Gamification and game-based education in neurology and neuroscience: Applications, challenges, and opportunities

Empowering human anatomy education through gamification and artificial intelligence: An innovative approach to knowledge appropriation

Gamification has appeared as an alternative educational methodology to traditional tools. Specifically, in anatomy teaching, multiple technological applications have emerged in response to the difficulties of accessing cadaveric material; however, there is insufficient information about the effects of these applications on the performance achieved by students, or about to the best way to adapt learning to meet their educational needs. In this study, we investigated how teaching human anatomy through a mobile gamified technological tool containing recommendation systems can be combined with a virtual assistant to improve the learning and academic performance of medical students in the Anatomy Department at the Universidad de La Frontera in Temuco, Chile and the Anatomy Department at the Pontificia Universidad Católica de Chile. In total, 131 students participated in the experiment, which was divided into two case studies. The main findings led to the conclusion that gamified components support students in learning anatomy. In addition, the predictions and recommendations provided by the virtual assistant enabled the academic aspects that the students needed to improve to be extracted adequately. Future work is expected to support adaptive learning by incorporating new artificial intelligence in education elements that can generate personalized scenarios for studying anatomy based on the application.

Metaverse Wearables for Immersive Digital Healthcare: A Review

The recent exponential growth of metaverse technology has been instrumental in reshaping a myriad of sectors, not least digital healthcare. This comprehensive review critically examines the landscape and future applications of metaverse wearables toward immersive digital healthcare. The key technologies and advancements that have spearheaded the metamorphosis of metaverse wearables are categorized, encapsulating all-encompassed extended reality, such as virtual reality, augmented reality, mixed reality, and other haptic feedback systems. Moreover, the fundamentals of their deployment in assistive healthcare (especially for rehabilitation), medical and nursing education, and remote patient management and treatment are investigated. The potential benefits of integrating metaverse wearables into healthcare paradigms are multifold, encompassing improved patient prognosis, enhanced accessibility to high-quality care, and high standards of practitioner instruction. Nevertheless, these technologies are not without their inherent challenges and untapped opportunities, which span privacy protection, data safeguarding, and innovation in artificial intelligence. In summary, future research trajectories and potential advancements to circumvent these hurdles are also discussed, further augmenting the incorporation of metaverse wearables within healthcare infrastructures in the post-pandemic era.

Evaluating TESLA-G, a gamified, telegram-delivered, quizzing platform for surgical education in medical students: protocol for a pilot randomised controlled trial

INTRODUCTION

Online multiple-choice question (MCQ) quizzes are popular in medical education due to their ease of access and ability for test-enhanced learning. However, a general lack of motivation among students often results in decreasing usage over time. We aim to address this limitation by developing Telegram Education for Surgical Learning and Application Gamified (TESLA-G), an online platform for surgical education that incorporates game elements into conventional MCQ quizzes.

METHODS AND ANALYSIS

This online, pilot randomised control trial will be conducted over 2 weeks. Fifty full-time undergraduate medical students from a medical school in Singapore will be recruited and randomised into an intervention group (TESLA-G) and an active control group (non-gamified quizzing platform) with a 1:1 allocation ratio, stratified by year of study.We will evaluate TESLA-G in the area of endocrine surgery education. Our platform is designed based on Bloom's taxonomy of learning domains: questions are created in blocks of five questions per endocrine surgery topic, with each question corresponding to one level on Bloom's taxonomy. This structure promotes mastery while boosting student engagement and motivation. All questions are created by two board-certified general surgeons and one endocrinologist, and validated by the research team. The feasibility of this pilot study will be determined quantitatively by participant enrolment, participant retention and degree of completion of the quizzes. The acceptability of the intervention will be assessed quantitatively by a postintervention learner satisfaction survey consisting of a system satisfaction questionnaire and a content satisfaction questionnaire. The improvement of surgical knowledge will be assessed by comparing the scores of preintervention and postintervention knowledge tests, which consist of separately created questions on endocrine surgery. Retention of surgical knowledge will be measured using a follow-up knowledge test administered 2 weeks postintervention. Finally, qualitative feedback from participants regarding their experience will be obtained and thematically analysed.

