Concept Mapping and Gamification in Arterial Blood Gas Analysis Education

Overview

Arterial blood gas (ABG) analysis is a complex clinical competency that requires the integrated interpretation of acid-base balance, oxygenation, and ventilation parameters in relation to the clinical presentation. Although various student-centered educational approaches have been used in ABG education, higher-order cognitive outcomes such as problem-solving, decision-making, and long-term retention of learning have received comparatively limited attention. This two-arm, parallel-group randomized controlled trial evaluates the effects of an interactive instructional approach integrating concept mapping and gamification on ABG education among first-year students enrolled in the Anesthesia Program. Participants are randomly assigned in a 1:1 ratio to either the intervention or control group. Both groups receive one 90-minute educational session per week for four consecutive weeks, with the educational content, learning objectives, duration of instruction, and weekly sequence of topics standardized across groups. The control group receives structured lectures using a traditional instructor-centered teaching approach, supplemented by responses to students' questions and written instructional materials. The intervention group receives an interactive educational program integrating concept mapping, clinical case analysis, Wordwall activities, Kahoot! quizzes, points, digital badges, and a leaderboard. The primary outcome is conceptual knowledge of ABG analysis. Secondary outcomes include clinical scenario interpretation skills, problem-solving ability, and clinical decision-making tendencies. Outcomes are assessed at baseline, immediately after completion of the four-week educational program, and three months after completion of the program to assess retention of learning.

Arterial blood gas (ABG) analysis is a fundamental clinical competency that requires the integrated interpretation of acid-base balance, oxygenation, and ventilation parameters in relation to the clinical presentation. Students may experience difficulty integrating relationships among physiological concepts, transferring theoretical knowledge to clinical scenarios, and interpreting complex acid-base disorders. Although various student-centered educational approaches have been used in ABG education, higher-order cognitive outcomes such as problem-solving, decision-making, and long-term retention of learning have received comparatively limited attention. This study is designed as a two-arm, parallel-group randomized controlled trial with pretest, posttest, and follow-up assessments. The study is conducted among first-year students enrolled in the Anesthesia Program of the Vocational School of Health Services at KTO Karatay University. The Anesthesia Program is a two-year associate degree program that trains anesthesia technicians who assist in maintaining airway patency and the safe delivery of anesthesia under the supervision of an anesthesiologist. Participants are randomly assigned in a 1:1 ratio to either the intervention or control group. Both groups receive one 90-minute educational session per week for four consecutive weeks. The educational content, learning objectives, duration of instruction, and weekly sequence of topics are standardized across groups, with the primary difference being the instructional approach. In the control group, instruction is delivered through structured lectures using a traditional instructor-centered teaching approach. Fundamental concepts and the steps involved in ABG interpretation are explained using examples. The sessions are supplemented by responses to students' questions and written instructional materials aligned with the course content. In the intervention group, instruction is delivered using an interactive approach integrating concept mapping and gamification. Concept maps developed with CmapTools are used to present fundamental concepts and the relationships among them, followed by completion and review of semi-structured concept maps. Clinical case scenarios are analyzed in small groups, followed by interactive Wordwall activities and weekly Kahoot! quizzes. Gamification elements include points, digital badges, and a leaderboard. Immediate feedback is provided throughout the educational activities. All educational sessions are delivered according to a standardized educational protocol. The primary outcome is conceptual knowledge of ABG analysis. Secondary outcomes include clinical scenario interpretation skills, problem-solving ability, and clinical decision-making tendencies. Outcomes are assessed at baseline before the educational program, immediately after completion of the four-week educational program, and three months after completion of the program to assess retention of learning.