Participants in this group received standard theoretical instruction on pressure ulcers, followed by a structured game-based escape room intervention. The escape room intervention consisted of interactive learning activities, including crossword puzzles, word search tasks, matching exercises, and puzzle-based problem-solving activities. Participants worked in small groups under facilitator supervision and completed sequential tasks designed to achieve learning objectives related to pressure ulcer prevention and management.

Participants in this group received standard lecture-based theoretical instruction on pressure ulcers delivered in a classroom setting. No additional educational intervention was provided.

A structured, game-based educational intervention designed to enhance engagement and reinforce knowledge of pressure ulcers. The intervention consisted of multiple interactive learning activities, including crossword puzzles, word search tasks, matching exercises, and puzzle completion activities. These activities were facilitated in a simulated clinical learning environment under instructor supervision. The session was followed by a structured debriefing phase.

Assessed using the Pressure Ulcer Knowledge Assessment Tool 2.0 (PUKAT 2.0-T). The tool is a 25-item questionnaire with scores ranging from 0 to 25. Higher scores indicate a higher level of knowledge regarding pressure ulcer prevention and management.

The outcome was assessed using the Gameful Experience Scale (GAMEX) developed by Eppmann, Bekk, and Klein (2018). The original scale consists of 27 items covering six dimensions: enjoyment (6 items), absorption (6 items), creative thinking (4 items), activation (4 items), absence of negative affect (3 items), and dominance (4 items). The total score increases with a more positive gameful experience.

The Turkish adaptation of the scale was performed by Hatipoğlu and Türker (2018), who conducted validity and reliability analyses. The adapted version consists of 42 items; however, items after item 38 are specific to the marketing field and were excluded in non-marketing studies, including the present study.

The Turkish version demonstrated high internal consistency with a Cronbach's alpha coefficient of 0.931. Higher scores indicate a more positive gameful experience during the gamified learning intervention.