Effectiveness of a Gamified Educational Intervention on Palliative Care Knowledge Among Nursing Students: A...

Traditional palliative care education may limit the development of clinical competencies and attitudes required to alleviate suffering and improve quality of life. Gamification has been proposed as an alternative educational strategy in this field. Background/Objectives: This study aimed to assess the association between gamification-based intervention and palliative care knowledge among nursing students at a public university. Methods: This single-group, pre-post-intervention study was conducted in the Nursing Program of the Universidad Técnica del Norte, Ecuador, including 136 students from the accessible population. Palliative care knowledge was assessed before and after the intervention using the validated Palliative Care Quiz for Nursing (PCQN-SV). Student satisfaction and Moodle usability were assessed using a 10-item Likert-type questionnaire. The gamified educational intervention was delivered online over 60 h. Data were analyzed using descriptive statistics and Wilcoxon signed-rank tests for paired comparisons, and exploratory logistic regression analyses were conducted to evaluate contextual differences across hospitals. Statistical significance was set at α = 0.05. Results: The mean age was 22.9 years (SD = 1.89), and 73.5% were female. Knowledge scores increased significantly after the intervention (Wilcoxon signed-rank test, p < 0.001; r = 0.35). The proportion of students achieving sufficient knowledge (≥13 correct responses) increased from 27.2% (37/136) at baseline to 49.3% (67/136) post-intervention. Contextual analysis indicated variability across clinical training sites, with Lago Agrio showing higher odds of sufficient knowledge (aOR = 3.25; 95% CI [1.26-8.41]; p = 0.015). Conclusions: The gamified intervention was associated with increased palliative care knowledge among nursing students. Heterogeneity across hospitals suggests that contextual factors may influence the magnitude of change.