study (Students who meet the exclusion criteria will be excluded from the study, but will continue to participate in the game activities. It is anticipated that their removal from the study could affect their performance in the course. Therefore, the scale scores of these students will not be included in the study analyses.)

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
Intervention / Treatment
Experimental: Puzzle Group
A 20-question puzzle, prepared by the researchers and validated through expert opinions from 10 academic midwifery instructors using the Content Validity Index (CVI), will be distributed to the students in this group. Students will be given 10 minutes to complete the puzzle. They will solve three different puzzles at three-week intervals. Each question will be selected from the topics taught by the instructor during the preceding three weeks.
Other: Puzzle
Students in this group will solve three different puzzles, each administered at three-week intervals.
Experimental: Kahoot Group
Students in this group will form the Kahoot group. They will answer the same questions that the puzzle group solved, via the Kahoot application. Visuals will also be used in the questions at this stage. Students will respond with short answers and will be given 10 minutes for each quiz. The application will be conducted three times at three-week intervals, as with the puzzle group. Each question will be selected from the topics taught by the instructor during the preceding three weeks.
Other: Kahoot
Students in this group will complete three different Kahoot quizzes, each conducted at three-week intervals.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Personal Information Form
Time Frame: The form will be administered at the pre-test during students' first participation in the study.
This is a 6-item form that includes questions about students' demographic characteristics, academic grade point averages, and gaming experience
The form will be administered at the pre-test during students' first participation in the study.
Learning Motivation Scale in Higher Education (YÖMÖ-Ü)
Time Frame: Pre-test: Administered immediately before the first game session (on the same day). Post-test: Administered immediately after the final game session (on the same day).
The scale consists of three sub-dimensions: learning goals, approach goals, and avoidance goals, and validity and reliability analyses have shown that it is a reliable measurement tool for Turkish university students. Each sub-dimension is scored separately, and a total score is not calculated. The scores obtained from the sub-dimensions are evaluated separately to determine which behaviors motivate students toward learning.
Pre-test: Administered immediately before the first game session (on the same day). Post-test: Administered immediately after the final game session (on the same day).
Gaming Experience (GAMEX) Scale
Time Frame: Pre-test: Administered immediately after the completion of the first game session (on the same day). Post-test: Administered immediately after the completion of the final game session (on the same day)
The scale consists of 27 items, each scored on a 1-5 Likert scale. Items in the "Absence of Negative Effects" sub-dimension (3 items) are reverse-coded. The total score obtainable from the scale ranges from 27 to 135. Except for the "Absence of Negative Effects" sub-dimension, higher scores in the other sub-dimensions indicate a better gaming experience
Pre-test: Administered immediately after the completion of the first game session (on the same day). Post-test: Administered immediately after the completion of the final game session (on the same day)
Satisfaction Questionnaire
Time Frame: It will be completed immediately after the final game session (on the same day)
Developed by the researchers based on the literature. Students' perceptions of the learning method will be evaluated using this questionnaire
It will be completed immediately after the final game session (on the same day)
Game (Kahoot-Puzzle) Achievement Test
Time Frame: Administered immediately after each game session (three time points: pre-test, mid-test, post-test) on the same day.
Each session will include 20 prepared questions. Since the test will be scored out of 100 points, each correct answer will be worth 5 points. The scores from the games administered in the three sessions will be compared between groups.
Administered immediately after each game session (three time points: pre-test, mid-test, post-test) on the same day.

Collaborators and Investigators

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

Sponsor

Agri Ibrahim Cecen University

Investigators

  • Principal Investigator: Rumeysa ÖZAYABAKAN, Agri Ibrahim Cecen University
  • Principal Investigator: Betül Uncu, Istanbul University - Cerrahpasa
  • Principal Investigator: Rukiye DUMAN, Istanbul University - Cerrahpasa

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)

November 19, 2025

Primary Completion (Actual)

December 31, 2025

Study Completion (Actual)

December 31, 2025

Study Registration Dates

First Submitted

November 18, 2025

First Submitted That Met QC Criteria

November 27, 2025

First Posted (Actual)

December 1, 2025

Study Record Updates

Last Update Posted (Actual)

April 17, 2026

Last Update Submitted That Met QC Criteria

April 14, 2026

Last Verified

November 1, 2025

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • Agri Ibrahim Cecen Uni.

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

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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