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Volume 15
Issue 12
10.3390/nursrep15120447
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Study Protocol

Co-Design and Evaluation of a Gamified E-Resource About Healthcare Decarbonisation: A Study Protocol

by
Nuala McLaughlin-Borlace
1,*,
Stephanie Craig
1,
Nuala Flood
2,
Laura Steele
3,
Tara Anderson
1,
Sara Lynch
4,
Jesús Sánchez-Martín
5,
Rose Gallagher
6,
Naomi Tutticci
7,
Charlotte McArdle
8,
Tracy Levett-Jones
9,
Fadwa Al Halaiqa
10,
Dalal Hammodi Halat
11,
Norfadzilah Binti Ahmad
12 and
Gary Mitchell
1
1
School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT9 7BL, UK
2
School of Natural and Built Environment, Queen’s University Belfast, Belfast BT9 5AG, UK
3
Queen’s Business School, Queen’s University Belfast, Belfast BT9 5EE, UK
4
Estates Directorate, Queen’s University Belfast, Belfast BT7 1NN, UK
5
Facultad de Educación y Psicología, Universidad de Extremadura, 06006 Badajoz, Spain
6
Royal College of Nursing, London W1G 0RN, UK
7
School of Nursing and Midwifery, Griffith University, Brisbane 4111, Australia
8
Faculty of Health Science, Ulster University, Northland Rd, Londonderry BT48 7JL, UK
9
School of Nursing and Midwifery, University of Technology Sydney (UTS), Ultimo 2007, Australia
10
Pre-Clinical Affairs, College of Nursing, Qatar University, Doha P.O. Box 2713, Qatar
11
QU Health Office of Assessment and Accreditation, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
12
Faculty of Nursing, International Islamic University Malaysia, Kuantan Campus, Kuantan 25200, Pahang, Malaysia
 
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Author to whom correspondence should be addressed.
Nurs. Rep. 2025, 15(12), 447; https://doi.org/10.3390/nursrep15120447
Submission received: 31 October 2025 / Revised: 8 December 2025 / Accepted: 10 December 2025 / Published: 13 December 2025
Versions Notes

Abstract

Climate change poses a major global health threat, with healthcare systems contributing substantially to global greenhouse gas emissions. Health professionals and students play an essential role in advancing sustainable practice, yet many lack the knowledge, skills, and confidence needed to address the environmental impacts of healthcare. This study aims to co-design and evaluate a gamified e-resource that enhances pre-registration health profession students’ knowledge, self-efficacy, and attitudes towards healthcare decarbonisation, while encouraging sustainable behaviour change. A sequential explanatory design will be employed in three phases: (1) a scoping review of the literature; (2) four co-design workshops with students (n = 20) followed by post-workshop focus groups using focused ethnography to explore co-design experiences; and (3) pre- and post-test questionnaires (n = 200) assessing knowledge, attitudes, self-efficacy, behaviours, willingness to act, and usability, followed by focus groups (n = 30) exploring behavioural changes after using the e-resource. The study will generate evidence on how a co-designed, gamified e-resources influence student learning and engagement with healthcare decarbonisation. Findings will inform the integration of sustainability and decarbonisation principles within education and support efforts to equip future health professionals with the competencies required for a low-carbon healthcare system.
Keywords: healthcare decarbonisation; sustainable healthcare; climate change; carbon emissions; health professions education; gamified learning; digital education; co-design healthcare decarbonisation; sustainable healthcare; climate change; carbon emissions; health professions education; gamified learning; digital education; co-design

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MDPI and ACS Style

McLaughlin-Borlace, N.; Craig, S.; Flood, N.; Steele, L.; Anderson, T.; Lynch, S.; Sánchez-Martín, J.; Gallagher, R.; Tutticci, N.; McArdle, C.; et al. Co-Design and Evaluation of a Gamified E-Resource About Healthcare Decarbonisation: A Study Protocol. Nurs. Rep. 2025, 15, 447. https://doi.org/10.3390/nursrep15120447

AMA Style

McLaughlin-Borlace N, Craig S, Flood N, Steele L, Anderson T, Lynch S, Sánchez-Martín J, Gallagher R, Tutticci N, McArdle C, et al. Co-Design and Evaluation of a Gamified E-Resource About Healthcare Decarbonisation: A Study Protocol. Nursing Reports. 2025; 15(12):447. https://doi.org/10.3390/nursrep15120447

Chicago/Turabian Style

McLaughlin-Borlace, Nuala, Stephanie Craig, Nuala Flood, Laura Steele, Tara Anderson, Sara Lynch, Jesús Sánchez-Martín, Rose Gallagher, Naomi Tutticci, Charlotte McArdle, and et al. 2025. "Co-Design and Evaluation of a Gamified E-Resource About Healthcare Decarbonisation: A Study Protocol" Nursing Reports 15, no. 12: 447. https://doi.org/10.3390/nursrep15120447

APA Style

McLaughlin-Borlace, N., Craig, S., Flood, N., Steele, L., Anderson, T., Lynch, S., Sánchez-Martín, J., Gallagher, R., Tutticci, N., McArdle, C., Levett-Jones, T., Al Halaiqa, F., Hammodi Halat, D., Binti Ahmad, N., & Mitchell, G. (2025). Co-Design and Evaluation of a Gamified E-Resource About Healthcare Decarbonisation: A Study Protocol. Nursing Reports, 15(12), 447. https://doi.org/10.3390/nursrep15120447

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