Investigating the Effect of Gamification Based on Adaptive Microlearning on Knowledge, Skills, and Self-Efficacy in ECG Interpretation Among Undergraduate Nursing Students
Investigating the Effect of Gamification Based on Adaptive Microlearning on Knowledge, Skills, and Self-Efficacy in ECG Interpretation Among Undergraduate Nursing Students
Design
This three-group experimental study includes 51 undergraduate nursing students (17 per group): a control group receiving routine instruction, Intervention 1 receiving routine instruction plus adaptive microlearning, and Intervention 2 receiving Intervention 1 plus gamification.
Students are randomly assigned to internship groups. To reduce information transfer between groups, the control group completes its course and post-test first.
Settings and conduct
“At Qom University of Medical Sciences, students are randomized into three study arms: control (standard CCU training) or adaptive microlearning (with or without gamification). This six-session intervention is evaluated at pre-test, post-test, and one-month follow-up.”
Participants/Inclusion and exclusion criteria
Currently pursuing a Bachelor's degree in Nursing
Completed the Intensive Care course
No prior experience participating in similar interventions
No prior participation in ECG training courses or workshops
Intervention groups
Control Group: Receives routine CCU clinical training only.the training and takes the post-test first.
Intervention Group 1: Receives routine training plus two phases of microlearning: pre-internship multimedia content over 10 days, followed by personalized, adaptive microlearning content delivered during the internship based on individual learning needs.
Intervention Group 2 : Receives the full intervention of Group 1, with the addition of the “ECG Duel” card game in supervised sessions to increase motivation and reinforce ECG interpretation skills.
Main outcome variables
Adaptive Micro-learning-Gamification- Knowledge, Skills, and Self-Efficacy in ECG Interpretation
General information
Reason for update
Acronym
IRCT registration information
IRCT registration number:IRCT20260921071142N1
Registration date:2026-10-08, 1405/07/16
Registration timing:registered_while_recruiting
Last update:2026-10-08, 1405/07/16
Update count:0
Registration date
2026-10-08, 1405/07/16
Registrant information
Name
Hussein Rais_Mirzaie
Name of organization / entity
Country
Iran (Islamic Republic of)
Phone
+98 25 3665 1270
Email address
rm.hussein2002@gmail.com
Recruitment status
recruiting
Funding source
Expected recruitment start date
2026-09-19, 1405/06/28
Expected recruitment end date
2026-12-14, 1405/09/23
Actual recruitment start date
empty
Actual recruitment end date
empty
Trial completion date
empty
Scientific title
Investigating the Effect of Gamification Based on Adaptive Microlearning on Knowledge, Skills, and Self-Efficacy in ECG Interpretation Among Undergraduate Nursing Students
Public title
Investigating the Effect of Gamification Based on Adaptive Microlearning on Knowledge, Skills, and Self-Efficacy in ECG Interpretation
Purpose
Education/Guidance
Inclusion/Exclusion criteria
Inclusion criteria:
Currently pursuing a Bachelor's degree in Nursing
Completed the Intensive Care course/module
Exclusion criteria:
• No prior experience participating in similar interventions
• Failure to participate in ECG training courses or workshops
Age
From 18 years old
Gender
Both
Phase
N/A
Groups that have been masked
No information
Sample size
Target sample size:
50
Randomization (investigator's opinion)
Not randomized
Randomization description
Blinding (investigator's opinion)
Not blinded
Blinding description
Placebo
Not used
Assignment
Factorial
Other design features
Secondary Ids
empty
Ethics committees
1
Ethics committee
Name of ethics committee
Ethics Committee of Qom University of Medical Sciences
Street address
No. 140, North Taghavi Street, Modarres Boulevard, Zein-ed-Din Square
City
QOM
Province
Ghoum
Postal code
3715134471
Approval date
2026-09-16, 1405/06/25
Ethics committee reference number
IR.MUQ.REC.1405.224
Health conditions studied
1
Description of health condition studied
Knowledge, Interpretation Skills, and Self-Efficacy in ECG
ICD-10 code
ICD-10 code description
Primary outcomes
1
Description
ECG Knowledge
Timepoint
Before the intervention – after the intervention – one month after the intervention
Method of measurement
Using the ECG-KAT tool
2
Description
ECG interpretation skills
Timepoint
Before the intervention – after the intervention – one month after the intervention
Method of measurement
Using the ECG-SAT tool
3
Description
Self-efficacy in ECG interpretation
Timepoint
Before the intervention – after the intervention – one month after the intervention
Method of measurement
Using the ECG-SES tool
Secondary outcomes
empty
Intervention groups
1
Description
Intervention Group 1 (Adaptive Micro-learning): In addition to standard clinical training in the CCU, students in this group receive an educational intervention delivered in two phases: 1. Pre-internship phase: For 10 days prior to starting their rotation, students are provided with 3–4 pieces of multimedia micro-learning content daily via an online platform (covering key points and concise summaries on ECG interpretation, cardiac arrhythmias, conduction disorders, and common pharmacological/interventional treatments) to establish the necessary foundational knowledge. 2. During-internship phase: Educational content is delivered adaptively from a database. At this stage, content is selected and presented based on the identification of each student's specific weaknesses and learning gaps, thereby enabling targeted improvement of their ECG interpretation skills.
