Cross-cultural adaptation and validation of the gameful experience scale (GAMEX) for Brazil

Abstract

Abstract Background Gamification has emerged as an innovative teaching methodology, particularly in nursing education, fostering engagement and active learning. Objective To translate, culturally adapt, and evaluate the psychometric properties of the Gameful Experience Scale (GAMEX) for Brazilian Portuguese. Methods A methodological, quantitative, cross-sectional study was conducted in three phases: linguistic and cultural adaptation, content validation, and construct validation. The cross-cultural adaptation followed World Health Organization guidance and the six-stage process described by Beaton et al.: forward translation, synthesis, back translation, expert committee review, pre-testing, and documentation of the final version. Content equivalence was assessed through expert committee review and pre-testing with representatives of the target population. Construct validity was examined using confirmatory factor analysis (CFA) with a diagonally weighted least squares (DWLS) estimator and polychoric correlations, and reliability was assessed using Cronbach’s alpha and McDonald’s omega. Discriminant validity was examined using the average variance extracted (AVE), the Fornell-Larcker criterion, and the heterotrait-monotrait ratio (HTMT). Results A total of 135 participants were included in the validation sample, with a mean age of 30.1 ± 13.1 years (range: 17–67 years). The sample comprised 82 students (60.7%) and 53 professionals (39.3%) from the nursing school setting. The Brazilian Portuguese adaptation demonstrated promising psychometric performance. Domain reliability levels were as follows: Enjoyment (α = 0.911; ω = 0.910), Absorption (α = 0.917; ω = 0.917), Creative Thinking (α = 0.866; ω = 0.869), Activation (α = 0.657; ω = 0.556), Absence of Negative Affect (α = 0.852; ω = 0.856), and Dominance (α = 0.770; ω = 0.770). CFA supported the overall six-factor structure, with χ² = 581.706, df = 309, χ²/df = 1.883, CFI = 0.958, TLI = 0.953, RMSEA = 0.081 (90% CI: 0.071–0.091), and SRMR = 0.102. However, RMSEA and SRMR were marginally above the prespecified thresholds, and the Activation domain showed weaker psychometric performance. Items Q18 and Q19 require further linguistic, experiential, and psychometric refinement. Conclusions The Brazilian Portuguese adaptation of GAMEX showed promising evidence of structural validity and internal consistency for assessing gamified learning experiences, such as escape rooms, in this nursing education sample.

The authors' abstract, as published at the source. BMC Medical Education, 2026 · DOI ↗