Arterial Blood Gas Analysis Education
Conditions
Keywords
Blood Gas Analysis, Gamification, Concept Formation, Problem Solving, Decision Making, Education
Brief summary
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.
Detailed description
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.
Interventions
BEHAVIORALConcept Mapping
As part of the four-week intervention program, concept mapping was used to support theoretical instruction in arterial blood gas (ABG) analysis. Concept maps developed using CmapTools were used to present fundamental concepts and the relationships among them. Students were then provided with semi-structured concept maps from which selected concepts, connections, and linking phrases had been removed. Students completed the missing components individually, reviewed their responses through small-group discussions, and participated in a whole-class review with instructor feedback and clarification of the correct conceptual relationships.
BEHAVIORALTraditional Education
Participants in the control group received one 90-minute educational session per week for four consecutive weeks using a structured, traditional instructor-centered teaching approach. Fundamental concepts and the steps involved in arterial blood gas (ABG) interpretation were explained using examples. The sessions were supplemented by responses to students' questions and written instructional materials aligned with the course content.
BEHAVIORALGamification-Based Education
As part of the four-week intervention program, students participated in gamification-based learning activities related to ABG analysis. Clinical case scenarios aligned with the weekly educational content were analyzed in small groups, followed by interactive Wordwall activities and a weekly Kahoot! quiz consisting of 10 multiple-choice questions. Immediate feedback was provided after the activities. A multicomponent reward system consisting of points, digital badges, and a leaderboard was used. Student performance was evaluated on a 100-point scale during each session, and students achieving a weekly total score of ≥80 received a digital badge and had their scores displayed on the leaderboard. Students scoring \<80 received feedback on areas requiring further learning.
Sponsors
Cemile Nida Kayış
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Outcomes Assessor)
Masking description
The statistician responsible for data analysis will be blinded to group allocation. Participants and researchers delivering the educational interventions will not be blinded due to the nature of the study.
Intervention model description
Participants will be randomly assigned in a 1:1 ratio to either the intervention group or the control group. The intervention group will receive concept mapping and gamification-based arterial blood gas analysis education, while the control group will receive traditional lecture-based education. Outcome measures will be assessed before the intervention, immediately after the intervention, and three months after the intervention to evaluate retention of learning.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Voluntary agreement to participate in the study * Being a first-year student in the Anesthesia Program * Ability to understand and speak Turkish * Using a mobile device with Android v5.0 or higher or iOS v9.0 or higher operating system
Exclusion criteria
* Having previously completed another undergraduate degree before enrollment in the Anesthesia Program * Having previously received arterial blood gas analysis education in any educational program * Failure to complete the post-test or retention test assessments
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Conceptual Knowledge of Arterial Blood Gas Analysis | Baseline, immediately after the intervention, and 3 months after the intervention | Conceptual knowledge of arterial blood gas (ABG) analysis will be assessed using the Arterial Blood Gas Analysis Knowledge Test developed by the research team. The test consists of 25 true/false items, including 15 items assessing conceptual knowledge and 10 items assessing clinical scenario interpretation skills. Each correct response is scored as 1 and each incorrect response as 0. Raw scores for each section are converted to standardized scores ranging from 0 to 100. Only the 15 conceptual knowledge items will be used for the primary outcome analysis. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Clinical Scenario Interpretation Skills | Baseline, immediately after completion of the intervention, and 3 months after the intervention. | Clinical scenario interpretation skills will be assessed using the clinical scenario interpretation section of the Arterial Blood Gas Analysis Knowledge Test developed by the research team. This section consists of 10 true/false items based on clinical scenarios. Each correct response is scored as 1 and each incorrect response as 0. Raw scores are converted to standardized scores ranging from 0 to 100, with higher scores indicating better clinical scenario interpretation skills. |
| Problem-Solving Skills | Baseline, immediately after completion of the intervention, and 3 months after the intervention | Problem-solving skills will be assessed using the Problem Solving Inventory (PSI). The inventory evaluates perceived problem-solving skills, with lower scores indicating better problem-solving ability. |
| Clinical Decision-Making Tendencies | Baseline, immediately after completion of the intervention, and 3 months after the intervention | Clinical decision-making tendencies will be assessed using the Decision-Making Styles Scale (DMSS). The scale evaluates rational, intuitive, dependent, avoidant, and spontaneous decision-making tendencies. Higher scores indicate a greater tendency toward the corresponding decision-making style. |
Countries
Turkey (Türkiye)
Outcome results
None listed