The effectiveness of the Public Health Nursing gamulation co-developed by St. David’s School of Nursing and Redmer Productions has been validated through trials and testing. Results are now available in a number of nursing related publications. Click on any of the four images below to access that publication’s article.
Background: Community and public health nursing (C/PHN) needs to expand to meet evolving population health needs, yet
baccalaureate nursing graduates often lack the competencies required for these roles.
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Purpose: The aim of this study was to enhance nursing student self-efficacy in C/PHN competencies through virtual simulation games (gamulations).
PHN Trial
Methods: Researchers developed 6 public health scenarios in collaboration with a software company and piloted gamulations with 90 senior nursing students, 3 faculty, and 1 practicing PHN. Pre- and post-assessments measured self-efficacy in C/PHN competencies.

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Results: Two-Two-tailed t-testing showed significant improvement in overall self-efficacy scores from pre-assessment (M = 44.76) to post-assessment (M = 54.93) (t(47) = −7.78, P < .001). Paired competency self-efficacy scores across all 19 individual competencies showed significance (P < .001) in self-efficacy improvement. Cohen’s d ranged from 0.44 to 0.72.
Conclusions: Implementation of game-based educational approaches has the potential to improve new nurse graduates’ self-efficacy in C/PHN competencies, thereby improving entry to practice in community and public health roles.


