The Effect of Digital Games on Ethical Sensitivity and Decision Making in Nursing Students

NCT07235241 | Not Yet Recruiting

• 1 other identifier: IMU17
• Study Type: interventional
• Target: 60
• Locations: 0 countries
• Sites: N/A

Brief Summary

The study was planned using a randomised controlled experimental design to determine the effectiveness of digital game-based teaching in the development of ethical sensitivity and ethical decision-making processes among nursing students.

Conditions

Decision Making; Ethics

Keywords

Ethics; Decision Making; Digital Game; Nursing Students

Outcome Measures

Primary Outcomes (2)

• Adapted Ethical Sensitivity Scale for Nursing Students

  This scale determines the ethical sensitivity levels of nursing students. The 7-point Likert-type scale (1=Strongly disagree, 7=Strongly agree) consists of 30 items and six subscales. Items 8, 24, and 29 are reverse-scored. The total score ranges from 30 to 210; a high score indicates high ethical sensitivity. Item averages are evaluated as 7-5.9 (very important), 5.8-5 (important), 4.9-3.1 (neutral), and below 3.1 (unimportant).

  3 times; a week before implementation, a week after implementation, 2 months after implementation

• The Ethical Dilemma Test in Nursing

  The scale developed under the name 'Nursing Dilemma Test' aims to identify ethical issues in nursing and consists of six scenarios. Each scenario has three sections (A, B, C): Section A (Action): Measures the decision to be made in the face of an ethical dilemma (to act/not to act/to be undecided). Section B (Thinking Style): Determines the 'Principled Thinking' (NPT - importance given to ethical principles) and 'Practical Thinking' (PT - importance given to environmental factors) scores by ranking six statements based on Kohlberg's theory. Section C (Familiarity): Calculates the 'familiarity' score by questioning the case experience. Scoring: NPT Score: ranges from 18 to 66. PT Score: ranges from 6 to 36. Familiarity Score: 6-17 (familiar), 18-30 (unfamiliar). Reliability (Turkish Version): Cronbach's Alpha: NPT (0.59), PT (0.50). Test-Retest: NPT (0.77), PT (0.73).

  3 times; a week before implementation, a week after implementation, 2 months after implementation

Secondary Outcomes (1)

• Student Satisfaction and Self-Confidence in Learning Scale

  Once; a week after implementation

Study Arms (2)

Experimental group

EXPERIMENTAL

Both the experimental and comparison groups will receive a reminder lecture from the researcher on ethical principles and codes prior to the applications. Participants in the experimental group will simultaneously play digital games and participate in classroom group work after the reminder lesson.

Other: Digital game; Other: In-class group work

Comparison

OTHER

They will only participate in in-class group work.

Other: In-class group work

Interventions

Digital game OTHER

Digital Game: The developed digital game aims to enhance medical students' ethical awareness and decision-making skills. The digital game first provides students with reminders about ethical principles. The game covers a four-week process, focusing on a specific ethical principle each week. Each weekly module presents two cases supported by animated visuals written by the researcher, reviewed by experts, and created by the software company. After watching and reading the cases, students answer related questions. The modules and principles covered are as follows: Week 1 (Do No Harm/Beneficence): Cases related to treatment refusal and palliative care compliance. Week 2 (Autonomy/Respect): Cases related to organ donation decisions and chemotherapy refusal. Week 3 (Justice/Equity): Cases related to resource (air mattress) allocation and patient prioritisation. Week 4 (Confidentiality/Privacy): Cases related to HIV diagnosis confidentiality and psychiatric service confidentiality.

Experimental group

In-class group work OTHER

Face-to-face case analysis will be conducted over 4 weeks. These sessions are scheduled outside the course programme, once a week for 40 minutes. A total of 4 cases, each relating to an ethical principle, will be given to students in printed form at the beginning of each session, and they will be asked to analyse them simultaneously. Before the exercises, students will be explained how to analyse the cases.

Comparison; Experimental group

Eligibility Criteria

• Age: 18 Years - 40 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Students must:
• Have taken and successfully completed the Nursing Ethics course,
• Be a fourth-year nursing student who has successfully completed all professional courses and is undertaking the 'Professional Training in the Workplace' placement.

You may not qualify if:

• Students who have not taken the Nursing Ethics course or have failed the course before taking the Professional Training in the Workplace course.
• Having a conditional grade point average (CGPA \<2.00) up to the period when the data was collected.

Sponsors & Collaborators

• Istanbul Medeniyet University: lead

Study Officials

• Furkan Keles, PhD Student

  Istanbul University - Cerrahpasa

  PRINCIPAL INVESTIGATOR

• Funda Büyükyılmaz, Prof. Dr.

  Istanbul University - Cerrahpasa

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Furkan Keles, PhD Student

CONTACT

+90 507 491 77 96; FurkanS_1996@hotmail.com

Funda Büyükyılmaz, Prof. Dr.

CONTACT

+90 505 454 92 16; funda.buyukyilmaz@iuc.edu.tr

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: Participants do not know which group they will be in.
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: MSc

Model Details: A total of two groups, comprising one experimental group and one control group

Study Record Dates

• First Submitted: November 13, 2025
• First Posted: November 19, 2025
• Study Start: March 1, 2026
• Primary Completion: April 1, 2026
• Study Completion: June 1, 2026
• Last Updated: November 19, 2025

Record last verified: 2025-11

Data Sharing

• IPD Sharing: Will not share