Perception of nursing students about the implementation of GREENS© methodology in nursing studies.

Background: The Gymkhana Room for Education and Evaluation in Nursing Studies (GREENS©) is a pedagogical model that can be used as a learning and assessment method in nursing training workshops. This model combines the advantages of gamification, the flipped classroom and the use of low-fidelity clinical simulation, also including self-reflection and peer evaluation of the situations experienced.

Objectives: To evaluate the students' perception of the implementation of GREENS© as a learning and assessment tool in an academic course at the University of Almeria.

Design: A cross-sectional descriptive study.

Settings: Academic year 2018/2019, at the University of Almeria (UAL), Spain.

Participants: 77 students enrolled in their 2nd year of the Nursing Degree who attended the "Health Promotion and Safety" class.

Methods: After completing the GREENS© activity, the perception and anxiety of students were analyzed through an online ad hoc questionnaire composed of 17 questions. Data were collected in January 2019.

Results: All of the questions scored above 4 out of a maximum of 5 on a Likert scale. For all the questions, >50% of the students were in total agreement with the questions answered, showing a high acceptance of the GREENS© methodology implementation. The students reported that their anxiety decreased significantly, with a score of 4.7 points on average (95% CI: 4.16 to 5.33, p < 0.001), after knowing that the assessment would be through a gamification tool, not an oral one. More than 60% of the students answered "agree" or "strongly agree" with the idea that GREENS© is useful for improving motivation, teamwork, learning, fun and knowledge assessment.

Conclusions: The use of GREENS© has generated a high satisfaction and motivation of the students in their learning process, and as an assessment tool, it created a lower degree of anxiety as compared to an oral examination.