Integration of Digital Modality in Virtual Classroom Enhancing Nursing Students’ Inclusivity in Learning: A Game-Based Approach

By Sanam Hanif¹, Rabab Vadivala²

Affiliations

1. School of Nursing and Midwifery, The Aga Khan University, Karachi, Pakistan
2. Department of Paediatrics, The Aga Khan University Hospital, Karachi, Pakistan

doi: 10.29271/jcpsp.2025.10.1353

ABSTRACT
COVID-19 and virtual learning were transformative changes for educators and students in nursing education. This rapid shift led educators to explore innovative methodologies to ensure effective learning experiences for students in virtual classrooms. Gamification in nursing education plays a pivotal role in enhancing ubiquitous learning within virtual classrooms. Digital pedagogies based on gamification facilitates students’ interest, active participation, and acquisition of theoretical knowledge through fun. The use of digital learning apps, the BOPPPS model, and quiz-based assessments are examples of student-centric digital modalities that engage students in virtual classrooms. This paper provides an overview of the effect of integrating digital pedagogies and game-based approaches in virtual nursing classrooms.

Key Words: Teaching pedagogies, Interactive tools, BOPPPS model.

Innovation in teaching pedagogy plays a pivotal role in enhancing ubiquitous learning in the medical education system. Technology in virtual classrooms has become an emerging trend in medical sciences to achieve Sustainable Development Goal (SDG) 4 — that is, to provide an equitable, technical, and vocational quality education by influencing learners’ behaviour so youth learners can have better lifelong opportunities to succeed.¹ Digital pedagogy based on gamification in virtual classrooms facilitates students’ interest, active participation, and acquisition of theoretical knowledge through fun. A study on Asian students found that 67.7% of students reported positive effects of gamification on online learning, citing increased engagement, motivation, and participation.² Another study highlighted that game-based pedagogical strategies in health education improved learning outcomes by 16% and boosted retention and classroom participation rates.³ Interactive virtual classroom strategies, such as Kahoot, Mentimetre, and Zoom breakout rooms, and the use of annotation tools improved expeditiously during and after the catastrophic effects of the pandemic. Despite extensive professional and vocational training, nursing educators are still struggling to acclimate to digital applications and their effective execution  in  virtual  classrooms.

Gamification in classroom learning refers to the integration of game-like elements, principles, interactive strategies, and mechanics into traditional educational settings to enhance students’ engagement, motivation, and overall learning outcomes. After COVID-19, innovations in virtual classrooms have improved and redefined the nursing education system. The entire education community, including educators, students, and university management strived to work smartly with technologies, so that effective learning could take place, and learning outcomes could be enhanced. Nowadays, teaching philosophy revolves around the innovative use of digital modalities for active participation and skill acquisition to enhance students’ learning outcomes in virtual classrooms.

To make a virtual classroom of 150 undergraduate nursing students more interactive, educators attended panel discussions and technology-integration workshops designed to address the primary barriers to online education and to train them in hands-on digital learning pedagogies. It was observed that the nature of a synchronous classroom was demanding in terms of content delivery and students’ participation and attention throughout the virtual session. Moreover, educators were in dire need of learning and implementing various e-learning modalities to create interactive web-based classrooms used worldwide, such as Boot Camp, Mentimetre, Google Drive, Chat box, Annotate, Kahoot, Breakout rooms, Microsoft Teams, Near Pod, and Padlet.

Taking these challenges into consideration, a series of virtual learning sessions was conducted for the first year undergraduate nursing students. It included the use of interactive PowerPoint presentations to visualise medical concepts through pictures, examples, points, and summaries. Annotation was used as a digital modality, where most of the students were enthusiastic about sharing their thoughts and experiences on a live, colourful dashboard. The pre- and post-class assessments were done through online quizzes.

Implementation of technology and innovative approaches, such as quiz-based assessments in virtual classrooms, brought opportunities as well as challenges for educators. The quiz game format served as a dynamic tool to assess students' comprehension while fostering a sense of constructive competition. The time-bound challenge added an element of urgency, encouraging swift thinking and quick recall of information. Furthermore, the introduction of a leaderboard created a sense of achievement and motivation among students. This not only contributed to a contribute to more interactive virtual environment but also effectively addressed the challenge of sustaining students’ attention during synchronous sessions. Visualisation technologies in virtual classrooms boosted students’ motivation, captured their attention to the specific context, and encouraged them to utilise immediately relevant information in real time.⁴ On the contrary, lack of competency, time constraints in designing digital lesson plans, fear of troubleshooting issues in digital classroom teaching, and the tendency to promote traditional teaching methods for convenience were the barriers to implementing technology  in  classrooms  for  some  educators.

The BOPPPS model (bridge-in, objectives, pre-test, participatory learning, post-test, and summary) is an acronym for student-centred approach that helps educators improve classroom effectiveness.⁵ According to this model, teaching objectives should be attained by implementing active learning, which includes participatory teaching pedagogies and meaningful student engagement in the classroom. Moreover, this model enhances the effectiveness of virtual classrooms by providing a structural framework for active learning. First, it promotes student-teacher interaction through activities such as collaborative brainstorming, live polls, and scenario-based tasks. Moreover, it firmly emphasises the importance of pre-assessment to assess the prior conceptual understanding of the students. This also helps an educator to tailor teaching pedagogies and creates a student-centred classroom environment. Lastly, the BOPPPS model enables learners to take an active role in their learning journey. This is exemplified by voluntary participation of students in summarising content, which encourages reflection and reinforces learning. The integration of this model facilitates a structured and comprehensive approach to cater to the diverse needs of learners and achieve learning outcomes, thereby creating a meaningful learning  experience.

By being an educator and interacting with students using smartphones, tablets, laptops, and wireless connections, daily lesson content can be made engaging and enjoyable through the use of online platforms such as Kahoot, Socrative, Quiz, Acadly or Poll Everywhere, which are easy and convenient due to advances in information and communication technology (ICT).⁶

It was observed that the use of interactive tools and technology, such as instructional videos, checklists, Mentimetre, and annotations, created an immersive and dynamic virtual learning experience for both students and educators. Scenario-based learning helped students engage in real-world scenarios and apply their acquired knowledge practically. Furthermore, students were more responsive towards digital apps as compared to sharing their thoughts verbally. Some of them shared their ideas through a chat box, which was commendable in the virtual classroom. Thus, frequent utilisation of web-based classrooms will develop competency in both educators and students to conduct or attend virtual courses with ease. It will increase satisfaction level and promote the efficient use of technology over time. The certification of basic systematic computer competencies could be proposed to higher authorities to revise the job description of newly hired faculty. Moreover, besides MOODLE, the development of policies, protocols, safety, and security of all digital data in virtual classrooms should be considered a key area of concern.

In conclusion, digital modalities and game-based approaches in the online classroom actively promote SDG 4. Digital literacy among educators empowers learners with the skills necessary to thrive in this digital age. Moreover, applying the BOPPPS model in lesson planning and execution can lead to improved learning outcomes. The integration of digital learning apps, quizzes, and technology in virtual classrooms opens up new possibilities for education while ensuring a more comprehensive and engaging learning experience for all involved.

COMPETING  INTEREST:
The  authors  declared  no  conflict  of  interest.

AUTHORS’  CONTRIBUTION:
SH: Conception of the study, drafting, editing, and critical revision  of  the  manuscript.
RV: Editing and critical revision of the manuscript critically for important  intellectual  content.
Both authors approved the final version of the manuscript to be published.
 

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