AIM: This study aims to understand the factors contributing to the low engagement rate of Chinese students with Confucian heritage culture in online learning games to improve their learning experience and outcomes. BACKGROUND: Incorporating gamification into higher education has proven to be an effective teaching and learning strategy for enhancing students' academic performance, boosting motivation and improving their retention of critical concepts. However, despite these benefits, Chinese nursing students have demonstrated low engagement with online learning games. DESIGN: This study employed reflexive thematic analysis, an appropriate method for exploring the online learning game experiences and uncovering the root causes of low engagement rates among Chinese nursing students. METHODS: The narrative data were collected through focus group interviews. Participants were invited by the snowballing strategy. The narrative data were coded, categorised, themed and vigorously interpreted. The researcher's comments have been incorporated into the discussion to facilitate the co-construction of knowledge. FINDINGS: The study identified two themes contributing to the low engagement rate of Chinese nursing students in online learning games: learning approaches and knowledge acquisition. The findings underscore the need for cultural sensitivity when implementing gamification in lectures for Chinese students with a Confucian heritage culture. CONCLUSIONS: This study's findings offer promising insights for nursing educators and academic managers considering integrating gamification into nursing programs, particularly for students with a Confucian heritage culture. Since Chinese students have different learning approaches and knowledge acquisition strategies, online learning games may not be the best teaching and learning strategy design.