ETHICS AND DISSEMINATION

This research is approved by Singapore Nanyang Technological University (NTU) Institutional Review Boards (Reference Number: IRB-2021-732). All participants will be expected to read and sign a letter of informed consent before they are considered as recruited into the study. This study poses minimal risk to participants. Study results will be published in peer-reviewed open-access journals and presented in conference presentations.

TRIAL REGISTRATION NUMBER

NCT05520671.

Using a mobile application for psychiatry training in medical students: a quasi-experimental study

OBJECTIVE

Microlearning and gamification through mobile technology can significantly enhance knowledge acquisition and satisfaction. Roozbehyar application, was designed using microlearning and gamification approaches for psychiatry clerkship training.

METHOD

This quasi-experimental study was conducted in Roozbeh Hospital, in 2021. The intervention group was assigned to the Roozbehyar during a 4-week course. Knowledge and satisfaction were assessed after 4 weeks.

RESULTS

We recruited 27 (F/M: 19/8) and 35 students (F/M: 22/13) in the intervention and control groups, respectively. Learning through Roozbehyar was associated with higher scores in the final written exam (p value: 0.031). No difference was seen in the final global assessment scores. The satisfaction scores of the students regarding the content and learners' aspect of the application were above average, yet scores in structural and support aspects were below average.

CONCLUSIONS

We highlighted the effect of a microlearning mobile application in increasing knowledge and satisfaction in psychiatry training in medical students.

Gamification of POCUS: Are Students Learning?

INTRODUCTION

While gamification of point-of-care ultrasound (POCUS) is well received by learners, little is known about the knowledge gained from material taught during these events. We set out to determine whether a POCUS gamification event improved knowledge of interpretation and clinical integration of POCUS.

METHODS

This was a prospective observational study of fourth-year medical students who participated in a 2.5-hour POCUS gamification event consisting of eight objective-oriented stations. Each station had one to three learning objectives associated with the content taught. Students completed a pre-assessment; they then participated in the gamification event in groups of three to five per station and subsequently completed a post-assessment. Differences between pre- and post-session responses were matched and analyzed using Wilcoxon signed-rank test and Fisher's exact test.

RESULTS

We analyzed data from 265 students with matched pre- and post-event responses; 217 (82%) students reported no to little prior POCUS experience. Most students were going into internal medicine (16%) and pediatrics (11%). Knowledge assessment scores significantly improved from pre- to post-workshop, 68% vs 78% (P=0.04). Self-reported comfort with image acquisition, interpretation, and clinical integration all significantly improved from pre- to post-gamification event (P<0.001).

CONCLUSION

In this study we found that gamification of POCUS, with clear learning objectives, led to improved student knowledge of POCUS interpretation, clinical integration, and self-reported comfort with POCUS.

Gamification of the National Institutes of Health Stroke Scale (NIHSS) for simulation training-a feasibility study

BACKGROUND

Training prehospital personnel in identifying patients with acute stroke is key to providing rapid treatment. This study aimed to investigate whether game-based digital simulation training is a feasible alternative to standard in-person simulation training.

METHODS

Second-year paramedic bachelor students at Oslo Metropolitan University in Norway were invited to participate in a study to compare game-based digital simulation (intervention) to standard in-person training (control). For 2 months, students were encouraged to practice the NIHSS, and both groups logged their simulations. Then, they performed a clinical proficiency test, and their results were assessed using a Bland-Altman plot with corresponding 95% limits of agreement (LoA).

