Nurse educators are faced with many challenges while preparing students to safely enter clinical practice. Due to technological advances in the health care field and student demographic changes, educators have been looking for alternative methods to traditional lecture format to meet the needs of current learners. Using the framework of Adult Learning Theory, this quasi-experimental two-group, repeated measures study explored the use of gaming in the classroom on cognitive performance, course engagement, and metamotivational state in undergraduate nursing students. The study was conducted with a convenience sample of 63 nursing students enrolled in a nursing pharmacology course during the second year of the nursing curriculum. The intervention consisted of three sessions of "Kahoot!" "Teach with Slides" lasting approximately 60 minutes to reinforce course content each week during scheduled class sessions. Instruments to measure outcomes included: (a) Student Course Engagement Questionnaire (SCEQ), (b) Telic/Paratelic State Inventory (T/PSI), and (c) module examination developed by faculty. The English Language Acculturation Scale (ELAS) was used to measure study participants' use of English providing insight to the effect of gaming on students with varied levels of English acculturation. The sample exhibited a wide range of ELAS scores, 5-25 (M = 19.95; SD = 7.32), indicating students in both groups had varying English language acculturation levels. An independent sample t test showed no significant difference between intervention and control groups, t(54) = 1.093, p = 0.140. The first study used a quasi-experimental two-group, pretest-posttest design to assess cognitive performance and course engagement. An independent samples t test showed a statistically significant difference in cognitive performance between groups, t(61) = 2.160, p = 0.035. English Language Acculturation was a statistically significant predictor of cognitive performance; however, there was no difference between intervention and control groups in language acculturation. There was no statistically significant interaction between group and time of testing for course engagement scores between groups over time. There was no correlation between cognitive performance and course engagement, r(34) = 0.102, p = 0.565. The second study employed a quasi-experimental two-group, repeated measures design to assess the metamotivational states of students along with the relationship of metamotivational state to cognitive performance and course engagement. Chi-square analyses of metamotivational states between groups revealed no statistical difference between intervention and control groups. A two-way ANOVA revealed a statistically significant interaction between gaming and metamotivational state, F(1,30) = 4.603, p = 0.041. Paratelic students in the intervention group had statistically significantly higher course engagement, t(18) = -3.06, p = 0.007. The study findings indicate that gaming is a comparable activity to non-gaming active teaching strategies such as group discussion and case studies. There was an increase in course engagement for those in the paratelic state of the intervention group indicating that those who are playful can be engaged in the classroom. The results of this study indicate that "Kahoot!" is a gaming activity that can be used in nursing education to increase cognitive performance. Further research is needed to explore other student learning outcomes. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]