A self-determination theory-based digital gaming approach to enhancing EFL learners' competence in applying professional English

In the clinical medical field, case studies, medication records, examination results, and physician prescriptions are documented in English. As a consequence, the English for Medical Professionals (EMP) program has become one of the important courses in nursing education in non-English-speaking countries. For English as a Foreign Language (EFL) learners, learning English for medical professionals can become challenging without the support of appropriate learning contexts. In general, the didactic teaching strategy widely used in the EMP program in large classrooms is a passive method without a feedback mechanism. To address the issues of English for Medical Professionals for EFL learners, the study proposed a self-determination theory-based digital gaming approach with autonomy, competence, and relatedness. To verify the effectiveness of the proposed approach, we conducted an experiment in the EMP program by comparing the self-determination theory-based digital gaming approach with the conventional approach, and explored the differences between these two approaches in terms of learning achievement, learning attitude, critical thinking tendency, technology acceptance, and flow experience. The experimental results showed that nursing students who learned with the self-determination theory-based digital gaming approach significantly enhanced their learning achievement, learning attitude, critical thinking tendency, technology acceptance, and flow experience in the EMP program.