RESULTS

Fifty students participated in the study. Individuals in the game group (n = 23) spent an average (SD) of 42:36 min (36) on gaming and performed 14.4 (13) simulations on average, whereas the control group (n = 27) spent 9:28 min (8) simulating and performed 2.5 (1) simulations. Comparing time variables collected during the intervention period, the mean time for each simulated assessment was significantly shorter in the game group (2:57 min vs. 3:50 min, p = 0.004). In the final clinical proficiency test, the mean difference from the true NIHSS score was 0.64 (LoA: - 1.38 to 2.67) in the game group and 0.69 (LoA: - 1.65 to 3.02) in the control group.

CONCLUSION

Game-based digital simulation training is a feasible alternative to standard in-person simulation training to acquire competence in NIHSS assessment. Gamification seemed to give an incentive to simulate considerably more and to perform the assessment faster, with equal accuracy.

TRIAL REGISTRATION

The study was approved by the Norwegian Centre for Research Data (reference no. 543238).

Taking modern psychiatry into the metaverse: Integrating augmented, virtual, and mixed reality technologies into psychiatric care

The landscape of psychiatry is ever evolving and has recently begun to be influenced more heavily by new technologies. One novel technology which may have particular application to psychiatry is the metaverse, a three-dimensional digital social platform accessed via augmented, virtual, and mixed reality (AR/VR/MR). The metaverse allows the interaction of users in a virtual world which can be measured and manipulated, posing at once exciting new possibilities and significant potential challenges and risks. While the final form of the nascent metaverse is not yet clear, the immersive simulation and holographic mixed reality-based worlds made possible by the metaverse have the potential to redefine neuropsychiatric care for both patients and their providers. While a number of applications for this technology can be envisioned, this article will focus on leveraging the metaverse in three specific domains: medical education, brain stimulation, and biofeedback. Within medical education, the metaverse could allow for more precise feedback to students performing patient interviews as well as the ability to more easily disseminate highly specialized technical skills, such as those used in advanced neurostimulation paradigms. Examples of potential applications in brain stimulation and biofeedback range from using AR to improve precision targeting of non-invasive neuromodulation modalities to more innovative practices, such as using physiological and behavioral measures derived from interactions in VR environments to directly inform and personalize treatment parameters for patients. Along with promising future applications, we also discuss ethical implications and data security concerns that arise when considering the introduction of the metaverse and related AR/VR technologies to psychiatric research and care.

Inaugural Pan-Canadian RADGames: Results From a Successful Approach to Radiology Education for Medical Students

RATIONALE AND OBJECTIVES

A goal in radiology undergraduate medical education is to improve exposure to the field. In 2022, the Canadian Association of Radiologists' Medical Student Network hosted for the first time "RADGames," an interactive image interpretation contest for medical students across Canada. This program was aimed to spark interest in radiology and improve students' image interpretation skills through gamification with expert guidance.

MATERIALS AND METHODS

Volunteers from Radiology Interest Groups in Canadian medical schools set up a virtual event for the competition using breakout rooms and a quiz platform. Participant recruitment was through social media and advertisement by medical student associations. Participants were surveyed anonymously for feedback following the event. Data about previous exposure to and knowledge of radiology, and an evaluation of the event including self-perceived impact on participants' understanding of the field were collected.

RESULTS

Eighty seven medical students from 15 of Canada's 17 medical schools competed against one another virtually. Forty seven (54%) responded to the post-event evaluation survey. All responses about the event itself were favourable. Respondents overwhelmingly indicated that RADGames increased their interest in radiology (38, 81%), their understanding of the work of a radiologist (31, 66%) and their knowledge about medical imaging (46, 98%), and improved their confidence in basic imaging interpretation (36, 77%).

CONCLUSION

The Canadian Association of Radiologists' Medical Student Network hosted Canada's first national image interpretation competition for medical students, RADGames. Feedback was overwhelmingly positive, with perceived benefits to participants on their understanding of and interest in radiology.

