The ability of graduating nursing students to detect changes in vital signs varies globally, posing potential life-threatening risks. This underscores the critical need to rigorously assess these competencies at graduation. However, objective exit exams that assess both knowledge and skills remain uncommon. The study aimed to assess nursing students’ knowledge and skills in vital signs through an objective exit exam and to evaluate the usability of a simulation game platform as a skill test in the exit exam.

A cross-sectional study using the Vital Signs Knowledge Test (VSKT, n = 159) and Vital Signs Skill Test (VSST, n = 187) was conducted. The P-SUS survey gathered feedback on the VSST’s usability as a skill test. Data were analyzed using univariate descriptive analysis and Pearson correlation with significance tests. Multivariate models estimated mean differences between categories.

Variation in knowledge and skills was found, particularly in nursing procedures and interpreting electrocardiogram changes. Participants who performed well on the VSKT also performed well on the VSST. The P-SUS survey indicated good usability of the game.

This study emphasizes the importance of assessing both knowledge and skills to fully gauge the competence of graduating nursing students.