Effects of a serious game on undergraduate nursing students’ learning motivation, engagement and outcomes in community nursing home visit education: A cluster quasi-experimental study

AIM: To evaluate the impact of the serious game 'Home Visit Navigator' on undergraduate nursing students' motivation, engagement and learning outcomes during home-visit training. BACKGROUND: Some challenges of traditional community-nursing home-visit education include uneven practical resources, lack of spatial context in textual case studies and a disjunction between theory and practice, affecting student engagement and learning effectiveness. Although serious games enhance engagement, reduce cognitive load and improve learning outcomes, their application in community nursing home-visit teaching remains unexplored. DESIGN: Cluster quasi-experimental study. METHODS: Totally, 134 undergraduate nursing students were divided into experimental (Home Visit Navigator gamified learning) and control (text-based case study learning) groups. Learning outcomes were assessed via post-class tests and end-of-term examination scores on home visitation-related questions; engagement was evaluated by knowledge-point access frequency; and motivation was measured using the Situational Motivation Scale. RESULTS: The experimental group demonstrated significantly higher scores in post-class knowledge tests (P < 0.001), end-of-term examinations (P = 0.021) and knowledge-point access frequency (P < 0.001) than the control group. Among the four dimensions of the Situational Motivation Scale, scores for intrinsic motivation (P = 0.032) and identified regulation (P = 0.036) were higher in the experimental than in the control group, whereas scores for amotivation (P < 0.001) and external regulation (P = 0.516) were lower. CONCLUSIONS: The serious game 'Home Visit Navigator' effectively enhances nursing students' intrinsic motivation, engagement and learning outcomes through contextual immersion and non-linear decision-making mechanisms. The study findings provide empirical support for digital transformation of community-nursing education.