Content area
Aim
To conduct a bibliometric and content analysis of publications on educational games in the field of nursing education.
BackgroundEducational games are an innovative active teaching method. Its use in nursing education has advantages; it has the potential to support students' active participation in the educational process.
DesignBibliometric and content analysis.
MethodsThe data for this study were screened from the Web of Science database. Bibliometric analysis and data visualization were performed using VOSviewer and Bibliometrix software, employing techniques such as scientific mapping and performance analysis. For content analysis, a synthetic knowledge synthesis approach based on bibliometric mapping was adopted.
ResultsA total of 223 publications involving 819 authors were analyzed. These publications appeared in 87 different journals, with an average of 1.67 citations per publication. The journals “Nurse Education Today” and “Clinical Simulation in Nursing” featured the highest number of articles. The USA and Spain were leading countries in terms of total link strength, connections and the number of articles and citations. The most frequently cited author was Gómez-Urquiza (n = 308). Commonly used keywords included “nursing education,” “gamification,” “serious games,” and “nursing students.” The content analysis revealed five primary themes: 1) technology in nursing education, 2) effects of educational games, 3) applications of educational games in nursing education, 4) types of educational games used in nursing education and 5) gamification in the learning-teaching process.
ConclusionsResearch on educational games in nursing education is on the rise. The findings of this study provide new insights for researchers interested in the application of educational games in nursing education.
Educational games are designed to contribute to the learning process by integrating game elements such as points, badges and leaderboards into educational activities, thereby making learning more engaging and competitive ( Demirtaş et al., 2021). The learners of today, known as Generation Z, are characterized by their competitive nature, immersion in technology and inclination toward active teaching methods, making the implementation of innovative instructional strategies inevitable ( Bakır et al., 2023). Consequently, these learners should be supported through the integration of innovative active learning techniques that complement traditional educational methods. One of the active teaching methods increasingly used by educators is gamification ( Sarker et al., 2023). Educational games are particularly well-suited to meet the needs of this generation due to their significant roles in providing motivation, making learning enjoyable and accommodating diverse learning styles ( Şahin and Başak, 2019).
Although the concept of games is relatively new in nursing, it is being incorporated into educational curricula as an innovative teaching technique. Game-based learning is increasingly used in nursing education to meet the demands of 21st-century healthcare and complex clinical practice environments ( Gimenes and Faleiros, 2014; Mannino and Cotter, 2016). Educational games support nursing education by concretizing learning materials, making learning meaningful and lasting and developing skills such as problem-solving, creativity and teamwork. The literature emphasizes that games enhance students’ socialization, encourage them to learn from their mistakes, provide immediate feedback and foster creativity ( Moreno and Pineda, 2018). Moreover, educational games are recognized as valuable learning tools for modern learners ( Gómez-Urquiza et al., 2019; Brown, 2018). Examples of these games include escape rooms, serious games, simulation games and card games.
With the changing needs of generations, nursing educators are increasingly turning to educational games. A systematic review involving 53 studies and 4612 nursing students from 16 countries demonstrated that game-based educational interventions could enhance the learning experiences of nursing students ( Xu et al., 2021). A literature review covering the period between 2009 and 2019, focusing on nursing and games, revealed that educational games positively impacted increased knowledge, higher test scores and favorable learner feedback, establishing their utility as a valuable assessment tool ( Reed, 2020; Ozdemir and Dinç, 2022). Furthermore, literature reviews indicate that game-based learning facilitates cognitive learning outcomes, enhances competitiveness, motivates students to actively participate in learning processes and has numerous positive effects, such as improving critical thinking, problem-solving, collaboration, clinical reasoning and the knowledge and performance of nursing students ( Pront, 2018; Min, 2022; Ozdemir and Dinç, 2022).
Bibliometrics is an analytical tool used in various contexts ( Kaur, 2013). In recent years, bibliometric analysis has gained increasing popularity in scientific research in nursing ( Donthu et al., 2020, Khan et al., 2021). This can be attributed to the accessibility of software such as VOSviewer and Bibliometrix, as well as international scientific databases, e.g., Web of Science, along with the benefits bibliometric analysis offers in processing large volumes of data and generating significant impact ( Donthu et al., 2021). Furthermore, bibliometric analysis provides a reliable means of mapping the scientific development of data, collaboration among authors and countries and ranking ( Bornmann et al., 2014). In this study, bibliometric analysis was chosen as a crucial tool for identifying current trends in the literature, highlighting trend studies and authors and guiding future research by uncovering emerging topics and trends.
