Teaching the Invisible: A Game-Based Simulation for Learning Health Care Economics in Clinical Nurse Leader Education

BACKGROUND: Health care economics and financing increasingly influence clinical practice, yet many nursing students struggle to understand how reimbursement structures and payment incentives shape care delivery. These concepts are often perceived as abstract and difficult to connect to bedside practice. METHOD: A kinesthetic, role-based board simulation-the Health Systems Strategy Game-was implemented in a baccalaureate-to-Master of Science in Nursing Clinical Nurse Leader course. Over a 5-week period, students participated in brief lectures, structured gameplay, and facilitated debriefing designed to make health care system dynamics tangible. RESULTS: Forty-seven students completed course evaluations assessing perceived understanding of health care economics, confidence discussing financial influences on care delivery, and systems-level learning. Students reported increased knowledge of health care financing concepts, improved confidence, and stronger understanding of interdependencies among stakeholders. CONCLUSION: Game-based experiential learning may enhance systems literacy and support nursing students' understanding of health care economics.