Designing and evaluating a serious game on improving nursing students' knowledge, confidence and skill performance in the safe administration of blood transfusion: A clustered randomised controlled trial

Background & Hypothesis: Technological advances have given rise to serious gaming, which can optimise learning on the safe administration of blood transfusion in a safe virtual environment. This study aims to design and evaluate the effectiveness of serious gaming in enhancing knowledge, confidence and skill performance of nursing students in the administration of blood products. Methods: A clustered, randomised controlled trial was conducted on 103 second‐year undergraduate nursing students. Students were randomised into control or experimental group based on their tutorial grouping. The experimental group underwent a blood transfusion game. The game involved processes of pre‐, during‐ and post‐blood transfusion. Multimedia instructional materials for knowledge acquisition and formative assessment through mini‐games specific to game objectives with real‐time feedback were included. Pre‐ and post‐tests through knowledge and confidence questionnaires were conducted. Experimental group participants evaluated their learning experience through a survey. Two weeks later, participants' blood transfusion skill performance was assessed in a simulated environment. Results: The experimental group demonstrated significant improvement (P <0.001) in post‐test knowledge and confidence scores. Group comparisons indicated that the experimental group had significant improvements in postknowledge (P <0.001) and confidence scores (P <0.001). Results show no significant difference (P = 0.105) in skill performance between groups. Experimental group participants rated the serious game positively. Discussion & Conclusion: This study revealed the effectiveness of serious games in enhancing knowledge and confidence of students, but not skill performance. Serious gaming provides an innovative way to optimise learning when blended with hand‐on simulation. Future study can evaluate this blended learning to improve nursing competencies in the safe administration of blood transfusion.