case study research and application design and methods

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Case Study Research and Applications Design and Methods

• Robert K. Yin - COSMOS Corporation
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Password-protected Instructor Resources include the following:

• An expanded glossary provided by the author in the form of downloadable Briefs.
• Additional tutorials written by the author which correspond to Chapters 1, 2, 3, 5, and 6.
• A selection of author Robert Yin's SAGE journal articles.
• Tables and figures from the book available for download.

“The book is filled with tips to the researcher on how to master the craft of doing research overall and specifically how to account for multi-layered cases.”

“Yin covers all of the basic and advanced knowledge for conducting case study and why they are useful for specific research studies without getting lost in the weeds.”

“The applications enhance the original material because it gives the reader concrete examples.”

“Yin is much more in-depth on case study methods both within a general qualitative text and any other case study text I have seen.”

On demand used as recommendation for basic literature for case study research

An essential reading for people doing case studies.

very thoruogh introduction

Very good introduction to Case Study design. I have used case study approach for my PhD study. I would recommend this book for an indepth understanding of case study design for research projects.

Dr Siew Lee School of Nursing, Midwifery and Paramedic Practice Robert Gordon University, Aberdeen.

The book is a really good introduction to case study research and is full of useful examples. I will recommend as the definitive source for students interested in pursuing this further in their projects.

In our Doctor of Ministerial Leadership (DML), Case Study is the Methodology that is required in this program. Robert Yin's book provides the foundational knowledge needed to conduct research using his Case Study design.

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Preface: Spotlighting "Case Study Research"

Chapter 1: Getting Started

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Case Study Research and Applications: Design and Methods, Edition 6

About this ebook.

Recognized as one of the most cited methodology books in the social sciences, the Sixth Edition of Robert K. Yin′s bestselling text provides a complete portal to the world of case study research. With the integration of 11 applications in this edition, the book gives readers access to exemplary case studies drawn from a wide variety of academic and applied fields. Ultimately, Case Study Research and Applications will guide students in the successful use and application of the case study research method.

About the author

Robert K. Yin is President of COSMOS Corporation, an applied research and social science firm. Over the years, COSMOS has successfully completed hundreds of projects for federal agencies, state and local agencies, and private foundations.Outside of COSMOS, Dr. Yin has assisted numerous other research groups, helping to train their field teams or to design research studies. The most recent such engagements have been with The World Bank, the Division of Special Education and disAbility Research at George Mason University, the Department of Nursing Research and Quality Outcomes at the Children’s National Health System (Washington, DC), and the School of Education, Southern New Hampshire University.Dr. Yin has authored over 100 publications, including authoring or editing 11 books (not counting the multiple editions of any given book). Earlier editions of the present book have been translated into eight languages (Chinese, Japanese, Korean, Swedish, Romanian, Italian, Polish, and Portuguese), and a second book on Qualitative Research from Start to Finish (2016) is in its 2nd edition and has been translated into four languages (Chinese, Korean, Swedish, and Portuguese). Dr. Yin received his B.A. in history from Harvard College (magna cum laude) and his Ph.D. in brain and cognitive sciences from MIT.

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Case study research and applications : design and methods

"[This book] provides a complete portal to the world of case study research. With the integration of 11 applications in this edition, the book gives readers access to ... case studies drawn from a ...

"[This book] provides a complete portal to the world of case study research. With the integration of 11 applications in this edition, the book gives readers access to ... case studies drawn from a wide variety of academic and applied fields. Ultimately, [this book] will guide students in the ... design and use of the case study research method. New to this edition: includes 11 in-depth applications that show how researchers have implemented case study methods successfully; increases reference to relativist and constructivist approaches to case study research, as well as how case studies can be part of mixed methods projects; places greater emphasis on using plausible rival explanations to bolster case study quality; discusses synthesizing findings across case studies in a multiple-case study in more detail; adds an expanded list of 15 fields that have text or texts devoted to case study research; and sharpens discussion of distinguishing research from non-research case studies. The author brings to light at least three remaining gaps to be filled in the future: how rival explanations can become more routinely integrated into all case study research; the difference between case-based and variable-based approaches to designing and analyzing case studies; and the relationship between case study research and qualitative research."--

