From course-based initiatives to institutional adoption: levels of integration of gamification in undergraduate nursing education – a scoping review

Gamification has increasingly been adopted in health professions education as a strategy to enhance student engagement, motivation, and learning outcomes. In undergraduate nursing education, gamification has been implemented at varying levels, ranging from isolated, course-based initiatives to broader institutional strategies embedded across curricula. However, the extent to which gamification is integrated, the forms it takes, and the contexts in which it is applied remain heterogeneous and insufficiently mapped. The purpose of this scoping review is to systematically explore and map the existing literature on the integration of gamification in undergraduate nursing education. Specifically, the review aims to identify and categorize the different levels of gamification integration, from individual teaching activities to program- or institution-wide implementations. It will also examine the educational contexts, types of gamification strategies used, targeted learning outcomes, and reported benefits or challenges associated with these approaches. This scoping review will follow established methodological guidance for scoping reviews and will be reported in accordance with the PRISMA-ScR framework. By synthesizing and organizing the available evidence, this review is expected to provide a comprehensive overview of how gamification is currently integrated into undergraduate nursing education. The findings will help identify research gaps, inform educators and institutions about current practices, and support the development of more coherent and sustainable gamification strategies in nursing education.