Current studies provide bibliometric analyses on the use of educational games in education ( Rojas-Sanchez et al., 2023; Harnal et al., 2024) and medicine ( Zohari et al., 2023). However, to the best of our knowledge, there is no bibliometric analysis focused on educational games in nursing. The increasing number of studies investigating the effects of educational games on student achievement and motivation shows the potential of this method in education ( Yu et al., 2021). This study provides guidance for researchers and educators to better understand the existing literature and provide a roadmap for future studies by identifying how and to what extent educational games are used in nursing education, the most productive countries, authors, scientific trends and relationships and trends for future research through bibliometric analysis. Educational games help nursing students to transform their theoretical knowledge into practical skills, while making the learning process more interactive and enjoyable ( Castro et al., 2019). In this context, the bibliometric analysis of studies on the use of educational games in nursing education is considered to fill an important gap in the literature and make a valuable contribution to the literature by providing a comprehensive resource that highlights the impact and importance of educational games in nursing education.
Aim: This study aimed to perform a bibliometric analysis of studies on educational games in the context of nursing education.
Research questions:
- What has been the distribution of publications on educational games in nursing education over the years?
- Which are the top ten most cited publications in the field of educational games?
- Who are the top ten most cited authors in the field of educational games?
- What are the journal and country dynamics of publications on educational games?
- What are the most frequently used keywords in publications on educational games?
- What themes emerge from the content analysis?
- What are the trending topics identified in the studies?
2.1 Search strategy
In research using bibliometric analysis, the Web of Science databases are commonly employed ( Donthu et al., 2021). There are several important reasons for choosing Web of Science as our database. First, it covers a wide range of disciplines, including the sciences, health sciences, social sciences and arts and humanities ( Birkle et al., 2020). This database includes articles published in high-impact journals and its selective nature increases the quality and reliability of our research. In addition, Web of Science provides detailed bibliographic data required for citation analyses and bibliometric studies. The reason for using a single database is to ensure consistency and comparability of data, while also making the analysis process more manageable and focused ( Visser et al., 2021). In this way, the validity and reliability of our research results are increased. There are some limitations to using a single database.
In the current study, the Web of Science database (Clarivate PLC; https://www.webofscience.com/wos) was used as the data source and a specific keyword set was employed for the search: “(TITLE-ABS-KEY (educational game OR gamification OR serious game OR game-based learning OR game based educational interventions) AND TITLE-ABS-KEY (nursing education))”. The search focused on “titles,” “abstracts,” and “keywords,” with the inclusion criterion being research on educational games in nursing education. No exclusion criteria were applied ( Fig. 1).
The search was conducted on February 20, 2024, yielding 231 publications. Of these publications, 223 met the inclusion criteria and were selected for bibliometric analysis. Two researchers independently reviewed the publications. To ensure reliability, a random sample of 10 % (23 publications) was evaluated by a third and fourth researcher, confirming 100 % agreement on inclusion criteria.
2.2 Bibliometric methodologyBibliometric analysis is a method used to reveal the performance of various components (such as articles, authors and keywords) related to a research topic or field and visualize intellectual relationships using mapping techniques ( Donthu et al., 2021). This study used performance analysis and scientific mapping techniques. Performance analysis aims to discover the contributions of research components to the field. In this study, performance analysis aimed to identify highly connected journals, authors and countries ( Donthu et al., 2021). For scientific mapping, co-occurrence analysis was employed to reveal relationships and potential connections among research components. Citations, keywords, co-authorship and trend topics were analyzed.
Prior to data analysis, the “data.svc” file obtained from Web of Science was pre-processed using Microsoft Excel (Microsoft Corporation, Redmond, Washington, USA). For data analysis, VOSviewer version 1.6.18 (Leiden University, Netherlands, https://www.vosviewer.com) and Bibliometrix version 4.1.3 (K-Synth Srl, University of Naples Federico II Academic Spin-Off) were used.
In our study, VOSviewer and Bibliometrix software were preferred for bibliometric analysis, they are widely preferred tools ( Aytaç et al., 2023). These tools can get the data required for bibliometric analysis from various sources (e.g. Web of Science, Scopus, PubMed). VOSviewer represents bibliometric data with visual network graphs. Bibliometrix offers statistical analysis and various visualization options. This helps users to better understand their datasets. In addition, as open-source software, they appeal to a wide range of users and provide an accessible option for researchers.