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• Campbell, Donald T. (Donald Thomas), 1916-1996, writer of foreword
• Sixth edition
• Thousand Oaks, California : SAGE Publications, Inc., [2018]
• xxx, 319 pages : illustrations ; 24 cm
• Earlier editions called: Case study research : design and methods.
• Includes bibliographical references and indexes.
• Foreword / Donald T. Campbell -- Preface -- Getting started : how to know whether and when to use the case study as a research method -- Designing case studies : identifying your case(s) and establishing the logic of your case study -- Preparing to collect case study evidence : what you need to do before starting to collect case study data -- Collecting case study evidence : the principles you should follow in working with six sources of evidence -- Analyzing case study evidence : how to start your analysis, your analytic choices, and how they work -- Reporting case studies : how and what to compose
• Case method.
• Social sciences -- Research -- Methodology.
• Social Sciences -- methods. Medical Subject Heading
• Research Design. Medical Subject Heading

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• Foreword / Donald T. Campbell
• Getting started : how to know whether and when to use the case study as a research method
• Designing case studies : identifying your case(s) and establishing the logic of your case study
• Preparing to collect case study evidence : what you need to do before starting to collect case study data
• Collecting case study evidence : the principles you should follow in working with six sources of evidence
• Analyzing case study evidence : how to start your analysis, your analytic choices, and how they work
• Reporting case studies : how and what to compose.

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Case Study Research and Applications: Design and Methods

You are here, student resources, welcome to the companion site.

This site is intended to enhance your use of  Case Study Research and Applications, Sixth Edition,  by Robert K. Yin. Please note that all the resources on this site are especially geared toward maximizing your understanding of the material. 

Recognized as one of the most cited methodology books in the social sciences, the  Sixth Edition  of Robert K. Yin's bestselling text provides a complete portal to the world of case study research. With the integration of 11 applications in this edition, the book gives readers access to exemplary case studies drawn from a wide variety of academic and applied fields. Ultimately,  Case Study Research and Applications  will guide students in the successful use and application of the case study research method.

Acknowledgments

We gratefully acknowledge Robert K. Yin for writing an excellent text and creating the materials on this site.

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Case Study Research: Design and Methods (Applied Social Research Methods) Fifth Edition

There is a newer edition of this item:.

• ISBN-10 1452242569
• ISBN-13 978-1452242569
• Edition Fifth
• Publisher SAGE Publications, Inc
• Publication date May 10, 2013
• Language English
• Dimensions 7.25 x 0.5 x 9.25 inches
• Print length 312 pages
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Editorial Reviews

About the author.

Robert K. Yin is President of COSMOS Corporation, an applied research and social science firm.  Over the years, COSMOS has successfully completed hundreds of projects for federal agencies, state and local agencies, and private foundations.

Outside of COSMOS, Dr. Yin has assisted numerous other research groups, helping to train their field teams or to design research studies. The most recent such engagements have been with The World Bank, the Division of Special Education and disAbility Research at George Mason University, the Department of Nursing Research and Quality Outcomes at the Children’s National Health System (Washington, DC), and the School of Education, Southern New Hampshire University.

Dr. Yin has authored over 100 publications, including authoring or editing 11 books (not counting the multiple editions of any given book). Earlier editions of the present book have been translated into eight languages (Chinese, Japanese, Korean, Swedish, Romanian, Italian, Polish, and Portuguese), and a second book on Qualitative Research from Start to Finish (2016) is in its 2nd edition and has been translated into four languages (Chinese, Korean, Swedish, and Portuguese).  Dr. Yin received his B.A. in history from Harvard College (magna cum laude) and his Ph.D. in brain and cognitive sciences from MIT.

