The Effectiveness of Gamified Metaverse-Based Training on Patient Safety for Nursing Students

Condition(s) studied

Investigational drug(s) / intervention(s)

Gamified metaverse-based educational application: Students in the intervention group will receive gamified metaverse-based training.

Study summary

Introduction: Patient safety issues, such as medication errors, healthcare-associated infections, unsafe surgical procedures, and diagnostic errors, can negatively impact the quality of healthcare and patient outcomes due to preventable risks. There is a need for innovative, interactive educational approaches to ensure the lasting acquisition of patient safety competencies in nursing students and to strengthen their transfer to the clinical environment. Aim: This study aims to evaluate the effect of gamified metaverse-based training on patient safety competencies in nursing students and to assess student opinions regarding metaverse-based training. Method: The research will be conducted using a mixed-methods design. The quantitative phase will be an experimental design including intervention and control groups, pre-test-post-test, and a one-month follow-up (retention test). The research will be conducted between February 2026 and May 2026 with second-year students studying in the Spring semester of 2025-2026 at Başkent University Nursing Department in Ankara. According to G\*Power calculations, a minimum sample size of 52 was found; considering a possible 10% loss, the total sample size was planned as 60 students (intervention=30, control=30). All participants will take the Patient Safety Knowledge Level Test (pre-test) and the Patient Safety Competency Self-Assessment Tool before the training. This will be followed by 2 hours of traditional theoretical training on patient safety; the intervention group will also receive gamified metaverse-based training via Spatial.io for two weeks. Post-tests will be administered after the training and one month later. Data collection tools include the Demographic Information Form, the Patient Safety Knowledge Level Test, the Patient Safety Competency Self-Assessment Tool (PSCS), and focus group interviews to be conducted in the intervention group. Quantitative data will be analyzed through within-group and between-group comparisons; qualitative data will be analyzed using thematic analysis, and the findings will be interpreted holistically. Findings (Expected): Gamified metaverse-based training is expected to provide a greater increase in mean scores on the Patient Safety Knowledge Level Test (PSL) and total and sub-dimension scores (knowledge-skills-attitudes) of nursing students compared to the control group, and to support the retention of these results.

Conclusion: This study is expected to generate evidence regarding the effectiveness of gamified metaverse-based training in improving patient safety competencies in nursing education and to contribute to the structuring of patient safety training in a more integrated, student-centered, and sustainable manner.

Eligibility

Primary outcome measure(s)

• The Patient Safety Knowledge Level Test — Before the intervention, within 1 hour after the intervention, and one month after the intervention.
  The Patient Safety Knowledge Level Test, developed by Buldak and Tüzer (2025), will be administered as follows: a pre-test to determine students' current knowledge level regarding patient safety, a post-test (1) within one hour following the metaverse application, and a 1st retention test/post-test-2 one month later to measure the retention of learning. The Patient Safety Knowledge Level Test consists of 20 multiple-choice questions with 5 options each, related to patient safety knowledge. A minimum score of 0 and a maximum score of 100 are possible on this test. A higher score indicates an increased knowledge level.
• Patient Safety Competency Self-Evaluation Tool — Before the intervention, within 1 hour after the intervention, and one month after the intervention.
  The scale was developed to measure nursing students' knowledge, skills, and attitudes regarding patient safety through self-assessment, and its Turkish adaptation was done by Eskici et al. (2021). The multidimensional scale consists of 3 dimensions (Knowledge=6 items, Skills=21 items, Attitudes=14 items), 12 factors, and a total of 41 items; items are scored on a 5-point Likert scale according to the dimensions (Knowledge: 1=I have no knowledge-5=I know very well; Skills: 1=I cannot do it at all-5=I can do it very easily; Attitudes: 1=I strongly disagree-5=I strongly agree). Items 38 and 39 are reverse-scored, and evaluation is done based on total and sub-dimension/factor average scores due to the multidimensional nature of the scale; higher scores indicate better patient safety competence. The internal consistency of the Turkish form was found to be high (total Cronbach's alpha=0.941; sub-dimensions 0.642-0.932).

Trial sites (1)

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