VOSviewer is a software tool for mapping and visualizing network data and relationships. Network data represent items such as publications and researchers, while relationships represent the connections between these items. In the visualization, data dimensions are represented by circles whose sizes are determined by weight. As the weight increases, so does the size of the circle. The strength of the connection increases with the total link strength (TLS) value. Data can be presented and clustered on the map. As the relationship between two data points increases, the thickness of the visualization line on the map also increases, making it easier to rank importance and relationships ( Eck and Waltma, 2018).
Bibliometrix is an open-source bibliometric analysis software written in the R programming language and operated on R Studio (The Comprehensive R Archive Network, https://cran.r-project.org) ( Aytaç et al., 2023; Aria and Cuccurullo, 2017). The Bibliometrix web interface can be accessed using the biblioshiny() command. In this study, the “webofscience.bip” file from the Web of Science database was imported into the Bibliometrix software to visualize data statistics and collaboration analysis.
They can get the data required for bibliometric analysis from various sources (e.g. Web of Science, Scopus, PubMed). VOSviewer represents bibliometric data with visual network graphs ( Kuzior and Sira, 2022). Bibliometrix offers statistical analysis and various visualization options ( Rodríguez-Soler et al., 2020). These tools are preferred by a wide range of users due to their open-source nature and help researchers obtain unbiased results in their studies. This helps users better understand data sets ( Aytaç et al., 2023). As open-source software, they can be accessed by a wide range of users. Instead of supporting a specific view, these tools have neutral functionality independent of users' personal interests in analyzing data. In this context, they support reaching unbiased and reliable results. On the other hand, although these tools, which are part of the research process, allow data analysis, the researcher's own decisions are effective in this process ( Aria and Cuccurullo, 2017). The data provided by these tools serve the research and do not create a conflict of interest. This situation does not create a conflict of interest and contributes to obtaining accurate, objective and effective study results. In addition, the impartial use of the tools supports the reliability of the results and minimizes the risk of conflict of interest.
2.3 Content analysisBibliometric analysis reveals various information clusters by identifying relationships between data points. Accordingly, in this study, content analysis was conducted using the synthetic knowledge synthesis method. This approach allows for the synthesis of both quantitative and qualitative information. The following steps, as outlined in the synthetic knowledge synthesis method developed by Kokol (2022), were followed:
- • Publications related to the use of educational games in nursing education were compiled. This dataset represents the content to be analyzed.
- • Text mining was used to categorize publications according to author keywords. Themes and codes were generated through bibliometric mapping. Findings from this step are presented in Section 3.5.
- • The relationships among codes within individual clusters were analyzed and categorized. Findings from this step are presented in Section 3.5.
- • Categories were internally analyzed, and each cluster was assigned a thematic name.
- • The emerging themes represent the output of qualitative analysis data ( Kokol, 2022) and are presented in Table 3.
3.1 Publication characteristics
A total of 223 publications authored by 819 researchers were identified, including articles (n = 180), reviews (n = 23), proceedings (n = 15), letters to the editor (n = 2) and book chapters (n = 3). Fig. 2 shows that the first study on educational games in nursing was published in 2006. There has been a significant increase in the volume of research since 2016, with the highest number of publications occurring in 2022 (n = 52) and 2021 (n = 36). Our findings indicate that publications on educational games in nursing have increased over time. Similarly, bibliometric analyses in the fields of medicine and education have found that most publication types are research articles ( Chen et al., 2021; Zohari et al., 2023). Furthermore, reviews of educational game publications in nursing education have reported that most such publications are research articles ( Ozdemir and Dinç, 2022; Xu et al., 2021). Consistent with our study, content analysis studies focusing on educational games in this field found that the number of publications on educational games has increased and is expected to continue to rise in the future ( Oliveira et al., 2023). Educational games are preferred in nursing education because they cater to the needs of the current generation ( Anguas-Gracia et al., 2021; Dacanay et al., 2021), suggesting that the number of such studies is likely to grow.
3.2 Top 10 most cited publications and authorsAll the most cited publications were research articles, with five of them published in the journal Nurse Education Today. The most frequently cited publication focused on the impact of the “Escape Room” educational game on nursing students’ opinions and motivation ( Gómez-Urquiza et al., 2022). The second most cited publication discussed how virtual reality combined with game-based learning principles could promote mastery learning and retention ( Butt et al., 2018). The third most cited publication evaluated the creation, implementation and use of an escape room-supported urosepsis simulation ( Brown, 2018). The seventh most cited publication examined the impact of a game-based virtual reality mobile application on tracheostomy care education ( Bayram et al., 2019). Overall, these publications support the use of educational games in nursing education, providing new perspectives and proposing a roadmap for further implementation ( Table 1).