Product details

• Publisher ‏ : ‎ SAGE Publications, Inc; Fifth edition (May 10, 2013)
• Language ‏ : ‎ English
• Paperback ‏ : ‎ 312 pages
• ISBN-10 ‏ : ‎ 1452242569
• ISBN-13 ‏ : ‎ 978-1452242569
• Item Weight ‏ : ‎ 1.15 pounds
• Dimensions ‏ : ‎ 7.25 x 0.5 x 9.25 inches
• #218 in Social Sciences Methodology
• #415 in Social Sciences Research
• #1,987 in Medical General Psychology

About the author

Robert k. yin.

Robert K. Yin, Ph.D., serves as Chairman of the Board and CEO of COSMOS Corporation, an applied research and social science firm that has been in operation since 1980. Over the years, COSMOS has successfully completed hundreds of projects for government agencies, private foundations, and other entrepreneurial and non-profit organizations. At COSMOS, Dr. Yin actively leads various research projects, including those in which the case study method is used. He has authored numerous books and peer-reviewed articles, including Case Study Research and Applications of Case Study Research. In 1998 he founded the “Robert K. Yin Fund” at M.I.T., which supports seminars on brain sciences, as well as other activities related to the advancement of pre-doctoral students in the Department of Brain and Cognitive Sciences.

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ORIGINAL RESEARCH article

This article is part of the research topic.

Rewilding in Practice

Developing guidelines and a theory of change framework for rewilding application based on an empirical study of rewilding practice Provisionally Accepted

• 1 University of Cumbria, United Kingdom
• 2 University of Leeds, United Kingdom

The final, formatted version of the article will be published soon.

There remain a number of debates and conflicts about the concept of rewilding which can be barriers to its application. Some of these conflicts stem from the variety of contextual interpretations of rewilding, leading to conflict between rewilding theories and approaches.Conclusions have also been drawn about rewilding based on limited case studies, so that emergent rewilding theories aren't applicable to all rewilding projects, limiting their support in the field. Past theories have distinguished different types of rewilding, encouraging debate over the proposed methods, although in practice these approaches often share similar goals and use similar interventions. One barrier to achieving consensus in the practice of rewilding is that there are no clear guidelines for rewilding, and there are limited broad-scale studies focusing on how rewilding is practiced. This paper addresses this by offering the first broad study of rewilding guidelines and interventions, using data sourced from rewilding organisations, case studies, and research. Drawing from these data, the paper offers three tools to guide rewilding practitioners: (1) an overview of guidelines for rewilding practice, (2) a list of interventions used in rewilding, considering them against rewilding goals, (3) a theory of change framework to guide rewilding application. The tools presented here will inform work towards IUCN rewilding guidelines and suggests several areas that require further consideration. We hope that this initial study of application can improve agreement and collaboration among the rewilding community.

Keywords: rewilding, Adaptive co.management, Theory of change (ToC), Transformative conservation, Rewilding and Restoring

Received: 09 Feb 2024; Accepted: 23 Apr 2024.

Copyright: © 2024 Hawkins, Convery and Carver. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Sally Hawkins, University of Cumbria, City of Carlisle, United Kingdom

Training nurses in an international emergency medical team using a serious role-playing game: a retrospective comparative analysis

• Hai Hu 1 , 2 , 3   na1 ,
• Xiaoqin Lai 2 , 4 , 5   na1 &
• Longping Yan 6 , 7 , 8  

BMC Medical Education volume  24 , Article number:  432 ( 2024 ) Cite this article

64 Accesses

Metrics details

Although game-based applications have been used in disaster medicine education, no serious computer games have been designed specifically for training these nurses in an IEMT setting. To address this need, we developed a serious computer game called the IEMTtraining game. In this game, players assume the roles of IEMT nurses, assess patient injuries in a virtual environment, and provide suitable treatment options.

The design of this study is a retrospective comparative analysis. The research was conducted with 209 nurses in a hospital. The data collection process of this study was conducted at the 2019-2020 academic year. A retrospective comparative analysis was conducted on the pre-, post-, and final test scores of nurses in the IEMT. Additionally, a survey questionnaire was distributed to trainees to gather insights into teaching methods that were subsequently analyzed.

