Background: Community and public health nursing (C/PHN) needs to expand to meet evolving population health needs, yet baccalaureate nursing graduates often lack the competencies required for these roles.
Purpose: The aim of this study was to enhance nursing student self-efficacy in C/PHN competencies through virtual simulation games (gamulations).
Methods: Researchers developed 6 public health scenarios in collaboration with a software company and piloted gamulations with 90 senior nursing students, 3 faculty, and 1 practicing PHN. Pre- and post-assessments measured self-efficacy in C/PHN competencies.
Results: Two-tailed t -testing showed significant improvement in overall self-efficacy scores from pre-assessment ( M = 44.76) to post-assessment ( M = 54.93) ( t (47) = -7.78, P < .001). Paired competency self-efficacy scores across all 19 individual competencies showed significance ( P < .001) in self-efficacy improvement. Cohen's d ranged from 0.44 to 0.72.
Conclusions: Implementation of game-based educational approaches has the potential to improve new nurse graduates' self-efficacy in C/PHN competencies, thereby improving entry to practice in community and public health roles.
Keywords: gamification; nursing education; public health competencies; public health nursing; self-efficacy.
Copyright © 2025 The Authors. Published by Wolters Kluwer Health, Inc.