https://www.selleckchem.com/products/donafenib-sorafenib-d3.html Background The Gymkhana Room for Education and Evaluation in Nursing Studies (GREENS©) is a pedagogical model that can be used as a learning and assessment method in nursing training workshops. This model combines the advantages of gamification, the flipped classroom and the use of low-fidelity clinical simulation, also including self-reflection and peer evaluation of the situations experienced. Objectives To evaluate the students' perception of the implementation of GREENS© as a learning and assessment tool in an academic course at the University of Almeria. Design A cross-sectional descriptive study. Settings Academic year 2018/2019, at the University of Almeria (UAL), Spain. Participants 77 students enrolled in their 2nd year of the Nursing Degree who attended the "Health Promotion and Safety" class. Methods After completing the GREENS© activity, the perception and anxiety of students were analyzed through an online ad hoc questionnaire composed of 17 questions. Data were collected in January 2019. Results All of the questions scored above 4 out of a maximum of 5 on a Likert scale. For all the questions, >50% of the students were in total agreement with the questions answered, showing a high acceptance of the GREENS© methodology implementation. The students reported that their anxiety decreased significantly, with a score of 4.7 points on average (95% CI 4.16 to 5.33, p less then 0.001), after knowing that the assessment would be through a gamification tool, not an oral one. More than 60% of the students answered "agree" or "strongly agree" with the idea that GREENS© is useful for improving motivation, teamwork, learning, fun and knowledge assessment. Conclusions The use of GREENS© has generated a high satisfaction and motivation of the students in their learning process, and as an assessment tool, it created a lower degree of anxiety as compared to an oral examination.Pregnancy represents an immuno