There was a significant difference in the overall test scores between the two groups, with the game group demonstrating superior performance compared to the control group (odds ratio = 1.363, p value = 0.010). The survey results indicated that the game group exhibited higher learning motivation scores and lower cognitive load compared with the lecture group.

Conclusions

The IEMT training game developed by the instructor team is a promising and effective method for training nurses in disaster rescue within IEMTs. The game equips the trainees with the necessary skills and knowledge to respond effectively to emergencies. It is easily comprehended, enhances knowledge retention and motivation to learn, and reduces cognitive load.

Peer Review reports

Since the beginning of the twenty-first century, the deployment of international emergency medical teams in disaster-stricken regions has increased world wide [ 1 ]. To enhance the efficiency of these teams, the World Health Organization (WHO) has introduced the International Emergency Medical Team (IEMT) initiative to guarantee their competence. Adequate education and training play a vital role in achieving this objective [ 2 ].

Nurses play a vital role as IEMTs by providing essential medical care and support to populations affected by disasters and emergencies. Training newly joined nurses is an integral part of IEMT training.

Typical training methods include lectures, field-simulation exercises, and tabletop exercises [ 3 , 4 , 5 ]. However, lectures, despite requiring fewer teaching resources, are often perceived as boring and abstract. This may not be the most ideal method for training newly joined nurses in the complexities of international medical responses. However, simulation field exercises can be effective in mastering the knowledge and skills of disaster medicine responsiveness. However, they come with significant costs and requirements, such as extended instructional periods, additional teachers or instructors, and thorough preparation. These high costs make it challenging to organize simulation exercises repeatedly, making them less ideal for training newly joined nurses [ 6 ].

Moreover, classic tabletop exercises that use simple props, such as cards in a classroom setting, have limitations. The rules of these exercises are typically simple, which makes it challenging to simulate complex disaster scenarios. In addition, these exercises cannot replicate real-life situations, making them too abstract for newly joined nurses to fully grasp [ 7 , 8 ].

Recently, game-based learning has gained increasing attention as an interactive teaching method [ 9 , 10 ]. Previous studies have validated the efficacy of game-based mobile applications [ 11 , 12 ]. Serious games that align with curricular objectives have shown potential to facilitate more effective learner-centered educational experiences for trainees [ 13 , 14 ]. Although game-based applications have been used in disaster medicine education, no serious computer games have been designed specifically for training newly joined nurses in an international IEMT setting.

Our team is an internationally certified IEMT organization verified by the WHO, underscoring the importance of providing training for newly joined nurses in international medical responses. To address this need, we organized training courses for them. As part of the training, we incorporated a serious computer game called the IEMTtraining game. In this game, players assume the roles of IEMT nurses, assess patient injuries in a virtual environment, and provide suitable treatment options. This study aims to investigate the effectiveness of the IEMTtraining game. To the best of our knowledge, this is the first serious game specifically designed to train newly joined nurses in an IEMT setting.

The IEMTtraining game was subsequently applied to the training course for newly joined nurses, and this study aimed to investigate its effectiveness. To the best of our knowledge, this is the first serious game specifically designedto train newly joined nurses in an IEMT setting.

Study design

This study was conducted using data from the training records database of participants who had completed the training. The database includes comprehensive demographic information, exam scores, and detailed information from post-training questionnaires for all trainees. We reviewed the training scores and questionnaires of participants who took part in the training from Autumn 2019 to Spring 2020.

The local Institutional Review Committee approved the study and waived the requirement for informed consent due to the study design. The study complied with the international ethical guidelines for human research, such as the Declaration of Helsinki. The accessed data were anonymized.

Participants

A total of 209 newly joined nurses needed to participate in the training. Due to limitations in the size of the training venue, the trainees had to be divided into two groups for the training. All trainees were required to choose a group and register online. The training team provided the schedule and training topic for the two training sessions to all trainees before the training commenced. Each trainee had the opportunity to sign up based on their individual circumstances. Furthermore, the training team set a maximum limit of 110 trainees for each group, considering the dimensions of the training venue. Trainees were assigned on a first-come-first-served basis. In the event that a group reached its capacity, any unregistered trainees would be automatically assigned to another group.

