Disaster nursing competence status and needs of undergraduate nursing students under gamified teaching: A mixed-methods study.

BACKGROUND: As disasters occur with increasing frequency worldwide, enhancing the disaster response skills of nursing staff has become a crucial objective of nursing education. However, undergraduate nursing education currently lacks systematic disaster nursing training, resulting in students' inexperience and insufficient response capabilities. Therefore, it is essential to explore scientific and effective teaching methods to improve nursing students' overall disaster response competency. AIM: This study aimed to assess the current level of disaster nursing competencies among Chinese undergraduate nursing students, identify influencing factors, and explore students' perceptions and needs concerning disaster nursing and gamified teaching, thereby informing curriculum development. DESIGN: A sequential, explanatory mixed-methods study was performed. METHODS: The study involved 679 nursing students from 9 universities in Sichuan, China, from March to May 2025. Participants completed a self-designed questionnaire and the validated Disaster Nursing Competency Questionnaire. A descriptive design was used to evaluate competency levels and influencing factors. Subsequently, semi-structured interviews were conducted with 9 students from 4 institutions, and analyzed using thematic analysis. The results from both phases were triangulated to enhance understanding of the phenomenon. RESULTS: The overall disaster nursing ability of undergraduate nursing students is at a passing level (3.09 ± 0.46). Using triangulation, 5 comprehensive themes and 10 sub-themes were identified: willingness and motivation to learn (recognizing the value and usefulness of disaster nursing and its potential impact on career development), curriculum suggestions (support for making it an elective course and recommendations for lesson planning), content needs (focusing on common disaster types and essential on-scene first aid skills), teaching method preferences (combining theory and practice, and positively accepting gamification), and faculty requirements (practical courses should emphasize real-world experience and authentic contexts, focusing on teaching effectiveness and classroom engagement). CONCLUSION: Undergraduate nursing students demonstrated limited disaster nursing skills, revealing a significant gap between their abilities and the actual requirements of rescue operations, despite their strong motivation to learn. Therefore, disaster nursing education should focus on creating a competency-based teaching framework that emphasizes practical skills, while also exploring gamification-integrated models to boost learning engagement and improve skill transfer effectiveness.