This randomized controlled study aims to examine the effect of a concept mapping and gamification-based educational approach on arterial blood gas analysis skills among first-year anesthesia program students. The study will be conducted with students enrolled in the Anesthesia Program of a Vocational School of Health Services. Participants will be randomly assigned to an intervention group or a control group. The intervention group will receive concept mapping and gamification-based arterial blood gas analysis training, while the control group will receive traditional education through lecture, slide presentation, and written materials. The primary outcome is students' arterial blood gas analysis knowledge and interpretation skills, measured using the Arterial Blood Gas Analysis Knowledge Test. Secondary outcomes include problem-solving skills and decision-making styles. Data will be collected before the intervention, immediately after the education, and three months after the education to assess retention.

Arterial blood gas analysis is an important clinical assessment method used in critical care, emergency, operating room, and intensive care settings. Correct interpretation of arterial blood gas parameters is essential for evaluating oxygenation, ventilation, and acid-base balance. Therefore, anesthesia students are expected to develop adequate knowledge and interpretation skills related to arterial blood gas analysis before graduation.

This study is designed as a two-arm, parallel-group randomized controlled experimental study with pre-test, post-test, and follow-up measurements. The study population consists of first-year students enrolled in the Anesthesia Program of a Vocational School of Health Services. A total of 100 students are planned to be included in the study, with 50 students assigned to the intervention group and 50 students assigned to the control group. Participants meeting the inclusion criteria will be randomly allocated to the groups in a 1:1 ratio using simple randomization. Allocation concealment will be ensured using numbered, opaque, sealed envelopes prepared by an independent person.

Before the educational intervention, students in both groups will complete the Arterial Blood Gas Analysis Knowledge Test, the Problem Solving Inventory, and the Decision-Making Styles Scale. The educational intervention will then be implemented over four weeks, with one 90-minute session per week.

Students in the control group will receive traditional education. This education will include lecture-based instruction, slide presentations, and written materials covering arterial blood gas physiology, oxygenation and ventilation parameters, acid-base balance, preanalytical processes, and basic case examples. Concept mapping and gamification strategies will not be used in the control group during the study period.

Students in the intervention group will receive a concept mapping and gamification-based arterial blood gas analysis education program. In the first stage of the intervention, key concepts related to arterial blood gas analysis will be presented using concept maps, and students will actively complete conceptual connections. In the following weeks, a gamified learning module named "Blood Gas Hero" will be implemented. In this module, students will solve clinical case cards, earn points, receive badges, and progress through levels. Interactive question-and-answer activities using Kahoot! will also be used to reinforce learning and increase active participation. Clinical case examples will be structured to reflect real clinical situations and will be gradually made more difficult to support students' decision-making skills.

The primary outcome of the study is arterial blood gas analysis knowledge and interpretation skills. This outcome will be measured using the Arterial Blood Gas Analysis Knowledge Test developed by the researchers. The test consists of 25 true-false items, including knowledge-based questions and clinical scenario-based interpretation questions. The content validity of the test was evaluated using the Davis technique based on expert opinions, and the content validity index was determined as 0.96.

The secondary outcomes are problem-solving skills and decision-making styles. Problem-solving skills will be assessed using the Problem Solving Inventory, and decision-making styles will be assessed using the Decision-Making Styles Scale. All outcome measures will be administered before the intervention, immediately after the completion of the education, and three months after the education to evaluate retention of learning.

Ethical approval was obtained from the KTO Karatay University Non-Drug and Non-Medical Device Research Ethics Committee with decision number 25/073. Institutional permission will be obtained from the Vocational School of Health Services, and written informed consent will be obtained from students who agree to participate in the study.

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

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.