3.3 Most productive journalsThe studies were published in 87 different sources. The most productive journals were Nurse Education Today (n = 38), Clinical Simulation in Nursing (n = 17), Nurse Education in Practice (n = 13) and CIN: Computers Informatics Nursing (n = 12). Journals with at least four publications are listed in Table 2. These productive journals can guide academics interested in educational games in selecting appropriate journals for their publications.
In terms of citation count, the most productive journals were Nurse Education Today (n = 846), Clinical Simulation in Nursing (n = 403), Nurse Education in Practice (n = 127) and Journal of Nursing Education (n = 120). These journals can offer suggestions for journal selection to researchers interested in the implementation of educational games in nursing.
The high citation count of Nurse Education Today suggests that studies on educational games in nursing published in this journal are well-received and influential. One notable study published in Nurse Education Today is “The impact on nursing students' opinions and motivation of using a ‘Nursing Escape Room’ as a teaching game: A descriptive study” (Gómez-Urquiza et al., 2019), which highlighted the use of escape room teaching games in nursing education. The popularity of this article can be attributed to the efficacy of the game in assessing both theoretical and practical knowledge ( Antón-Solanas et al., 2022), fostering teamwork ( Morrell and Ball, 2020), providing an enjoyable learning experience ( Dacanay et al., 2021) and enhancing the ability to perform under pressure ( Anguas-Gracia et al., 2021).
3.4 Keyword analysisA synthetic information synthesis methodology, text mining and bibliometric mapping were used for keyword analysis. Text mining yielded 767 keywords from 203 publications. Cluster analysis using VOSviewer software for bibliometric mapping revealed seven different clusters with at least two keywords co-occurring ( Fig. 3A and Table 3). The size of the nodes representing each author’s keywords indicates the frequency of occurrences. The most common keywords were nursing education (n = 105), gamification (n = 98), nursing students (n = 74), nursing (n = 67), serious games (n = 57) and education (n = 56).
Like the findings reported by Ekin and Gül (2022), “game-based learning,” “serious games,” “games,” “gamification,” and “educational games” were frequently used keywords in educational research ( Ekin and Gül, 2022). The frequent use of these keywords indicates the growing adoption of educational games in nursing education.
Visualization of the co-occurrence analysis via VOSviewer is presented in Fig. 3B and Table 3. In the blue cluster, “nursing education” (TLS = 105) and “basic life support” were prominent, focusing on the application of educational games in nursing education. The orange cluster highlighted “gamification” (TLS = 98), “digital badges” (TLS = 6) and “undergraduate nursing education” (TLS = 1), focusing on the use of gamification in nursing education and practice. The red cluster’s keywords included “nursing students” (TLS = 74), “nursing” (TLS = 67), “education” (TLS = 56), “virtual reality” (TLS = 34) and “educational technology” (TLS = 33), focusing on the impact of educational technologies on nursing students and nursing education. The keywords in the purple cluster were “serious games” (TLS = 57) and “educational games” (TLS = 11), focusing on the design of educational games in nursing education. The yellow cluster featured keywords such as “simulation” (TLS = 51), “game-based learning” (TLS = 47) and “escape room” (TLS = 40). Focusing on the types of educational games used in nursing education. The green cluster’s focus was on the effects of educational games, while the turquoise cluster concentrated on teaching and learning processes. The co-occurrence analysis visualizes how the interaction between nursing education and educational games intersects and positions these concepts in the literature.
3.5 Content analysisContent analysis was performed based on author keywords identified through cluster analysis (see data analysis steps 3 and 4 in Section 2.2). Five themes, along with sub-themes and categories, were derived from the content analysis ( Table 3). The two largest themes were: technology in nursing education and the effects of educational games.
3.5.1 Theme 1: Technology in nursing education (Cluster 1)This theme includes concepts related to educational technologies commonly used in nursing education and these technologies have been integrated with various gamification methods. Our findings support the increasing use of educational technologies, such as computer simulation, virtual reality and virtual simulation, in nursing education. Technology has become an integral component that complements the learning and teaching process in nursing education. Students’ learning needs are evolving under the influence of new technologies ( Fonseca et al., 2016). Simulations and serious games provide deep learning opportunities while engaging students’ attention. Cloud computing and digital assistants not only enhance nursing education technology but also improve clinical skills, competencies and satisfaction in nursing ( Gause et al., 2022). Repeated use opportunities support the understanding of clinical practices ( Adamu, 2022). Virtual Reality technology plays an important role by contributing to improving clinical practice standards for nurses and promoting teamwork ( Li et al., 2024). Smart glasses indicate good usability and availability in nursing education and potential for use in hospital nursing practice ( Calik et al., 2024).
