The Effect of Gamified Metaverse-Based Training on Nursing Students' Self-Efficacy and Metaverse Perception Regarding Pressure Injury Management

April 25, 2026 updated by: BETUL SAHIN KILINC, Baskent University

The Effect of Gamified Metaverse-Based Training on Nursing Students' Self-Efficacy and Metaverse Perception Regarding Pressure Injury Management: A Randomized Controlled Study

Introduction: Pressure ulcers are a largely preventable clinical problem that negatively impacts the quality of patient care and constitutes a significant economic burden for healthcare systems. The prevention and effective management of these ulcers are closely related to nurses' knowledge, skills, and self-efficacy levels. However, current nursing education programs show a limited number of practice-based and interactive training approaches for the prevention and management of pressure ulcers. In recent years, innovative and technology-supported training methods such as gamification and metaverse have emerged as promising approaches for improving students' knowledge and self-efficacy levels by increasing their active participation in learning processes. Aim: The aim of this research is to evaluate the effect of gamified metaverse-based training developed for nursing students on their knowledge level, academic self-efficacy, and metaverse perception regarding pressure ulcer management.

Method: The research was planned as a randomized controlled experimental design. The population of the study will consist of students studying in the nursing department. The sample size was calculated using G*Power based on PUKAT 2.0-T scores; Assuming a two-way α=0.05 and power=0.80, at least 26 participants were selected for each group, and the total sample size was planned as 60 students, taking into account possible losses. Participants will be administered a Demographic Information Form, the Pressure Ulcer Knowledge Level Assessment Tool 2.0-Updated Version (PUKAT 2.0-T), and the Nursing Students Academic Self-Efficacy Scale. Participants will be randomly assigned to intervention and control groups based on their pre-test scores. The intervention group will receive traditional classroom theoretical training and gamified metaverse-based training for two weeks, while the control group will receive traditional classroom theoretical training. Post-tests will be administered immediately after the intervention and one month later. In addition, the Metaverse Perception Scale will be administered to the intervention group. Data will be collected using the Pressure Ulcer Knowledge Assessment Tool 2.0-Updated Version (PUKAT 2.0-T), the Nursing Students Academic Self-Efficacy Scale, and the Metaverse Perception Scale for Nursing Students.

Results: The obtained data will be analyzed using appropriate statistical methods.

Conclusion: This research is expected to provide evidence regarding the effectiveness of innovative digital education models in nursing education and contribute to the development of educational strategies for the prevention of pressure ulcers.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

60

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

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:

  • Voluntarily agree to participate in the research,
  • Be a second-year undergraduate nursing student,
  • Be able to understand and speak Turkish,
  • Have healthy hearing, vision, and speech.

Exclusion Criteria:

  • The student voluntarily requesting to withdraw from the study
  • The student ceasing to use the metaverse domain during the study period
  • Completing the survey form incompletely.

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: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Gamified metaverse-based educational application
Behavioral: Gamified metaverse-based educational application
Students in the intervention group will receive gamified metaverse-based training.
No Intervention: Traditional-based education practice
traditional-based education practice

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pressure Ulcer Knowledge Assessment Tool 2.0 - Updated Version (PUKAT 2.0-T)
Time Frame: Before the intervention, within 1 hour after the intervention, and one month after the intervention.
PUKAT 2.0 is a multiple-choice, true-false scored measurement tool. This test was developed by Manderlier et al. (2017) to determine nurses' knowledge level regarding pressure ulcers and adapted into Turkish by Dalli et al. (2022). The test addresses knowledge level regarding pressure ulcers within six themes and contains a total of 25 questions. The score ranges from 0 to 25. According to the validity and reliability study results of the Turkish version of the test; (1) content validity index is 0.90, (2) test-retest reliability is 0.83 (between 0.70-0.92 for sub-themes), (3) item difficulty indices range from 35-75%, (4) item discrimination indices range from 0.44-0.92, and (5) internal consistency (Cronbach's alpha) value is 0.72. Necessary permissions for the use of the measurement tool have been obtained from its developers.
Before the intervention, within 1 hour after the intervention, and one month after the intervention.
Academic Nurse Self-Efficacy Scale
Time Frame: Before the intervention, within 1 hour after the intervention, and one month after the intervention.
The scale developed by Bulfone et al. (2019) to determine the academic self-efficacy of undergraduate nursing students consists of 14 items and four sub-dimensions. The scale comprises the following sub-dimensions: internal emotion management (items 1, 2, 3), self-control behavior (items 4, 5, 6, 7), external emotion management (items 8, 9, 10, 11), and sociability (items 12, 13, 14). The items on this scale are scored between 1 and 5, and the question "How confident are you?" is scored using a 5-point Likert scale (1 = I have no confidence in myself, 5 = I have a lot of confidence in myself). As the scores obtained from the scale increase, the academic self-efficacy of nursing students increases. There are no items in the scale that are reverse-scored. The Cronbach alpha value of the original scale is 0.84, while in this study it is 0.82.
Before the intervention, within 1 hour after the intervention, and one month after the intervention.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Metaverse Perception Scale for Nursing Students
Time Frame: within 30 minutes after intervention
To evaluate the metaverse perception levels of nursing students, the Metaverse Perception Scale for Nursing Students, developed by Yıldırım and Karaman (2024), will be used. The scale consists of a total of 24 items and includes four sub-dimensions: Education (items 1-9), Technology (items 10-14), Challenges (items 15-19), and Lifestyle (items 20-24). The scale items will be rated on a 5-point Likert scale, with response options ranging from "1=Strongly Disagree" to "5=Strongly Agree". A high score obtained from the scale will indicate a high metaverse perception. Items belonging to the Challenges sub-dimension will be reverse-coded to calculate the average score, while the average score for the entire scale will be evaluated without reverse coding. The overall reliability coefficient of the scale is reported to be Cronbach's alpha=0.955, while the Cronbach's alpha values for the sub-dimensions range from 0.930 to 0.955.
within 30 minutes after intervention

Collaborators and Investigators

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

Sponsor

Baskent 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 (Estimated)

April 30, 2026

Primary Completion (Estimated)

May 30, 2026

Study Completion (Estimated)

June 30, 2026

Study Registration Dates

First Submitted

January 21, 2026

First Submitted That Met QC Criteria

January 31, 2026

First Posted (Actual)

February 9, 2026

Study Record Updates

Last Update Posted (Actual)

April 30, 2026

Last Update Submitted That Met QC Criteria

April 25, 2026

Last Verified

January 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 17162298.600-373

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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