Category
Other
2
Description
Intervention Group 2 (Adaptive Micro-learning + Gamification): Phase 1: Pre-internship (Micro-learning)—For 10 days prior to the internship, students receive 3–4 pieces of multimedia micro-content daily via digital platforms (covering key points and "capsule" summaries on ECG interpretation, cardiac arrhythmias, conduction disorders, and common pharmacological/interventional treatments) to establish the necessary foundational knowledge. Phase 2: During Internship (Adaptive Content + Card-based Gamification)—Implementation of the "ECG Duel" card game: Gamification sessions are conducted in person under the researcher's supervision during ward-based internship sessions. The game creates a competitive, engaging, and interactive environment where students can test their knowledge against clinical scenarios and actual ECG tracings. Personalization and adaptive content based on game performance: During and after the game, each student's diagnostic and therapeutic errors are identified. Based on these individual weaknesses, remedial and supplementary content is retrieved from an "educational content bank" and delivered to the specific student in a targeted, personalized manner.
Category
Other
Recruitment centers
1
Recruitment center
Name of recruitment center
School of Nursing and Midwifery, University of Medical Sciences
Full name of responsible person
Moghadam abbas
Street address
Nursing Faculty, No. 2 East Alley, Moallem Blvd
City
Qom
Province
Ghoum
Postal code
3715835155
Phone
+98 25 3783 1370
Email
rm.hussein2002@gmail.com
Sponsors / Funding sources
1
Sponsor
Name of organization / entity
Ghoum University of Medical Sciences
Full name of responsible person
Ebraze Ali
Street address
Shahid Lavasani St. (Saheli St.),Qom University of Medical Sciences
City
Qom
Province
Ghoum
Postal code
3713649373
Phone
+98 25 3772 6688
Email
rm.Hussein2002@gmail.com
Grant name
Grant code / Reference number
Is the source of funding the same sponsor organization/entity?
Yes
Title of funding source
Ghoum University of Medical Sciences
Proportion provided by this source
100
Public or private sector
Public
Domestic or foreign origin
Domestic
Category of foreign source of funding
empty
Country of origin
Type of organization providing the funding
Academic
Person responsible for general inquiries
Contact
Name of organization / entity
Ghoum University of Medical Sciences
Full name of responsible person
Hussein Rais_Mirzaie
Position
Master's student in Nursing
Latest degree
Bachelor
Other areas of specialty/work
Nursery
Street address
No. 140, North Taghavi St., Modarres Blvd., Zeyneddin Sq.
City
Qom
Province
Ghoum
Postal code
3715134471
Phone
+98 25 3665 1270
Fax
Email
Rm.hussein2002@gmail.com
Person responsible for scientific inquiries
Contact
Name of organization / entity
Ghoum University of Medical Sciences
Full name of responsible person
Hussein Rais_Mirzaie
Position
Master's student in Nursing
Latest degree
Bachelor
Other areas of specialty/work
Nursery
Street address
No. 140, North Taghavi St., Modarres Blvd., Zeyneddin Sq.
City
Qom
Province
Ghoum
Postal code
3715134471
Phone
+98 25 3665 1270
Fax
Email
Rm.hussein2002@gmail.com
Person responsible for updating data
Contact
Name of organization / entity
Ghoum University of Medical Sciences
Full name of responsible person
Hussein Rais_Mirzaie
Position
Master's student in Nursing
Latest degree
Bachelor
Other areas of specialty/work
Nursery
Street address
No. 140, North Taghavi St., Modarres Blvd., Zeyneddin Sq.
City
Qom
Province
Ghoum
Postal code
3715134471
Phone
+98 25 3665 1270
Fax
Email
Rm.hussein2002@gmail.com
Sharing plan
Deidentified Individual Participant Data Set (IPD)
No - There is not a plan to make this available
Justification/reason for indecision/not sharing IPD
“No decision has yet been made regarding data release; a final decision will be made after the completion of the study, taking the relevant circumstances into consideration.”
Study Protocol
Undecided - It is not yet known if there will be a plan to make this available
Statistical Analysis Plan
Undecided - It is not yet known if there will be a plan to make this available
Informed Consent Form
Undecided - It is not yet known if there will be a plan to make this available
Clinical Study Report
Undecided - It is not yet known if there will be a plan to make this available
Analytic Code
Undecided - It is not yet known if there will be a plan to make this available
Data Dictionary
Undecided - It is not yet known if there will be a plan to make this available