In the fall of 2019, 103 newly joined nurses opted for the lecture training course (lecture group). In this group, instructors solely used the traditional teaching methods of lectures and demonstrations. The remaining 106 newly joined nurses underwent game-based training (game group). In addition to the traditional lectures and demonstrations, the instructor incorporated an IEMTtraining game to enhance the training experience in the game group.

The IEMTTraining game

The IEMTtraining game, a role-playing game, was implemented using the RPG Maker MV Version1.6.1 (Kadokawa Corporation, Tokyo, Tokyo Metropolis, Japan). Players assumed the roles of rescuers in a fictional setting of an earthquake (Part1 of Supplemental Digital Content ).

The storyline revolves around an earthquake scenario, with the main character being an IEMT nurse. Within the game simulation, there were 1000 patients in the scenario. The objective for each player was to treat as many patients as possible to earn higher experience points compared to other players. In addition, within the game scene, multiple nonplayer characters played the role of injured patients. The players navigate the movements of the main character using a computer mouse. Upon encountering injured persons, the player can view their injury information by clicking on them and selecting the triage tags. The player can then select the necessary medical supplies from the kit to provide treatment. Additionally, the player is required to act according to the minimum standards for IEMTs, such as registration in the IEMT coordination cell and reporting of injury information following the minimum data set (MDS) designed by the WHO [ 15 , 16 ]. This portion of the training content imposes uniform requirements for all IEMT members, hence it is necessary for IEMT nurses to learn it. All correct choices result in the accumulation of experience points. Game duration can be set by the instructor and the player with the highest experience points at the end of the game.

Measurement

We have collected the test scores of the trainees in our training database to explore their knowledge mastery. Additionally, we have collected post-training questionnaire data from the trainees to investigate their learning motivation, cognitive load, and technology acceptance.

Pre-test, post-test, and final test

All trainees were tested on three separate occasions: (1) a “pre-test”before the educational intervention, (2) a “post-test”following the intervention, and (3) a “final test”at the end of the term (sixweeks after the intervention). Each test comprised 20 multiple-choice questions (0.5 points per item) assessing the trainees’ mastery of crucial points in their knowledge and decision-making. The higher the score, the better the grade will be.

Questionnaires

The questionnaires used in this study can be found in Part 2 of the Supplemental Digital Content .

The learning motivation questionnaire used in this study was based on the measure developed by Hwang and Chang [ 17 ]. It comprises seven items rated on a six-point scale. The reliability of the questionnaire, as indicated by Cronbach’s alpha, was 0.79.

The cognitive load questionnaire was adapted from the questionnaire developed by Hwang et al [ 18 ]. It consisted of five items for assessing “mental load” and three items for evaluating “mental effort.” The items were rated using a six-point Likert scale. The Cronbach’s alpha values for the two parts of the questionnaire were 0.86 and 0.85, respectively.

The technology acceptance questionnaire, which was only administered to the game group, as it specifically focused on novel teaching techniques and lacked relevance tothe lecture group, was derived from the measurement instrument developed by Chu et al [ 19 ]. It comprised seven items for measuring “perceived ease of use” and six items for assessing “perceived usefulness.” The items were rated on a six-point Likert scale. The Cronbach’s alpha values for the two parts of the questionnaire were 0.94 and 0.95, respectively.

The lecture group received 4 hours of traditional lectures. Additionally, 1 week before the lecture, the trainees were provided with a series of references related to the topic and were required to preview the content before the class. A pre-test was conducted before the lecture to assess the trainees’ prior knowledge, followed by a post-test immediately after the lecture, and a final test 6 weeks after training.

In the game group, the delivery and requirements for references were the same as those in the lecture group. However, the training format differed. The game group received a half-hour lecture introducinggeneral principles, followed by 3 hours of gameplay. The last halfhour was dedicated to summarizing the course and addressing questions or concerns. Similar to the lecture group, the trainees in this group also completed pre-, post-, and final tests. Additionally, a brief survey ofthe teaching methods was conducted at the end of the final test (see Fig.  1 ).

