"Game On!" In the Classroom: Evaluating the Use of Serious Games for Exam Preparation

Faculty teaching the first level Adult Health course developed and implemented a serious game as a strategy to engage students in a classroom setting. The game was designed based on the concept of the television show, The Amazing Race, allowing students to race to three locations, those being of the three phases of a surgical experience: pre-operative, intra-operative and post-operative. During the race, students played the role Breast Navigator Nurse, caring for a patient with breast cancer undergoing a mastectomy. The content of the game was derived from topics that were discussed during the didactic course and served as an interactive review for a unit exam. Students were divided into small groups and expected to complete three ‘challenges’ in order to move the patient through each phase of the surgery. For each ‘challenge’, the group was given an envelope with a case study and relevant questions to answer. Once the case study was complete, the faculty would review the answers for accuracy. Students had an opportunity to revise their answers if they were incorrect. Once the case study questions were answered correctly, the students would then receive a multi-question traditional NCLEX-RN style quiz. Each correct answer would provide a clue to answer a riddle. The final ‘challenge’ included a crossword puzzle and the first group to complete this task was deemed the winner of The Amazing Racegame. To determine the effectiveness of this teaching strategy, a pre-test was given one week prior to the game with results being compared to a post-test given at the conclusion of the game. Five traditional NCLEX-RN style questions served as the pre- and the post-test for one group of students. The same questions served as the pre-test for three additional groups of students, who then completed a 10-question post-test consisting of next generation NCLEX (NGN)-type questions designed to test clinical judgment using extended multiple response and cloze questions. Using paired samples t-tests, students’ individual pre-and post-test scores were compared. There was an increase in scores for the group of students (N=35) who completed the pre-test and post-test consisting of traditional NCLEX-RN style questions, but the increase was not statistically significant (p=.15). However, there was statistically significant improvement (p=.04) in post-test scores over the pre-test scores for students (N=64) completing the test consisting of NGN questions. The students’ evaluation of the serious game experience was overwhelmingly positive. After finishing the game, students completed a faculty-developed survey where the students rated their level of agreement with items reflecting their satisfaction with the experience. On a 1 (strongly disagree) to a 5 (strongly agree) Likert-type scale with a possible range in scores from 10-50, the mean score was 43.05 (SD=6.64). Faculty concluded that using the serious game as an examination review can be an effective teaching strategy for pre-licensure nursing students.