3.5.2 Theme 2: Effects of educational games (Cluster 2)Nurse educators who incorporate games into classroom, laboratory, or clinical settings report positive impacts on the learning process ( Sharma, 2017; Xu, 2016). Educational games provide nursing students with an exciting learning environment, enhancing understanding, retention, problem-solving and critical thinking skills ( Verkuyl et al., 2016). Reflective practices supported by games help students comprehend complex concepts, make decisions and explore new thinking methods and role-play ( Koivisto et al, 2016). Undergraduate nursing students who participated in an Instagram-based educational game were found to have better learning outcomes than their peers who did not participate in the game ( Rosa-Castillo et al., 2023). It has been determined that an innovative teaching strategy that integrates theoretical knowledge into games can significantly improve undergraduate nursing students’ humanistic caring ability and creative thinking ( Zhou et al., 2024). Game-based learning increases nursing students’ engagement in the learning process ( Navarro-Martinez et al., 2023). However, the application of games in large classes can be difficult ( Brown, 2018; Strickland and Kaylor, 2016; Graham and Richardson, 2008), potentially increasing stress, embarrassment and reluctance among students ( Graham and Richardson, 2008). Challenges such as material procurement, time investment ( Kinder and Kurz, 2018) and finding assistance and equipment for designing and developing simulation games ( Koivisto et al., 2016) have been reported.
3.5.3 Theme 3: Applications of educational games in nursing education (Cluster 3)The evolution of learner characteristics has prompted the emergence of innovative instructional strategies aimed at bolstering learner motivation ( Ferrer-Sargues, 2021). Game-based learning has garnered significant interest in recent years due to its capacity to enhance student motivation and engagement in learning activities ( Reed, 2020). Virtual simulations, digital games and other game-based learning activities represent secure and effective means to integrate students into targeted learning processes ( Keys et al., 2020; Mini Simon et al., 2022). Games are extensively used across numerous domains of nursing education, including medication dose calculation ( Foss et al., 2013), assessment of childbirth processes, fundamental clinical skills, communication, collaboration, critical thinking, problem-solving and creative thinking ( Chang et al., 2024a,b; Hara et al., 2021). They have also been identified as beneficial in enhancing motivation ( Chang, 2020) for use in nursing practices during emergencies, teamwork and managing work under pressure ( Gómez-Urquiza et al., 2022).
3.5.4 Theme 4: Types of educational games used in nursing education (Clusters 4 and 5)This theme focuses on various types of educational games used in nursing education activities. Serious games have been developed, including CARION, aiming to provide care to patients in emergency departments and GridlockED, focusing on chronic patient care in community health ( Chan et al., 2024). Immersive virtual reality games are used for nursing care in hyperglycemia ( Calik et al., 2024) and intravenous injection training ( Chang et al., 2024c). Escape room games, increasingly popular in recent years, have been reported to be effective in ensuring medication safety for the elderly ( Chen et al., 2023), increasing maternal health knowledge ( Yang et al., 2023), promoting positive attitudes toward individuals with mental disorders ( Rodríguez-Ferrer et al., 2022) and teaching the fundamentals of nursing courses ( Antón-Solanas et al., 2022).
3.5.5 Theme 5: gamification in the learning-teaching process (Clusters 6 and 7)Nursing education involves numerous concepts and practices that learners may find challenging to comprehend, potentially leading to stress and a loss of interest ( Day-Black et al., 2015). Gamification in the learning-teaching process blends game elements with non-game environments to achieve realism, encourage learner engagement, foster meaningful connections with complex nursing concepts and facilitate effective learning outcomes ( Khaldi, 2023). Educational games helped students develop self-confidence, critical thinking and teamwork and students also appreciated the relevance of the activity to real life ( Morrell and Eukel, 2021).The integration of game-based learning into nursing education has shown positive results in enhancing student engagement and critical thinking skills ( Anwer, 2023). Teaching and assessing through educational games motivate students and improves their self-assessment and understanding of concepts and enhances their critical thinking and decision-making skills ( Min, 2022). Gamification, involving the application of game design and elements in educational settings, is recognized as an effective strategy to engage and motivate students, thereby improving the learning process ( Bigdeli, 2023).
