Pooled gamification effects remain stable when high-risk-of-bias studies are excluded and in leave-one-out and fixed-effect sensitivity analyses¶

Claim · All claims
Evidence · 1 study · quant-synthesis r3 · q4
Currency · newest study 2026 · not yet checked against its sources · not reviewed by a person

Subclaims¶

q4 i? Excluding the two high-risk-of-bias studies did not materially change pooled effect sizes, no single study dominated the results, and fixed-effect models preserved effect directions. → Chen W.-L. 2026

Evidence¶

Chen W.-L. 2026¶

Chen W.-L., Winitchayothin S., Cheng C.-H., Tonapa S.I., Chou F.-H., & Zimmerman P.-A. (2026). A systematic review and meta-analysis of the effect of gamified clinical skill learning on learning outcomes in undergraduate nursing education. The Journal of Nursing Research. https://doi.org/10.1097/jnr.0000000000000772

q4 · i? · quant-synthesis · r3

Sensitivity analyses accompanying the review's meta-analyses: exclusion of the two high-risk studies, leave-one-out analysis, and fixed-effect versus random-effects comparison. The review reports pooled effect sizes "remained materially unchanged", and no single study dominated the outcomes (knowledge I2=82%, skills I2=95%). No separate effect size is printed for these analyses.

"When excluding the two studies identified with a high risk of bias (Aljezawi & Albashtawy, 2015; Al-Mugheed et al., 2022), the pooled effect sizes for knowledge, skills, and attitudes remained materially unchanged, further supporting the robustness of the results."

Discussion¶

Related Claims¶

• The pooled gamification effect is robust across dependence assumptions, quality thresholds, and model specifications, with no evidence of publication bias — related
• Pooled effects are robust in sensitivity analyses, but 10 of 13 studies carry serious risk of bias and publication bias is indicated — related
• Research on gamification in higher education is predominantly quantitative, English-language and review-scarce — related
• Clinical analysis skills effect size is unstable and sensitive to two studies, dropping to d = 0.50 after their exclusion — related
• Removing high-risk-of-bias studies does not materially change the pooled accuracy estimate — possibly the same claim (merge candidate)