General overview of the teaching procedure. Figure Legend: The diagram shows the teaching and testing processes for the two groups of trainees. Q&A: questions and answers

Data analysis

All data were analyzed using IBM SPSS Statistics (version 20.0;IBM Inc., Armonk, NY, USA). Only the trainees who participated in all three tests were included in the analysis. In total, there were 209 trainees, but 11 individuals (6 from the lecture group and 5 from the game group) were excluded due to incomplete data. Therefore, the data of 198 trainees were ultimately included in the analysis.

In addition, measurement data with a normal distribution were described as mean (standard deviation, SD). In contrast, measurement data with non-normal distributions were expressed as median [first quartile, third quartile]. Furthermore, enumeration data were constructed using composition ratios.

Moreover, a generalized estimating equation (GEE) was employed to compare the groups’ pre-, post-, and final test scores. The Mann–Whitney U test was used to compare the questionnaire scores between the two groups. The statistical significance was set at a level of 0.05.

Among the data included in the analysis, 97 (48.99%) participants were in the lecture group, and 101 (51.01%)were in the game group.

The number of male trainees in the lecture and game groups was 30 (30.93%) and 33 (32.67%), respectively. The mean age of participants in the lecture group was 27.44 ± 4.31 years, whereas that of the game group was 28.05 ± 4.29 years. There were no significant differences in sex or age (Table  1 ). Regarding the test scores, no significant differences were found between the two groups in the pre- and post-tests. However, a significant difference was observed in the final test scores conducted 6 weeks later (Table 1 ).

According to the GEE analysis, the overall scores for the post-test and final test were higher compared to the pre-test scores. Additionally, there was a significant difference in the overall test scores between the two groups, with the game group demonstrating superior performance compared to the control group (odds ratio = 1.363, p value = 0.010). Further details of the GEE results can be found in Part 3 of the supplementary materials .

Table  2 presents the results of the questionnaire ratings for the two groups. The median [first quartile, third quartile] of the learning motivation questionnaire ratings were 4 [3, 4] for the lecture group and 5 [4, 5] for the game group. There were significant differences between the questionnaire ratings of the two groups ( p  < 0.001), indicating that the game group had higher learning motivation for the learning activity.

The median [first quartile, third quartile] of the overall cognitive load ratings were 3 [3, 4] and 4 [4, 5] for the game and lecture groups, respectively. There was a significant difference between the cognitive load ratings of the two groups ( p  < 0.001).

This study further compared two aspects of cognitive load: mental load and mental effort. The median [first quartile, third quartile] for the mental effort dimension were 3 [2, 3] and 4 [4, 5] for the game and lecture groups, respectively (p < 0.001). For mental load, the median [first quartile, third quartile] were 4 [3, 4] and 4 [3, 4] for the game and lecture groups, respectively. There was no significant difference in the mental load ratings between the two groups ( p  = 0.539).

To better understand the trainees’ perceptions of the use of the serious game, this study collected the feedback of the trainees in the game group regarding “perceived usefulness” and “perceived ease of use,” as shown in Table 2 . Most trainees provided positive feedback on the two dimensions of the serious game.

To the best of our knowledge, this IEMT training game is the first serious game intended for newly joined nurses of IEMTs. Therefore, this study presents an initial investigation into the applicability of serious games.

Both lectures and serious games improved post-class test scores to the same level, consistent with previous studies. Krishnan et al. found that an educational game on hepatitis significantly improved knowledge scores [ 20 ]. Additionally, our study showed higher knowledge retention in the game group after 6 weeks, in line with previous studies on serious games. In a study on sexually transmitted diseases, game-based instruction was found to improve knowledge retention for resident physicians compared to traditional teaching methods [ 21 ]. The IEMTtraining game, designed as a role-playing game, is more likely to enhance knowledge retention in newly joined nurses in the long term. Therefore, serious games should be included in the teaching of IEMT training.

This study demonstrated improved learning motivation in the game group, consistent with previous research indicating that game-based learning enhances motivation due to the enjoyable and challenging nature of the games [ 22 , 23 ]. A systematic review by Allan et al. further supports the positive impact of game-based learning tools on the motivation, attitudes, and engagement of healthcare trainees [ 24 ].

