The aim of the study is to assess whether students' knowledge level, critical thinking, and problem-solving skills have increased after the serious game and standard patients practice.

This study aims to answer the following problematic: How to improve the learning of satisfaction and self-confidence, knowledge Levels, problem-solving, critical thinking skills in serious game, and standardized patients practice for students. This study tests nursing care skills learning in a serious game on diabetic ketoacidosis management designed scenarios.

50 students in nursing in 2nd year will participate in the experiment. They will be randomized into 2 groups:

Standardized patient Control group (25 participants): The participants spend one scenario 10 minutes; a scenario designed to train Nursing Care (management of diabetic ketoacidosis).

Serious game Experimental group (25 participants): The participants spend on one "MetaHospital" scenario in which Nursing Care (management of diabetic ketoacidosis).

Before the serious game and standard patients practice, students will be asked to fill out a questionnaire on their knowledge level, satisfaction and self-confidence, critical thinking, and problem-solving skills in line with the purpose of the study. The form was submitted to evaluate the usability of the game immediately after the students played the serious game.

Students will be given an information session regarding the case prior to the standard patient practice. Following that, each student will do a standard patient practice for 10 minutes once. After 25 students have finished the application, a 30-minute analysis session with the trainer will be placed. The knowledge levels, satisfaction and self-confidence, critical thinking, and problem-solving skills questionnaires will be filled out again after the session.

Before the serious game application, and after the students have been notified about the game, each student will be provided a username and password for the game login. For one day, students will have unrestricted access to the game. All students participating in the activities will be asked to complete a questionnaire about their knowledge level, satisfaction and self-confidence, critical thinking, and problem-solving abilities.

After the two applications are finished, a questionnaire regarding students' interests, knowledge level, satisfaction and self-confidence, critical thinking, and problem-solving skills will be provided to them one month later to evaluate their learning retention. Finally, the researcher will conduct focus group interviews with students to hear about their experiences.

Inclusion Criteria:

• Nursing students who have taken the Internal Medicine Nursing course
• Students willing and willing to participate in the research

Exclusion Criteria:

• Students who are absent from the Internal Medicine Nursing course
• Students who did not agree to participate in the study
• Students experiencing standard patient practice