The Impact of Gamified Teaching on Undergraduate Nursing Students' Disaster Nursing Competence, Self-Efficacy, and Self-Directed Learning Ability: Quasi-Experimental Study.

Background: Gamified teaching is considered an effective strategy for enhancing learning motivation. However, there is insufficient research on systematically designing theory-based gamified approaches for disaster nursing, particularly in resource-limited conventional classroom settings. Objective: This study aimed to compare the impact of gamified teaching versus conventional teaching on disaster nursing competence, self-efficacy, and self-directed learning ability among undergraduate nursing students. Methods: A quasi-experimental, nonequivalent control group pretest-posttest design was used. Participants were third-year nursing students who had completed foundational and medical-surgical nursing courses with no prior gamified learning (GL) experience. They were nonrandomly allocated to experimental (GL group, n=66) and conventional learning (CL group, n=66) groups based on scheduling feasibility. The GL group received 180 minutes (4 class hours) of gamification, incorporating points, group competitions, and collaboration. The CL group received traditional instruction. Outcomes were measured at 3 time points (preintervention, immediate posttest, and 1-week follow-up) using the Disaster Nursing Competence Scale, General Self-Efficacy Scale, and Self-Directed Learning Ability Scale of Nursing Undergraduates. Data were analyzed using linear mixed models with group, time, group × time interaction, and baseline differences (disaster experience) as covariates. Results: The GL group scored significantly higher than the CL group on the total posttest score for disaster nursing competence (mean difference [MD]=0.205, 95% CI 0.032-0.378; P=.02), although the difference was not statistically significant at follow-up. The knowledge dimension (MD=0.274; P=.01) and practical skills dimension (MD=0.201; P=.03) showed the same pattern of immediate improvement, whereas the physical and mental qualities dimension demonstrated a delayed effect at follow-up (MD=0.537; P=.003). The total score for self-directed learning ability was higher in the gamified teaching group than in the control group at follow-up (MD=0.116, 95% CI 0.012-0.220; P=.03), with significant improvements in collaborative learning ability (group × time interaction effect F2,390=5.17, P=.01; follow-up between-group difference=0.243, P=.001) and information competence (follow-up between-group difference=0.140; P=.04), but no significant change in self-management ability. There were no significant differences between the 2 groups in general self-efficacy at any time point (interaction effect P=.33). Conclusions: Unlike most studies focusing on digital gaming platforms, this study shows that a low-technology, highly interactive classroom gamification approach is feasible under conventional teaching conditions. The uniqueness of this gamified teaching lies in its ability to simultaneously improve multidimensional competencies (knowledge, skills, psychological qualities, self-directed learning, and learning collaboration ability) and reveal a delayed effect on physical and mental qualities-a pattern rarely reported before. This suggests potential utility in resource-limited nursing education and provides a practical, resource-sensitive solution for disaster nursing training. However, the absence of significant effects on general self-efficacy indicates that gamified teaching may not influence all psychological constructs equally. Furthermore, the 1-week follow-up may be insufficient to capture longer-term changes in psychological outcomes, and caution is warranted when generalizing these findings to other educational contexts without adaptation.