Educational games developed for students in perioperative nursing: A systematic review and appraisal of the evidence

A systematic review was conducted on electronic databases of MEDLINE/PubMed, Scopus, ISI Web of Science, CINAHL, and Embase until December 2017, using relevant keywords for educational games developed for nursing students in perioperative field. To evaluate the level of strength and quality of the evidence, the Association of periOperative Registered Nurses (AORN) revised model for evidence appraisal was used. Of the 852 evidence, only 10 met the criteria and were reviewed and appraised. Educational games had focused on different learning domains, including skills, feelings, emotion, knowledge, performance, attitude, motivation, and interest. With respect to the evidence level, most evidence was categorized as V (expert opinion = 2, case report = 2, literature review = 1, and organizational experiences = 1), and only one was in level I (randomized controlled trial). The quality level of most evidence was high (n = 4) and low (n = 4), and the rating of most of them was moderate (n = 4) and limited (n = 4). Based on the findings, most evidence had inappropriate quality and was found to be weak. It seems that the investigated games are insufficient to promote the nursing students' learning outcomes in different domains. Accordingly, more high-quality studies are required to design and develop innovative and practical games for students in perioperative nursing by considering validity and reliability process.