As serious games are a novel learning experience for trainees, it is worth investigating the cognitive load they experience. Our study found that serious games effectively reduce trainees’ overall cognitive load, particularly in terms of lower mental effort. Mental effort refers to the cognitive capacity used to handle task demands, reflecting the cognitive load associated with organizing and presenting learning content, as well as guiding student learning strategies [ 25 , 26 ]. This reduction in cognitive load is a significant advantage of serious gaming, as it helps learners better understand and organize their knowledge. However, our study did not find a significant difference in mental load between the two groups. Mental load considers the interaction between task and subject characteristics, based on students’ understanding of tasks and subject characteristics [ 18 ]. This finding is intriguing as it aligns with similar observations in game-based education for elementary and secondary school students [ 27 ], but is the first mention of game-based education in academic papers related to nursing training.

In our survey of the game group participants, we found that their feedback regarding the perceived ease of use and usefulness of the game was overwhelmingly positive. This indicates that the designed game was helpful to learners during the learning process. Moreover, the game’s mechanics were easily understood by the trainees without requiring them to investsignificant time and effort to understand the game rules and controls.

This study had some limitations. First, this retrospective observational study may have been susceptible to sampling bias due to the non-random grouping of trainees. It only reviewed existing data from the training database, and future research should be conducted to validate our findings through prospective studies. Therefore, randomized controlled trials are required. Second, the serious game is currently available only in China. We are currently developing an English version to better align with the training requirements of international IEMT nurses. Third, the development of such serious gamescan be time-consuming. To address this problem, we propose a meta-model to help researchers and instructors select appropriate game development models to implement effective serious games.

An IEMT training game for newly joined nurses is a highly promising training method. Its potential lies in its ability to offer engaging and interactive learning experiences, thereby effectively enhancing the training process. Furthermore, the game improved knowledge retention, increased motivation to learn, and reduced cognitive load. In addition, the game’s mechanics are easily understood by trainees, which further enhances its effectiveness as a training instrument.

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Abbreviations

World Health Organization

International Emergency Medical Team

Minimum Data Set

Generalized estimating eq.

Standard deviation

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Acknowledgements

We would like to thank all the staffs who contribute to the database. We would like to thank Editage ( www.editage.cn ) for English language editing. We also would like to thank Dr. Yong Yang for statistics help. We would like to thank The 10th Sichuan University Higher Education Teaching Reform Research Project (No. SCU10170) and West China School of Medicine (2023-2024) Teaching Reform Research Project (No. HXBK-B2023016) for the support.

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Both Hai Hu and Xiaoqin Lai contributed equally to this work and should be regarded as co-first authors.

Authors and Affiliations

Emergency Management Office of West China Hospital, Sichuan University, The street address: No. 37. Guoxue Road, Chengdu City, Sichuan Province, China

China International Emergency Medical Team (Sichuan), Chengdu City, Sichuan Province, China

Hai Hu & Xiaoqin Lai

Emergency Medical Rescue Base, Sichuan University, Chengdu City, Sichuan Province, China

Day Surgery Center, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China

Xiaoqin Lai

Department of Thoracic Surgery, West China Tianfu Hospital, Sichuan University, Chengdu City, Sichuan Province, China

West China School of Nursing, Sichuan University, Chengdu City, Sichuan Province, China

Longping Yan

West China School of Public Health, Sichuan University, Chengdu, Sichuan, China

West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China

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HH conceived the study, designed the trial, and obtained research funding. XL supervised the conduct of the data collection from the database, and managed the data, including quality control. HH and LY provided statistical advice on study design and analyzed the data. All the authors drafted the manuscript, and contributed substantially to its revision. HH takes responsibility for the paper as a whole.

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Hu, H., Lai, X. & Yan, L. Training nurses in an international emergency medical team using a serious role-playing game: a retrospective comparative analysis. BMC Med Educ 24 , 432 (2024). https://doi.org/10.1186/s12909-024-05442-x

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