Screen-based digital learning methods in radiation oncology and medical education

The field of radiation oncology is rapidly advancing through technological and biomedical innovation backed by robust research evidence. In addition, cancer professionals are notoriously time-poor, meaning there is a need for high quality, accessible and tailored oncological education programs. Digital learning (DL) is well-placed to cater to these needs, as it provides teaching options that can be delivered flexibly and on-demand from anywhere in the world. The evidence for usage of these techniques in medical education has expanded rapidly in recent years. However, there remains many reservations in the oncological community to adopting and developing DL, largely due to a poor familiarity with the pedagogical evidence base. This article will review the application of the screen-based DL tools that are at educators' disposal. It will summarize best-practice in developing tailored, made-for-screen videos, gamification, and infographics. It also reviews data behind the following practical tips of 1) strategically combining text with graphics to decrease cognitive load, 2) engaging users through use of interactive elements in digital content, and 3) maximizing impact through thoughtful organization of animations/images. Overall, the digital space evolving is well placed to cater to the evolving educational needs of oncology learners. This review and its practical tips aim to inspire further development in this arena, production of high-yield educational products, use of engaging delivery methods and programs that are tailored to individual learning needs.

Augmented Reality and Gamification in Education: A Systematic Literature Review of Research, Applications, and Empirical Studies

This study scrutinizes the existing literature regarding the use of augmented reality and gamification in education to establish its theoretical basis. A systematic literature review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was conducted. To provide complete and valid information, all types of related studies for all educational stages and subjects throughout the years were investigated. In total, 670 articles from 5 databases (Scopus, Web of Science, Google Scholar, IEEE, and ERIC) were examined. Based on the results, using augmented reality and gamification in education can yield several benefits for students, assist educators, improve the educational process, and facilitate the transition toward technology-enhanced learning when used in a student-centered manner, following proper educational approaches and strategies and taking students’ knowledge, interests, unique characteristics, and personality traits into consideration. Students demonstrated positive behavioral, attitudinal, and psychological changes and increased engagement, motivation, active participation, knowledge acquisition, focus, curiosity, interest, enjoyment, academic performance, and learning outcomes. Teachers also assessed them positively. Virtual rewards were crucial for improving learning motivation. The need to develop appropriate validation tools, design techniques, and theories was apparent. Finally, their potential to create collaborative and personalized learning experiences and to promote and enhance students’ cognitive and social–emotional development was evident.

Game Technologies and Gamification Techniques in Teaching English: An Analysis of Pedagogical Experience

Game technologies (including computer-based ones) applied for teaching English have long occupied an important and permanent place in the structure of the lesson. They are very helpful in developing intercultural communicative competences as well as increasing motivation and self-organization. The purpose of this study is to objectively show how game methods of work and gamification techniques are actually implemented by modern teachers in English classes in both full-time and distance education. The theoretical significance of the study lies in the analysis of empirical psychological and pedagogical research on the problems of teaching English by both domestic and foreign scientists, on the basis of which the authors have compiled a questionnaire to summarize the experience of English teachers, classify electronic games and gamification techniques in the classroom. The study sample consisted of 48 English teachers with teaching experience from 1 to 13 years, the age range of their students being from 3 to 60 years old. The teachers used the questionnaire to analyze their experience in using gamification techniques and game technologies both in face-to-face and online lessons. All the teachers used game methods of work and gamification techniques in their classes regardless of the students’ age. The games that the teachers included in their lessons could be conveniently classified into didactic games (used by two-thirds of the teachers), multiplayer cooperation games (included by every fifth teacher) and hidden object games with a non-linear plot (used in class by a quarter of the teachers in the sample). Most of the teachers who used the gamification techniques noted a steady increase in students’ motivation in the classroom. The practical significance of the research results lies in the possibility of building an individual trajectory of self-education and professional development of English language teachers both in basic and in supplementary education. The generalized practical experience of the teachers who participated in the study can be used as the basis for methodological and pedagogical recommendations for improving informational and communicational competences and pedagogical skills of English language teachers.

