Digital Serious Games for Undergraduate Nursing Education: A Review of Serious Games Key Design Characteristics and Gamification Elements

Serious games in nursing education provide students with unique opportunities to increase knowledge and enhance decision-making and problem-solving skills. Hence, serious games from simple quizzes that test students’ knowledge to Virtual Reality simulations that gauge students’ ability skills have been developed. This evidence-based review examines the latest initiatives in serious games for nursing curriculum focusing on the design and their technological features to highlight the need of pre-selecting the appropriate elements when conceptualizing a nursing serious game. Using search algorithms in Scopus and PubMed, 1969 articles published between 2019 and 2023 were screened, resulting in 81 studies and 69 unique nursing serious games involving over 7000 nursing students. Geographical distribution of serious games, the games’ type, teaching subject, nursing courses incorporating the games, technologies embarked, and different gaming platforms/engines utilized for their development are reported. Furthermore, common gamification elements (e.g., score, avatars, and quests) and key-design features (e.g., player mode, player–game interaction, feedback provision, and failure option) are described. By reporting on the latest technological advancements, a useful guide is formed, enabling both programmers and educators to easily grasp the newest trends on serious game design and use the produced knowledge to further enhance the nursing curriculum.