Technology-enhanced learning is increasingly used in nursing education to promote engagement and knowledge acquisition. However, evidence directly comparing animation-based case scenarios and game-based learning for high-risk blood transfusion education remains limited.

This study compared post-intervention knowledge and motivation among nursing students receiving animation-based learning, game-based learning, or traditional role-play simulation.

A three-arm, parallel-group, posttest-only randomized controlled trial.

A total of 150 third-year undergraduate pediatric nursing students at Assiut University, Egypt, were randomly assigned (1:1:1) to animation-based learning (n = 50), game-based learning (n = 50), or traditional role-play simulation (n = 50). Knowledge was assessed using a 12-item researcher-developed Blood Transfusion Knowledge Questionnaire, reviewed by five experts for content validity and tested for reliability. Motivation was measured using an adapted Intrinsic Motivation Inventory. Data were analyzed using the Kruskal–Wallis test, Dunn’s post hoc comparisons, and effect size estimation.

Motivation differed significantly among groups (H=21.281, p < 0.001; ε²=0.131). Both animation-based and game-based learning produced significantly higher motivation than traditional role-play simulation, with no significant difference between the two digital approaches (p = 0.107). Knowledge also differed significantly (H=6.747, p = 0.034; ε²=0.032). Game-based learning produced significantly higher knowledge scores than traditional role-play simulation (p = 0.037), whereas animation-based learning did not (p = 0.195).

Both technology-enhanced approaches were associated with higher motivation, while the significant knowledge advantage was observed only for game-based learning. Further research should examine long-term knowledge retention and clinical performance.