Design and evaluation of a gamified mobile application for teaching cardiac rhythm interpretation to nursing students: a quasi-experimental pre–post study

Abstract

Background: Gamification has emerged as an innovative educational approach to enhance learner engagement and motivation in health professions education. In nursing education, accurate interpretation of cardiac rhythms is a critical competency that requires repeated practice and timely feedback. This study aimed to design, develop, and evaluate a gamified mobile application (RhythmPath) to support nursing students’ learning of cardiac rhythm interpretation. Methods: A quasi-experimental pretest–posttest study without a control group was conducted during the fall semester of 2024 among 13 seventh-semester nursing students at Kerman University of Medical Sciences, Iran. The RhythmPath application was developed using Unity 2021 and incorporated gamification elements such as points, badges, leaderboards, and timed assessments. Students used the application for two weeks. Knowledge of cardiac rhythm interpretation was assessed before and after the intervention using equivalent validated multiple-choice tests. Software quality and usability were evaluated using a validated questionnaire. Paired t-tests were used to compare pretest and posttest scores. Results: Mean knowledge scores increased significantly from 39.48 ± 19.52 at pretest to 51.79 ± 25.98 at posttest (t (12) = 2.45, p = 0.03). Participants spent an average of 7.2 ± 1.8 h using the application during the intervention period. Overall user satisfaction with the application was high (mean score = 4.45 ± 0.67 on a 5-point Likert scale), with ease of use and information quality receiving the highest ratings. Conclusions: The RhythmPath gamified mobile application demonstrated potential for improving nursing students’ knowledge of cardiac rhythm interpretation and achieving high user satisfaction. As a small-sample pilot study, these findings provide preliminary evidence supporting the use of gamified mobile learning tools in nursing education. Further studies with larger samples, control groups, and longer follow-up periods are recommended to confirm effectiveness and assess long-term learning outcomes.