Gamification and Augmented Reality in Mechanical Ventilation Teaching for Nursing Students

This study is designed to examine the effect of using gamification and augmented reality in mechanical ventilation teaching on Critical Care Nursing students' knowledge, self-efficacy, and motivation.

A pretest-posttest, prospective, randomized controlled trial will be conducted. Random assignment will place participants in either the experimental group using augmented reality games or the control group using traditional lectures (control group).

1. Preparation of Augmented Reality Models

   * Mechanical ventilator handout will be developed by the authors. This handout will be including images of physiology of respiration, mechanical ventilator machines, ventilator graphs, and ventilator settings.
   * An augmented reality (AR) mobile application with image based AR will be used by the participants in the experimental group. The three-dimensional (3D) virtual models and images will be shown in the AR handout, and the participants could display the objects on the mobile screen with the use of a marker on the page of the AR handout using the camera in the mobile app.
2. Preparation of Kahoot Game

   * A teacher account was constructed on Kahoot after signing up at "https://kahoot.com".
   * A Kahoot quiz with 20 multiple-choice questions and pictures will be constructed at "https://create.kahoot". Only one correct option will be possible for each of the 20 questions.
   * When a quiz is created and opened in "Kahoot".
   * The students access to Kahoot within the classical game mode (Player vs Player "1:1 Devices").
   * A typical session of Kahoot involves 200 students playing the game.
   * Once each teaching unit is completed, students will be asked to actively participate in the classroom using Kahoot.
   * Once all of the players' names have appeared on the screen, the teacher presses "START" to begin the quiz.
   * Students' responses and the scores' calculation will be automatically stored in the database.
   * After the test is finished, a report of the results will be created and made available for download to the researcher.

Data Collection Procedure

The study will be conducted between October 20, 2022 and December 30, 2022.

* The students in experimental group received a 30 minutes augmented reality games training for mechanical ventilator using a 3D images and videos.
* The control group will be learned with the traditional materials in which the teacher will give online lectures regarding the mechanical ventilation utilizing PowerPoint presentation through Microsoft Teams platform.
* The self-administered questionnaires of knowledge, self-efficacy and motivation survey will take 15 minutes to complete for each participant via an online form. The pretest for both groups will be administered on the first day of the study, and the post-test will be administered immediately after and after three weeks of the intervention.
* Three weeks after the baseline measurements, knowledge, self-efficacy and Motivation Survey will be assessed again.

Eligibility Criteria:
Inclusion Criteria:

* Third-year nursing students enrolled in the course of Critical Care Nursing (I) for the first time;
* Smartphone owners and users; those who have internet access;
* Those who understood the goal and nature of the study and voluntarily agreed to participate

Exclusion Criteria:

* Prior experience in mechanical ventilation
* Refusal to participation