Effectiveness of Gamified Teaching in Disaster Nursing Education for Health Care Workers: Systematic Review

Abstract

Background: With the continuous advancement of medical technology and the frequent occurrence of disaster events, the training of health care workers in disaster nursing has become increasingly significant. However, traditional training methods often struggle to engage learners' interest and enthusiasm, making it challenging to simulate emergencies in real-life scenarios effectively. Gamification, as an innovative pedagogical approach that enhances the enjoyment and practicality of learning through the incorporation of game elements, has garnered considerable attention in the realm of disaster nursing education for health care workers in recent years. This review systematically evaluates its effectiveness and explores its advantages in improving training outcomes.

Objective: This review aims to evaluate the effectiveness of gamified teaching methodologies in disaster nursing education and to identify the outcome of 16 indicators used in existing studies.

Methods: This study was conducted following the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines, using the PICO-SD framework (Population, Intervention, Control, Outcome, Study Design) to establish the inclusion criteria. The researchers systematically searched 8 databases on February 10, 2025, including the Cochrane Library, PubMed, CINAHL (EBSCO), Embase, Web of Science, CNKI, Wanfang, and SCOPUS. Ultimately, 16 quasi-experimental studies investigating the application of gamified teaching in disaster nursing education were included in the analysis. For randomized controlled trials (RCTs), the Cochrane Risk of Bias Assessment Tool (RoB 2.0) was used for quality assessment; for quasi-experimental studies, the Joanna Briggs Institute Risk of Bias Tool for Non-Randomized Intervention Studies was used for methodological quality evaluation. Given the heterogeneity of study designs and the diversity of study indicators, this study used a narrative synthesis to integrate the findings.

Results: The studies included in this review comprised 1 RCT and 15 quasi-experimental designs. Six gamified formats exhibited positive outcomes. The effectiveness of these formats was assessed through various metrics, including theoretical knowledge (14 studies), practical skills (11 studies), learner satisfaction (9 studies), knowledge retention (4 studies), and self-efficacy (2 studies). All formats demonstrated improvements in knowledge and skills, with high levels of satisfaction reported. However, data on long-term retention were limited.

Conclusions: Gamification teaching methods have shown significant potential to enhance core competencies such as emergency response, decision-making, and teamwork in disaster nursing education and have been effective in reinforcing learning engagement through elements such as cooperation, competition, scoring, and scenario simulation. However, there is a lack of standardized assessment frameworks for skill acquisition, longitudinal studies tracking behavior in real-life scenarios, and rigorous RCTs comparing it with traditional instruction. Although the existing evidence has not systematically confirmed its full effectiveness, based on the findings, this paper provides practical recommendations for developing and implementing gamified teaching strategies in disaster nursing education to enhance students' knowledge acquisition and practice.

Keywords: PRISMA; disaster nursing; effectiveness; gamification; health care workers; systematic review.