The effectiveness of serious games in nursing education: A meta-analysis of randomized controlled studies.

Objective: This systematic review and meta-analysis aimed to synthesize the effects of randomized controlled trials using serious gaming in nursing education on knowledge, skills, and confidence.

Design: Systematic review and meta-analysis of randomized controlled trials.

Data Sources: Randomized controlled trials published in English in PubMed, CINAHL, Web of Science, Scopus, Cochrane Library databases between 2000 and 2023.

Review Methods: Quality assessment was performed using the Joanna Briggs Institute Critical Appraisal Tool for Assessment of Risk of Bias for Randomized Controlled Trials and the review was reported according to the PRISMA-2020 protocol. The review was conducted by two independent reviewers.

Result: As a result of the database review, a total of 1886 studies were found and 8 studies were included in the meta-analysis. The use of serious games was found to have a low to moderate effect on the knowledge levels of nursing students (Hedge's g = 0.492; 95 % CI = -0.094-1.078), and a moderate effect on their skill (Hedge's g = 0.756; 95 % CI = 0.505-1.003) and self confidence levels (Hedge's g = 0.698; p = 0.362, 95 % CI = -0.801-2.196). The heterogeneity of the studies was found to be high for knowledge (I = 92 %), skill (I = 71.5 %) and self confidence (I = 95.9 %), and low for knowledge (p = 0.90; p = 0.29) and skill (p = 0.75; p = 0.69) in terms of bias analyses egger regression test and begg and mazumdar test, respectively.

Conclusion: The reviewed studies revealed that the use of serious games in nursing education has positive effects on knowledge, skills and self-confidence. In order to increase the reliability of the evidence, there is a need to increase the number of welldesigned randomized controlled trials using serious games and to examine the effects of these results in clinical practice with larger sample groups.