From experiencing to critical thinking: a contextual game-based learning approach to improving nursing students’ performance in Electrocardiogram training

  • Ching-Yi Chang
  • Chien-Huei Kao
  • Gwo-Jen HwangEmail author
  • Fu-Huang Lin
Development Article


The Electrocardiogram (ECG) is one of the important tools for diagnosing myocardial infarction. The ECG training course aims to help nurses establish basic competence in interpreting ECG readings. However, in traditional instruction, learners usually have difficulty memorizing the meanings of different ECG wave forms, which could represent clinical symptoms, or even life-threatening conditions/arrhythmia. Some serious problems could cause death if the nursing staff do not make correct judgments in time. This paper reports an explorative study which investigated a novel pedagogy for nursing school students’ ECG learning performance using a contextual game. A 2 week experiment was conducted to compare the learning performances of the nursing students who played the ECG contextual game and those who learned with traditional instruction. The experimental results show that the students learning with the contextual game showed better learning performance, attitude, motivation, and critical thinking tendency than those who received the traditional instruction.


Digital game-based learning Contextual learning Critical thinking Nursing education 



This study is supported in part by the Ministry of Science and Technology of the Republic of China under contract number MOST-108-2511-H-011-005-MY3.

Compliance with ethical standards

Conflict of interest

The authors would like to declare that there is no conflict of interest in this study.


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© Association for Educational Communications and Technology 2019

Authors and Affiliations

  1. 1.Department of Midwifery and Women Health CareNational Taipei University of Nursing and Health SciencesTaipeiTaiwan
  2. 2.Graduate Institute of Digital Learning and Education, National Taiwan University of Science and TechnologyTaipeiTaiwan
  3. 3.School of Public HealthNational Defense Medical CenterTaipeiTaiwan

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