Development and Usability Testing of a 3D Virtual Simulation Game in Teaching Intravenous Fluid Therapy in Nursing Education

Objective: To describe the gamification process of peripheral intravenous catheterization (PIVC) and intravenous fluid therapy (IFT) in nursing education and conduct usability testing of the 3D virtual simulation game. Materials and Methods: A 3D virtual simulation game was developed to teach PIVC and IFT based on the current literature, Kolb’s Experiential Learning Theory, and Schell’s Elemental Tetrad. The game, IntraveNurseGame, had 11 stages, and it rewarded the players with score-based titles based on Benner’s clinical competence stages. Usability testing was conducted with 17 participants, including 5 nursing experts and 12 senior nursing students. Heuristic evaluation with experts, think-aloud method, and user tests were performed using the Game Evaluation Questionnaire and GUESS-20-TR-Scale. Qualitative and quantitative data analysis were used. Results: Experts were satisfied with the game experience and had fun. The game met their expectations and could help the nursing students learn the subject. Experts provided suggestions, including visual similarity of some animations, instructions regarding how to use the mouse cursor, and encouragement for students to remember the steps of the actual procedure by removing the instructions from some stages. Users scored the GUESS-20-TR mean score above the moderate level (5.71 ± 0.90), showing they were satisfied with the gaming experience. Conclusion: The 3D virtual simulation game had good usability features with some areas of improvement. The theories and elements used in this study can help nurse educators and researchers develop effective games and engaging game-rewarding systems. The usability testing provided valuable information for the games to be developed in the future.