3.6 Most productive countries and collaborationPublications originated in 13 different countries. The top five countries in terms of publications were the USA (n = 55), Spain (n = 32), Canada (n = 24), Brazil (n = 16) and Taiwan (n = 15). Similar to our study, other studies in the literature have identified the USA and Spain as prominent countries ( Xu et al., 2021; Ozdemir and Dinç, 2022; Zohari et al., 2023). Therefore, it can be inferred that the USA has published more studies on educational games in nursing education. Particularly, the UK had the highest citation per publication (32.79) and ranked second in TLS ( Table 4). In addition, all countries with at least five publications had collaborations with other countries.
The visualization of co-authorship and citation analysis illustrates the countries involved in collaborations. Accordingly, the top three countries were the USA (TLS = 16), the UK (TLS = 12) and Canada (TLS = 10). Based on these findings, it can be inferred that there is a gap in international collaboration in the field of educational games.
On examining international collaborations, the USA emerged as a prominent country, having collaborations with the UK (n = 4), Norway (n = 4), Canada (n = 2), China (n = 2), Taiwan (n = 1), Iran (n = 1) and Spain (n = 1). Other collaborations included those between Finland and South Korea (n = 1), Norway and Finland (n = 1), Iran and Brazil (n = 1), Australia and Spain (n = 1), China and Australia (n = 1), Spain and Australia (n = 1) and the UK and Singapore (n = 1). Increasing international collaborations in the use of educational games in nursing education in the future could facilitate the development of innovative educational approaches.
3.7 Trend topicsTo identify trend topics, layer visualization was employed using VOSviewer and trend topic analysis was undertaken using Bibliometrix ( Fig. 3B; Fig. 3C). The size of circles in the visualization indicates the frequency of keyword use, while the color signifies the years when they were used, transitioning from blue to yellow, with yellow representing the most recent studies ( Donthu, 2020). According to the analysis, “mobile learning,” “higher education,” “online learning,” and “digital technology” emerged as trending topics.
To strengthen our findings and understand the recent evolution of studies, trend topic analysis was conducted using Bibliometrix, which follows a logical bibliometric workflow for statistical calculations. Here, the size of circles and their position in the table represent the frequency and the most frequent time of usage for each keyword. Based on the trend topic analysis using Bibliometrix, trend topics included “gamification,” “education,” “strategies,” “simulation,” “serious games,” “impact,” “students,” “knowledge,” and “game.” The trend topic analysis revealed the focus of publications on the following topics:
- • Mobile learning in nursing education ( Chen et al., 2021; Ozkaranan et al., 2024; Kim et al., 2019),
- • Online learning in nursing education ( Kurt et al., 2023; Alasagheirin et al., 2023; Zeng and Luo, 2023),
- • The role of digital technologies in nursing education ( Meum et al., 2021; Loureiro et al., 2021; Şenyuva, 2019),
- • The use of gamification in teaching nursing skills ( Adams, 2023; Chang et al., 2024a; Seymour et al., 2023).
The literature shows an increasing trend in studies related to mobile learning ( Yalcinkaya and Yucel, 2023), online learning ( Hwang et al., 2021), the use of digital technologies and gamification ( Seymour, 2023) in nursing education in recent years. The use of educational games and gamification in education can contribute to the development of 21st-century skills among nursing students and make education more engaging and sustainable.
4 Conclusion and recommendationsTo the best of our knowledge, this study represents the first bibliometric analysis focusing on the depth of publications related to the use of educational games in nursing education, providing insights into key topics and significant countries and authors in the field. Five main themes emerged from the content analysis: 1) technology in nursing education, 2) effects of educational games, 3) applications of educational games in nursing education, 4) types of educational games used in nursing education and 5) gamification in the learning-teaching process. Our primary recommendations in the literature review conducted in line with these themes are as follows; more research is needed to investigate how educators can effectively integrate technology and educational games into nursing education. At the same time, educators should carefully evaluate the effects of educational games, organize the learning environment accordingly and conduct more research on how they can be used in the teaching-learning process.
Educational games in nursing education can be seen as a growing field. This study can contribute valuable insights into the integration of educational games into nursing education. The analysis of country distributions showed that the USA and Spain lead in terms of TLS, connections, articles and citation numbers. However, it is observed that Turkey and Italy have weaker collaborations. Therefore, it is recommended to promote international collaborations in this context.
