The Effect of Game-Based Learning on Identifying Cognitive Distortions and Interpersonal Communication Competence in Nursing Students' in the Care of Anxious Individuals (Game-Based)

Game-based learning methods in nursing education are important intervention techniques in terms of case management.

This study aims to examine the effect of game-based learning in the care of anxious individuals on identifying cognitive distortions and interpersonal communication competence in nursing students.The research will be conducted at a state university's nursing faculty. The research will be conducted at a state university's nursing faculty. The sample of the research consists of first-year nursing students taking the self-awareness and communication course. There are 103 students taking the self-awareness and communication management course in the fall semester of 2025-2026. There are 80 first-year nursing students who have successfully completed the course. The study aims to reach the entire sample .

Study Overview

• Status: Completed
• Conditions: Game Based Learning
• Intervention / Treatment: Behavioral: Game based learning

Detailed Description

Data will be collected using the "Sociodemographic Information Form," "Cognitive Distortion Scale," and "Interpersonal Communication Competence Scale." Expert opinions will be obtained on the case of an anxious patient hospitalized, and the final outcome of the case will be provided. The case of the anxious patient will be turned into a game using an interactive web-based tool (https://www.powtoon.com/) that resembles real life. The program will use a voice chat tool and various characters. In the game, students in the intervention group will be asked to identify cognitive distortions and determine communication techniques through questions created for the anxious individual. Students in the intervention group will be given the opportunity to play the game at least twice over a two-week period. One week after playing the game, the Cognitive Distortion Scale and Interpersonal Communication Competence Scale will be completed. One week after playing the game, the Cognitive Distortion Scale and Interpersonal Communication Competence scales will be completed. To determine the interaction over time, follow-up tests (Cognitive Distortion Scale and Interpersonal Communication Competence) will be conducted two months after the final test application. Following the follow-up tests, the control group students will participate in a case discussion, student feedback will be collected, and the game link will be shared. The normality of the data distribution will be assessed using the Kolmogorov-Smirnov test and histogram. If the assumption of normal distribution is not met, generalized linear models or appropriate non-parametric methods (Friedman test and Mann-Whitney U test) will be used to compare changes between groups.

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

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Konya
    • Konya, Konya, Turkey (Türkiye)
      • Necmettin Erbakan University Faculty of Nursing

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Being a first-year nursing student,
• Successfully completing the self-awareness and communication management course,
• Having internet access, and
• Being willing to participate in the research.

Exclusion Criteria:

• Difficulty speaking and understanding Turkish,
• Not participating in theoretical training,
• Not playing the game prepared for the case,
• Incomplete or missing data collection forms,
• Wanting to leave the research.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Control; After the theoretical training given to the students, pre-tests will be administered, followed by post-tests two weeks later. Subsequently, the responsible researcher will discuss the case with the control group and collect feedback from the students. The game link will be shared with the control group.
Experimental: Game based learning; The case of an anxious patient will be turned into a game using an interactive web-based tool (https://www.powtoon.com/) (Powtoon platform) that resembles real life. The program will feature a voice-over tool and various characters. In the game, students will be asked to identify cognitive distortions and determine communication techniques through questions created for the anxious individual. A QR code will be generated from the prepared game link. After theoretical training, pre-tests will be administered, then the QR code will be projected onto the main screen in the classroom by the researcher in charge. Students will be given access using the QR code and will be asked to play the game. They will be given the opportunity to play the game at least twice over a two-week period. One week after playing the game, the Cognitive Distortion Scale and Interpersonal Communication Competence scales will be completed.	Behavioral: Game based learning; The case of an anxious patient admitted to the hospital was prepared by researchers in accordance with the literature. The prepared case was created based on the use of a game-based learning method for students in the intervention group. The case prepared in line with the literature and the questions related to the case were sent to three experts for evaluation. Revisions were made to the case based on the experts' recommendations, and the final version was produced.The responsible researcher will provide intervention and control group students with refresher theoretical training. After the theoretical training, students will be given a sociodemographic information form. Then, all students will be given a cognitive distortion and interpersonal communication competency scale (pre-test). Students in the intervention group will be given the the opportunity to play the game at least twice over a two-week period.One week after playing the game, post test will be conducted.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The effect of gamed based learning on interpersonal communication competence	Interpersonal Communication Competence Scale: The measurement tool developed by Huang and Lin (2018) was adapted into Turkish by Çıkrıkçı and Çinpolat (2021). The 15-item inventory is rated on a 5-point Likert. The inventory has 4 subscales. These subscales are listening skills, social comfort skills, empathy and expression skills.In the scoring, 2 items (items 10 and 13) are reverse-scored. The scores that can be obtained from the measurement tool range from 15 to 75 (Çıkrıkçı & Çinpolat 2021).	At the beginning of the study, two weeks after the application, and two months later.
The effect of gamed based learning on cognitive distortions	Cognitive Distortion Scale: This self-report scale was developed by Briere (2000). Batmaz et al. (2015) adapted the scale into Turkish. It consists of 15 questions related to cognitive distortions. Thinking in extremes, fortune telling (catastrophizing), discounting the positive, emotional reasoning, labeling, magnifying/minimizing, selective abstraction, mind reading, overgeneralization, personalization, impositions, jumping to conclusions, blaming oneself or others, what if? Thinking in extremes, and unfair comparison are assessed as cognitive distortions. Three different scores can be obtained from the scale: (i) frequency score, (ii) intensity score, and (iii) total score. The total (possible range = 0-75) is obtained by summing the scores of each item on the scale (Batmaz et al. 2015).	At the beginning of the study and two weeks after the application

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The effect of game based learning on cognitive distortions and communication competence	Sociodemographic Information Form: Prepared by researchers in line with the literature. It consists of questions such as age, gender, place of residence, family type, and income status.	At the beginning of the study

Collaborators and Investigators

• Sponsor: Necmettin Erbakan University

Study record dates

Study Major Dates

• Study Start (Actual): February 25, 2026
• Primary Completion (Actual): March 11, 2026
• Study Completion (Actual): March 11, 2026

Study Registration Dates

• First Submitted: February 23, 2026
• First Submitted That Met QC Criteria: February 27, 2026
• First Posted (Actual): March 2, 2026

Study Record Updates

• Last Update Posted (Actual): April 9, 2026
• Last Update Submitted That Met QC Criteria: April 3, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: care; cognitive distortions; game based learning; anxiety patient; communication competence
• Other Study ID Numbers: 2026/1332

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