Educational outcomes of CDIO-guided progressive case-based learning and gamification in undergraduate critical care nursing: an exploratory two-class quasi-experimental study

BackgroundThis study compared educational outcomes between nursing students receiving a CDIO-guided case-based and gamified teaching program and those receiving conventional teaching.Materials and methodsThis two-class quasi-experimental study included 140 nursing students from two classes between March and June 2025. Classes were assigned by lottery to the intervention (n = 65) or control (n = 75) group. The intervention integrated progressive cases, microlectures, teamwork, board games, and escape-room simulation, whereas the control received traditional lectures and Small Private Online Course self-study. Self-directed learning, critical thinking, and learning engagement were assessed before and after the course. Post-course outcomes included theoretical performance, cardiopulmonary resuscitation performance, course performance, and teaching evaluation. Analysis of covariance, Welch’s t tests, and Holm correction were applied.ResultsThe intervention class had higher adjusted post-course scores for self-directed learning (mean difference, 7.68; 95% CI, 3.29–12.07), critical thinking (15.27; 95% CI, 11.53–19.00), and learning engagement (7.06; 95% CI, 1.82–12.30). It also achieved higher theoretical, cardiopulmonary resuscitation, course, and teaching-evaluation scores. Students generally found the activities engaging, although some reported nervousness.ConclusionThe program was associated with improved educational outcomes, but intervention and class effects could not be separated. Multicenter studies with multiple classes per arm are required.