Trend topics in the field of educational games include gamification, education, strategies, simulation, serious games, impact, students, knowledge and games. Future studies are expected to focus on the integration of methods such as simulation, serious games and gamification.
Although e-learning, simulations and virtual reality have revolutionized nursing education, their use presents challenges such as diminished personal interaction, a lack of peer support and increased familiarity with global cultures ( James, 2022). Given the needs of contemporary learners and the benefits these tools provide, there is a pressing necessity to integrate technology into the processes of learning and teaching.
5 LimitationsThis study has several limitations inherent to its bibliometric analysis methodology. First, although the Web of Science is a large database, it may not encompass all relevant publications. First, relying solely on the Web of Science database may result in studies being overlooked in other important databases (e.g. Scopus, PubMed). This may narrow the scope of our research and lead to missing important studies ( Zhu and Liu, 2020). Additionally, since different databases cover different journals and conferences, relying on a single database may prevent us from obtaining a complete picture of the literature ( Mongeon and Paul-Hus, 2016).
Future studies should use multiple databases, including Google Scholar, ScienceDirect and PubMed, for a more comprehensive analysis. Second, while VOSviewer and Bibliometrix were used for bibliometric analysis in this study, future research could benefit from using other bibliometric analysis software such as Gephi, R, CiteSpace and SciMAT. The widespread use of VOSviewer and Bibliometrix can lead to the prominence of these machines in a particular community or research area. In this case, it may be that people only cover the popular ones without reviewing alternative tools. The widespread use of the tools may lead some researchers to focus on these tools, while the observation of alternative methods for this situation may lead to a succession. This provides the distribution of rates.
Source of fundingThe authors received no financial support from any funding agency in the public, commercial, or not-for-profit sectors.
CRediT authorship contribution statementFatma ORGUN: Writing – review & editing, Validation, Supervision, Project administration, Investigation, Conceptualization. Münüre Soybaş: Writing – original draft, Validation, Software, Resources, Project administration, Methodology, Investigation, Formal analysis, Data curation, Conceptualization. Duygu Ceren GÜNGÖR: Writing – review & editing, Writing – original draft, Validation, Software, Resources, Project administration, Methodology, Investigation, Formal analysis, Data curation, Conceptualization. Nilay ÖZKÜTÜK: Writing – review & editing, Validation, Supervision, Project administration, Investigation, Conceptualization.
Declaration of Competing InterestThe authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
| No | Title | Authors | Journal | Web of Science citation | Total citation | Publication Type |
| 1 | The impact on nursing students' opinions and motivation of using a "Nursing Escape Room" as a teaching game: A descriptive study | ( Gómez-Urquiza et al., 2019) | Nurse Education Today | 132 | 308 | Article |
| 2 | Using game-based virtual reality with haptics for skill acquisition | ( Butt et al., 2018) | Clinical Simulation in Nursing | 114 | 282 | Article |
| 3 | An escape room as a simulation teaching strategy | ( Brown, 2018) | Clinical Simulation in Nursing | 84 | 171 | Article |
| 4 | Designing and evaluating the effectiveness of a serious game for safe administration of blood transfusion: A randomized controlled trial | ( Tan et al., 2017) | Nurse Education Today | 71 | 132 | Article |
| 5 | Impact of a web based interactive simulation game (PULSE) on nursing students' experience and performance in life support training - A pilot study | ( Cook et al., 2012) | Nurse Education Today | 71 | 163 | Article |
| 6 | Teaching clinical reasoning and decision-making skills to nursing students: Design, development and usability evaluation of a serious game | ( Johnsen et al., 2016) | International Journal of Medical Informatics | 68 | 159 | Article |
