Comparing retrieval-based and collaborative gamification strategies for knowledge acquisition and retention in nursing education: A randomized controlled trial

Abstract

Aim

This study compared the effects of retrieval-based digital gamification (Gimkit) and collaborative educational escape room learning on nursing students’ knowledge acquisition and retention.

Background

Gamification is increasingly used in nursing education to enhance student engagement and learning outcomes. However, limited evidence exists regarding the comparative effectiveness of different gamification modalities. Understanding how retrieval-based and collaborative gamification approaches influence learning may help educators select strategies that align with specific educational objectives.

Design

A three-arm, pretest–posttest–follow-up randomized controlled trial.

Methods

The study was conducted with 82 third-year nursing students between April and June 2026. Following standardized theoretical instruction, students participated in a Gimkit activity, an educational escape room activity, or a control condition. Data were collected using the Human Papillomavirus (HPV) Knowledge Scale and the Gameful Experience Scale (GAMEX).

Results

HPV knowledge scores changed significantly over time, with a significant group × time interaction effect. Students in the Gimkit group achieved significantly higher post-intervention knowledge scores than those in the escape room and control groups, with large effect sizes. No statistically significant between-group differences were observed at the short-term follow-up. Both intervention groups reported positive and comparable gameful learning experiences.

Conclusions

Retrieval-based digital gamification produced greater immediate knowledge gains than collaborative escape room learning. Although follow-up knowledge scores did not differ significantly between groups, both gamification approaches were associated with positive learning experiences. The findings suggest that different gamification modalities may support different learning processes depending on the educational objective.