Gamification Versus E-Learning for Electrocardiogram Education

Comparing the Effectiveness of Gamification Educational Method and E-learning Educational Method

This randomized controlled study aims to compare the effectiveness of a gamification educational method and an e-learning educational method for electrocardiogram (ECG) education. Nursing students and novice nurses are randomly assigned to either a gamified learning group or an e-learning group. The study evaluates whether the gamification approach improves ECG knowledge, learning confidence, and learning satisfaction compared with conventional e-learning instruction.

Study Overview

• Status: Completed
• Conditions: Gamification; Electrocardiogram; Nursing Education Research; Electrocardiography (ECG); Electrocardiogram Interpretation; Electrocardiogram Education
• Intervention / Treatment: Behavioral: Gamification Educational Method; Behavioral: E-learning Educational Method

Detailed Description

Electrocardiogram (ECG) interpretation is an essential competency for nursing students and novice nurses. Traditional educational approaches, including lecture-based and self-directed e-learning methods, may not fully engage learners or promote active participation. Gamification has emerged as an innovative educational strategy that incorporates game elements into learning activities to enhance motivation, engagement, and knowledge acquisition.

This randomized controlled study was conducted to compare the effectiveness of a gamification educational method with a conventional e-learning educational method for ECG education. Participants were assigned to either a gamification group or an e-learning group. The gamification intervention incorporated interactive learning activities designed to facilitate active participation and reinforce ECG learning concepts, whereas the comparison group received self-directed e-learning instruction.

The study was designed to evaluate whether gamification could improve learning outcomes and provide evidence for the application of innovative educational strategies in nursing education and clinical training programs.

• Study Type: Interventional
• Enrollment (Actual): 297
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Taiwan
  • Taiwan
    • Tainan, Taiwan, Taiwan, 709
      • Tainan Municipal An-Nan Hospital, China Medical University

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Nursing students who completed medical-surgical nursing coursework
• Newly graduated nurses undergoing clinical orientation
• Able to understand study procedures
• Willing to provide informed consent

Exclusion Criteria:

• Previous participation in the study
• Failure to complete study questionnaires
• Declined participation

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Gamified ECG Education; Participants received electrocardiogram education through a gamification educational method that incorporated game-based learning activities designed to enhance learner engagement and participation.	Behavioral: Gamification Educational Method; Participants received electrocardiogram education through a self-directed e-learning educational method using online educational materials and instructional content.
Active Comparator: E-learning ECG Education; Participants received electrocardiogram education through a self-directed e-learning educational method using online instructional materials.	Behavioral: E-learning Educational Method; Participants received electrocardiogram education through a self-directed e-learning educational method using online educational materials and instructional content.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Electrocardiogram Knowledge Questionnaire Score	Measured using a 20-item electrocardiogram knowledge questionnaire. Scores range from 0 to 20, with higher scores indicating greater ECG knowledge.	Immediately before and immediately after the intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Learning Confidence Scale Score	The Learning Confidence Score Scale consists of 5 questions, designed to measure a participant's confidence in interpreting ECGs and applying them clinically after completing an ECG course. A 0-100mm line is divided into 100 divisions, marked with a scale from 1 to 100, where 0 represents no confidence and 100 represents full confidence. The test subject quantifies their self-perceived visual score from 0 to 100.	Baseline and immediately after completion of the educational intervention
Learning Satisfaction Questionnaire Score	This questionnaire includes key evaluation points for teaching effectiveness, such as lesson planning, teaching material presentation, teaching strategies, teaching assessment, and teaching atmosphere. It comprises 13 questions and uses a Likert scale, with 1 point for "very dissatisfied" and 5 points for "very satisfied." The total score ranges from 13 to 65 points, with higher scores indicating higher course satisfaction.	Immediately after completion of the educational intervention

Collaborators and Investigators

• Sponsor: Taiwan Municipal An-Nan Hospital-China Medical University

Study record dates

Study Major Dates

• Study Start (Actual): July 14, 2020
• Primary Completion (Actual): December 23, 2020
• Study Completion (Actual): December 23, 2020

Study Registration Dates

• First Submitted: June 3, 2026
• First Submitted That Met QC Criteria: June 9, 2026
• First Posted (Actual): June 12, 2026

Study Record Updates

• Last Update Posted (Actual): June 12, 2026
• Last Update Submitted That Met QC Criteria: June 9, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: Randomized Controlled Trial; Electrocardiogram; Gamification; Nursing Education
• Other Study ID Numbers: TMANH109-REC001(CR-1)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data will not be made available to protect participant confidentiality and because data sharing was not specified in the original study protocol and informed consent documents.

Drug and device information, study documents

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