Effect of using gamification and augmented reality in mechanical ventilation unit of critical care nursing on nurse students' knowledge, motivation, and self-efficacy: A randomized controlled trial

Background: Gamification and augmented reality (AR) are innovative teaching modalities. Research on the effects of combining these two strategies in nursing education is scarce. Objectives: To examine the effect of the combined use of gamification and AR in teaching mechanical ventilation (MV) on nurse students' knowledge, motivation, self-efficacy, and satisfaction. Design: Randomized controlled trial. Setting: A conveniently selected faculty of nursing in Egypt. Participants: A total of 410 nurse students. Methods: Participants were randomly assigned to the intervention or control group (205 in each). Kahoot games and AR were used in the intervention group, whereas a traditional lecture was applied in the control group. The outcomes included levels of students' knowledge, learning motivation, self-efficacy, and satisfaction. Results: Mixed design repeated-measures ANOVA test revealed a statistically significant difference in knowledge test scores within-subject over time (p-value [effect size]: <0.001 [0.515]), between-subject due to the main effect of interventions (<0.001 [0.146]), and within-between interaction effect of group and time (<0.001 [0.515]). After using Kahoot and AR, the total mean self-efficacy score was significantly higher in the intervention group than in the control group (<0.001 [0.662]). The total median motivation score was significantly higher for the Kahoot and the AR groups compared with the traditional lecture (<0.001 [0.558]). Conclusion: Kahoot games and AR significantly increased nurse students' knowledge, motivation, and selfefficacy compared with traditional MV learning classes. Nursing educators need to incorporate Kahoot and AR in their pedagogies to enhance nurse students' satisfaction and development.