Digital Tools for Learning Diabetes: Combination of Animation and Gamification

Study Overview
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Brief Summary
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COVID-19, a global epidemic that affects the world, has created significant changes in many areas, especially in the health system. One of the most affected areas is nursing education. The content of nursing education focuses on cognitive, psychomotor and affective areas. In order for nursing education to be successful, important initiatives should be provided in the education of these areas. However, difficulties were encountered in the distance education process. This study was conducted to evaluate the delivery of diabetes education in nursing with animation and gamification.

Detailed Description
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This study was conducted with a randomized-controlled experimental design. This study was conducted between October and November 2020 in the Department of Nursing at the Faculty of Health Sciences in Turkey. The inclusion criteria were as follows: being 18 years old or over, studying in the second year, volunteering to take a diabetes course, not attending any course for diabetes before, have a remote access tool (internet connection, personel comuter eg.), not to be absent on the date when the data of the research will be collected. The second-year nursing students were selected for the study since participants have not taken diabetes nursing courses before. In the randomization part of the study, the students were assigned to the experiment (n=35) and control (n=35) groups according to their number in the class list using the random numbers table. Data were callacted with Structured Student Identification Form, Diabete Nursing Knowledge Test, Instructional Materials Motivation Survey and  Opinion Form on Diabetes Education Program supported by digital tools. The Diabetes Nursing course is 2 hours per week fow 10 week. After students were assigned to groups with randomization, the application process of the research was explained to the students. The control group was taught with the traditional method and the experimental group was taught with learning activities based on animation and gamification. Direct lecture, question-answer teaching methods were used through Microsoft Power Point presentation to the control group of Diabetes Nursing course. At the end of the lesson, Diabete Nursing Knowledge Test and Instructional Materials Motivation Survey were used in control group. An animated video was watched at the beginning of each lesson in the experimental group. Later, lecture and question-answer teaching methods were used through Microsoft Power Point presentation. At the end of each lesson, Web 2.0 (Kahoot) application was used to reinforce students' knowledge.At the end of the lesson, Diabete Nursing Knowledge Test, Instructional Materials Motivation Survey and  Opinion Form on Diabetes Education Program supported by digital toolswere used in intervention group.

Official Title
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Digital Tools for Learning Diabetes: Combination of Animation and Gamification

Conditions
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Diabetes, Educational Problems

Intervention / Treatment
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* Other: Traditional education
* Device: Diabetes Education supported by digital tools


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Over18 years old Being 2nd year student Volunteering to take a diabetes course Not attending any course for diabetes before Have a remote access tool (internet connection, personel comuter eg.) Not to be absent on the date when the data of the research will be collected. Exclusion Criteria: Not being volunteer to participate in the study who have taken the course in previous years

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: This study was conducted between Octorber and November 2020 on 70 volunteer students studying in the Department of Nursing at the Faculty of Health Sciences in Turkey. The inclusion criteria were as follows: (a) being 18 years old or over, (b) studying in the second year, (c) volunteering to take a diabetes course (d) not attending any course for diabetes before e) have a smart phone f) no internet connection problem g) not to be absent on the date when the data of the research will be collected. The second-year nursing students were selected for the study since they have not taken diabetes courses before. The students included in the study were randomly divided into two groups.The control group was taught with the traditional method and the experimental group was taught with learning activities based on animation and gamification.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Traditional diabetes education<br>The subjects and activities were applied to the control group, who received traditional diabetes education, between 8:00 and 10:00 with the classical method, which lasted 2 hours, for 10 weeks. The training was completed by the researcher with the verbal narration method. Diabetes Achievement Assessment Test with question and answer method was administered to the students at the beginning and end of the application. These questions were the same questions asked to the experimental group. Interaction of groups with each other was limited. Students were informed about this and their consent was taken.At the end of the course, students' opinions were taken through the form developed by the researchers. Instructional Materials Motivation Survey (IMMS) was used to measure to student' motivation levels. | Other: Traditional education<br>* Diabetes education will be given by the trainer for 10 weeks, 2 hours of presentation.<br>|
| Experimental: Diabetes Education supported by digital tools<br>The subjects included in the course content were given between 10:00-12:00 with the animation supported method, which lasted for 2 hours. The animations were created by the researchers to reflect all guidelines for diabetes. The scenario of the animation video was prepared in line with the training content. Storyboards in videos and animations were created with the collaboration of researchers and experts in their fields (software specialists, computer programmers). The animation video was voiced in Turkish by a professional actor. Animations are 2 minutes each and a total of 18 minutes long. The 'Kahoot' application, a Web 2.0 tool, was used to apply Diabetes Achievement Evaluation Test. At the end of the course, students' opinions were taken through the form developed by the researchers. Instructional Materials Motivation Survey (IMMS) was used to measure to student' motivation levels. | Device: Diabetes Education supported by digital tools<br>* Diabetes education will be given for 10 weeks with 2-minute animations. At the end of the course, learners' knowledge was measured with a knowledge test using the Kahoot app.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Diabetes Nursing Course Knowledge Test, 10. week (after the course finished) | This knowledge test, which is prepared by submitting to expert opinion, consists of 40 multiple-choice questions. Each question is worth 2,5 points. The higher the test score, the higher the level of knowledge. | Through study completion, an average of 3 mounth | 
| Instructional Materials Motivation Survey (IMMS), 10. week (after the course finished) | The scale was prepared in a 5-point Likert type, 36 items. The highest score that can be obtained from the entire scale is 165, and the lowest score is 33. The increase in the score obtained from the scale is interpreted as an increase in the motivation towards the teaching material. | Through study completion, an average of 3 mounth | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Opinion Form on Diabetes Education Program supported by digital tools, for only experimental group, 10. week (at the end of the course) | The form was prepared for the students in the experimental group to determine their views on education supported by animation and gamification. IThe form consisted of 4 open-ended questions containing opinions and suggestions about teaching method and digital education materials. | Through study completion, an average of 3 mounth | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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diabetes, distance learning, digital tools, gamification, animation