| 7 | Effect of a game-based virtual reality phone application on tracheostomy care education for nursing students: A randomized controlled trial | ( Bayram et al., 2019) | Nurse Education Today | 58 | 132 | Article |
| 8 | The use of a game-based learning platform to engage nursing students: A descriptive, qualitative study | ( Gallegos et al., 2017) | Nurse Education in Practice | 55 | 147 | Article |
| 9 | Can a virtual patient trainer teach student nurses how to save lives-teaching nursing students about pediatric respiratory diseases | ( LeFlore et al., 2012) | Simulation in Healthcare-Journal of the Society for Simulation in Healthcare | 48 | 96 | Article |
| 10 | Developing the Serious Games potential in nursing education | ( Petit dit Dariel et al., 2013) | Nurse Education Today | 47 | 99 | Article |
| No | Source | Number
of articles* | Total
citation | Average
citation | Total link strengths | JCR
2022 (**) |
| 1 | Nurse Education Today | 38 | 846 | 22.26 | 89 | 3.9 |
| 2 | Clinical Simulation in Nursing | 17 | 403 | 23.71 | 41 | 2.6 |
| 3 | Nurse Education in Practice | 13 | 127 | 9.77 | 47 | 3.2 |
| 4 | CIN: Computers Informatics Nursing | 12 | 89 | 7.42 | 20 | 0.43 |
| 5 | Journal of Nursing Education | 7 | 120 | 17.14 | 35 | 2.0 |
| 6 | Teaching and Learning in Nursing | 7 | 40 | 5.71 | 17 | 1.0 |
| 7 | Nurse Education Perspectives | 6 | 83 | 13.83 | 19 | 0.48 |
| 8 | BMC Nursing | 6 | 12 | 2 | 2 | 1.60 |
| 9 | JMIR Serious Games | 6 | 26 | 4.33 | 6 | 0.92 |
| 10 | BMC Medical Education | 4 | 36 | 9 | 1 | 1.53 |
| 11 | Revista Brasileira de Enfermagem | 4 | 56 | 14 | 6 | 0.40 |
| 12 | Journal of Continuing Education in Nursing | 4 | 24 | 6 | 17 | 0.52 |
| Cluster color and no | Cluster theme | Number of elements | Codes (keywords) | Subcategories |
| 1
| Technology in nursing education | 13 | Nursing students (n = 34)Nursing (n = 30)Education (n = 27)Educational technology (n = 23)Computer simulation (14)Serious gaming (n = 12)Virtual reality (n = 11)Patient safety (n = 11)Nursing education research (n = 10)Problem-based learning (n = 8)Virtual simulation (n = 8) Evaluation (n = 7) | Nursing studentsEducationEducational technology |
| 2
| Effects of educational games | 12 | Motivation (n = 19)Games (n = 17)Validation (n = 13)E-learning (n = 11)Higher education (n = 11)Health care (n = 10) | MotivationGamesValidation |
| 3
| Applications of educational games in nursing education | 10 | Nursing education (n = 46)Cardiopulmonary resuscitation (n = 18)Online learning (n = 11)BLS (n = 9)Distance education (n = 6)Knowledge (n = 8)Mobile learning (n = 8)Public health (n = 9)Self-efficacy (n = 6) | Nursing educationOnline learningBLS |
| 4
| Types of educational games used in nursing education | 9 | Digital game-based learning (n = 6)Escape room (n = 22)Experimental learning (n = 8)Game-based learning (n = 22)Gaming (n = 9)Healthcare education (n = 7)Simulation (n = 24)Systematic review (n = 16)Undergraduate students (n = 5) | Simulation,Game-based learningEscape room |
| 5
| 9 | Clinical reasoning (n = 9)Educational game (n = 9)Game design (n = 6)Nurse education (n = 10)Nursing student (n = 13)Online education (n = 7)Serious game (n = 26)Serious games (n = 30)Video games (n = 7) | Serious gamesNursing studentNurse education | |
| 6
| Gamification in the learning-teaching process | 3 | Learning (n = 11)Students (n = 15)Teaching (n = 13) | StudentsTeachingNursing |
| 7
| 3 | Digital badges (n = 5)Gamification (n = 40)Undergraduate education (n = 1) | Gamification |
| | | | | |
| USA | 55 | 954 | 16 | 17.35 |
| UK | 14 | 459 | 12 | 32.79 |
| Canada | 24 | 394 | 10 | 16.42 |
| Norway | 8 | 165 | 9 | 20.63 |
| Australia | 9 | 158 | 6 | 17.56 |
| Singapore | 10 | 353 | 7 | 35.3 |
| People’s Republic of China | 8 | 32 | 5 | 4 |
| Spain | 32 | 377 | 4 | 11.78 |
| Iran | 5 | 26 | 4 | 5.2 |
| Brazil | 16 | 123 | 3 | 7.69 |
| Finland | 6 | 131 | 2 | 21.83 |
| South Korea | 7 | 69 | 1 | 9.86 |
| Taiwan | 15 | 145 | 1 | 9.67 |
| Turkey | 7 | 93 | 0 | 13.29 |
| Italy | 6 | 26 | 0 | 4.33 |
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