The "Neurospeed" game: a fun tool to learn the neurological semiology

BACKGROUND

Neurological semiology is often considered by medical students as particularly difficult to learn. Finding alternative teaching methods may improve students' motivation and understanding of this field.

METHODS

We developed the "Neurospeed", a game to learn neurological syndromes. We assessed its efficiency on short-term learning of neurological syndromes in third-year medical students, through Multiple Choice Questions (MCQs) before and after the game session. Students' satisfaction was evaluated by a satisfaction survey.

RESULTS

Out of the 199 third-year medical students of the Faculty of Medicine Sorbonne Paris Nord, 180 attended the Neurospeed in December 2020, and 148 answered 20 Multiple Choice Questions before and after the game, with significant improvement of their score (p < 0.001). Most of the participants agreed that the game was playful, stimulating, and helpful to learn neurological semiology.

CONCLUSIONS

Overall, our results show that the Neurospeed game is an interesting tool as a complement to traditional lectures. Further studies are necessary to compare the efficacy of different types of serious games on short-term and long-term learning of neurological semiology.

Exploring the experience of nursing undergraduates in using gamification teaching mode based on the flow theory in nursing research: A qualitative study

BACKGROUND

With the development of evidence-based nursing practice, nursing research courses are important in undergraduate programs. However, nursing research courses are highly theoretical, which is difficult for students to understand. Improving the teaching quality of nursing research courses is a challenge for educators.

OBJECTIVES

To understand the learning experience and the effect of gamification teaching on nursing undergraduates, and to provide new ideas for nurse educators.

DESIGN

A qualitative research design using individual semi-structured interviews.

SETTINGS

Gamification teaching was applied in an undergraduate nursing research course over one semester at a university in Central China.

PARTICIPANTS

Purposive sampling was adopted to select nine undergraduate nursing students who had recently completed gamification teaching in a nursing research course.

METHODS

Data were collected through semi-structured interviews and analyzed using Colaizzi's phenomenological method.

RESULTS

Three major themes and seven subthemes emerged from the interviewees' experience: (1) positive attitude (e.g., acceptance with pleasure and flow experience); (2) self-perceived competence improvement (e.g., creative thinking, collaboration, and knowledge internalization and application); and (3) challenges of gamification teaching (e.g., learning pressure and rationality of game design).

CONCLUSIONS

The gamification teaching mode based on the flow theory had a positive effect on the students' learning experience in the nursing research course. It is recommended to improve the game design model and to enhance its effectiveness for classrooms in the future.

User-centered evaluation of Discord in midwifery education during the COVID-19 pandemic: Analysis of the adaptation of the tool to student needs

INTRODUCTION

In the context of the COVID-19 pandemic in 2020, and in order to overcome the lack of face-to-face contact between students and teachers, the midwifery department of Grenoble (France) decided to use the Discord tool in the training of midwifery students. In order to evaluate the relevance of using instant messaging software for the education of future midwives, the tool was evaluated by the students.

METHODS

We conducted, in January 2021, a user-centered online study with all midwifery students in training for the classes of 2020-2021, using the French translation of Anstey and Watson's Rubric for the Evaluation of eLearning Tools. This evaluation analyzed the different dimensions of Discord in the context of training: functionality, accessibility, technology, design, privacy and data protection, social presence, pedagogical presence, and cognitive presence.

RESULTS

Discord had a good functionality for 75% of the students surveyed. They found Discord to be suitable for maintaining social links and creating serious games. But they did not find it useful for following courses or practical work. More than 80% of the midwifery students interviewed agreed that Discord can be adapted to different learning contexts.

CONCLUSIONS

The department can continue to use Discord without reservation for the creation of serious games, as well as for maintaining links between students and teaching staff in the department. Discord has the characteristics of a social network, allowing students to connect with each other.