JMIR Publications

Background:

So-called serious games, or educational games, are a category of games aimed at learning. They can produce motivation and strong user engagement through their dynamic, responsive, and visual nature. Given technological advancements and the integration of digital natives into the educational system, there is a clear need to enhance the immersion and engagement of the teaching-learning process. Accordingly, the implementation of serious games offers a significant opportunity. Pressure Ulcers (PU) are defined as injuries caused by the breakdown of the skin and adjacent soft tissues, a common complication in bedridden patients, leading to physical and psychological harm. PU treatment and prevention must be linked to a multiprofessional approach, as patients require holistic evaluation, and nurses must be integral to this process.

Objective:

To develop and evaluate a serious game as an educational tool about PU for undergraduate nursing students. In light of the new profile of digital-native learners, this approach aims to facilitate a paradigm shift in education by incorporating innovative technological tools.

Methods:

This is a methodological study. It was based on the Analysis, Design, Development, Implementation, Evaluation (ADDIE) model. This model, also known as Instructional System Design (ISD). Content validity was assessed by four experts with postgraduate degrees in nursing, with a minimum agreement threshold of 80% established for suitability. These experts completed an instrument based on the 12 criteria proposed by Pasquali et al. To evaluate technical and pedagogical aspects, three experts with subject matter expertise utilized the Learning Object Review Instrument (LORI) and GameFlow. Finally, the heuristic evaluation phase involved four judges who applied the Heuristic Evaluation for Digital Educational Games (HEDEG) instrument.

Results:

The evidence base was anchored in guidelines from two internationally recognized authorities: the European Pressure Ulcer Advisory Panel (EPUAP) and National Pressure Injury Advisory Panel (NPIAP). A hybrid virtual-physical quiz card game was developed. The proposed gameplay mechanics followed these rules: each player receives three answer cards (A, B, and C) corresponding to the response options displayed on each question card. The evaluation results demonstrate an effective serious game that supports nursing practice by facilitating integrated, high-quality care to promote patient recovery and wellbeing for the targeted health issues.

Conclusions:

It is concluded that the serious game "Pressure-Free" contains the necessary resources to promote meaningful learning among its players, establishing itself as a high-quality educational strategy. This study successfully fulfilled all the implementation phases proposed by the model. Furthermore, all evaluation stages were grounded in robust theoretical frameworks, distinguishing this research from current trends in the existing literature.

Clinicaltrial: