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Aster A, Laupichler MC, Zimmer S, Raupach T. Game design elements of serious games in the education of medical and healthcare professions: a mixed-methods systematic review of underlying theories and teaching effectiveness. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2024:10.1007/s10459-024-10327-1. [PMID: 38563873 DOI: 10.1007/s10459-024-10327-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 03/24/2024] [Indexed: 04/04/2024]
Abstract
Serious games, as a learning resource, enhance their game character by embedding game design elements that are typically used in entertainment games. Serious games in its entirety have already proven their teaching effectiveness in different educational contexts including medical education. The embedded game design elements play an essential role for a game's effectiveness and thus they should be selected based on evidence-based theories. For game design elements embedded in serious games used for the education of medical and healthcare professions, an overview of theories for the selection lacks. Additionally, it is still unclear whether and how single game design elements affect the learning effectiveness. Therefore, the main aim of this systematic review is threefold. Firstly, light will be shed on the single game design elements used in serious games in this area. Second, the game design elements' underlying theories will be worked out, and third, the game design elements' effectiveness on student learning outcome will be assessed. Two literature searches were conducted in November 2021 and May 2022 in six literature databases with keywords covering the fields of educational game design, serious game, and medical education. Out of 1006 initial records, 91 were included after applying predefined exclusion criteria. Data analysis revealed that the three most common game design elements were points, storyline, and feedback. Only four underlying theories were mentioned, and no study evaluated specific game design elements. Since game design elements should be based on theories to ensure meaningful evaluations, the conceptual GATE framework is introduced, which facilitates the selection of evidence-based game design elements for serious games.
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Affiliation(s)
- Alexandra Aster
- Institute of Medical Education, University Hospital Bonn, Venusberg-Campus 1, D-53127, Bonn, Germany.
| | - Matthias Carl Laupichler
- Institute of Medical Education, University Hospital Bonn, Venusberg-Campus 1, D-53127, Bonn, Germany
| | - Saskia Zimmer
- Institute of Medical Education, University Hospital Bonn, Venusberg-Campus 1, D-53127, Bonn, Germany
| | - Tobias Raupach
- Institute of Medical Education, University Hospital Bonn, Venusberg-Campus 1, D-53127, Bonn, Germany
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Rehman U, Pezas T, Timoney N, Atherton D. CleftED: A National Collaborative Study of Undergraduate Education and Exposure to Cleft lip and Palate Within the United Kingdom. Cleft Palate Craniofac J 2023:10556656231211422. [PMID: 37941383 DOI: 10.1177/10556656231211422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023] Open
Abstract
INTRODUCTION Cleft Lip and/or Palate (CLP) are the most common congenital orofacial anomalies. Those involved in CLP care may extend beyond the core members of the Cleft multidisciplinary team (MDT) with a variety of medical healthcare professionals destined to contribute to the management of CLP patients at some point during their respective careers. Therefore, it seems essential that a basic understanding of CLP, CLP-associated problems, and potential avenues for direct or indirect involvement in CLP care be introduced at undergraduate level. AIMS To investigate penultimate and final year undergraduate medical student CLP knowledge and exposure obtained whilst at medical school. METHODOLOGY An online questionnaire was distributed to penultimate and final year medical students throughout the UK. RESULTS A total of 3102 responses were received from 35 medical schools. 44.3% (n = 1374) of respondents had no exposure to CLP teaching up until their current year of education. 61.3% (n = 1903) of respondents had never been involved in the care of a CLP patient. 53.6% (n = 1662) of respondents were not confident in their current knowledge of CLP. 78.5% (n = 2257) of respondents indicated a desire to be involved in the care of CLP patients in their future career. CONCLUSION More than half of the medical student survey respondents were not confident in their current knowledge of CLP and had limited involvement in CLP care. This may translate to a delay in diagnosis when students qualify. Improving CLP education and exposure during undergraduate training can help achieve national CLP standards for early diagnosis.
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Affiliation(s)
- Umar Rehman
- Department of Plastic Surgery, Chelsea and Westminster Hospital, London, UK
| | - Theodore Pezas
- South Thames Cleft Service, Evelina London Children's Hospital, London, UK
| | - Norma Timoney
- South Thames Cleft Service, Evelina London Children's Hospital, London, UK
| | - Duncan Atherton
- South Thames Cleft Service, Evelina London Children's Hospital, London, UK
- School of Medicine, Kings College London, London, UK
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Lee MC, Melcer EF, Merrell SB, Wong LY, Shields S, Eddington H, Trickey AW, Tsai J, Korndorffer JR, Lin DT, Liebert CA. Usability of ENTRUST as an Assessment Tool for Entrustable Professional Activities (EPAs): A Mixed Methods Analysis. JOURNAL OF SURGICAL EDUCATION 2023; 80:1693-1702. [PMID: 37821350 DOI: 10.1016/j.jsurg.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 06/19/2023] [Accepted: 09/08/2023] [Indexed: 10/13/2023]
Abstract
OBJECTIVE As the American Board of Surgery transitions to a competency-based model of surgical education centered upon entrustable professional activities (EPAs), there is a growing need for objective tools to determine readiness for entrustment. This study evaluates the usability of ENTRUST, an innovative virtual patient simulation platform to assess surgical trainees' decision-making skills in preoperative, intra-operative, and post-operative settings. DESIGN This is a mixed-methods analysis of the usability of the ENTRUST platform. Quantitative data was collected using the system usability scale (SUS) and Likert responses. Analysis was performed with descriptive statistics, bivariate analysis, and multivariable linear regression. Qualitative analysis of open-ended responses was performed using the Nielsen-Shneiderman Heuristics framework. SETTING This study was conducted at an academic institution in a proctored exam setting. PARTICIPANTS The analysis includes n = 47 (PGY 1-5) surgical residents who completed an online usability survey following the ENTRUST Inguinal Hernia EPA Assessment. RESULTS The ENTRUST platform had a median SUS score of 82.5. On bivariate and multivariate analyses, there were no significant differences between usability based on demographic characteristics (all p > 0.05), and SUS score was independent of ENTRUST performance (r = 0.198, p = 0.18). Most participants agreed that the clinical workup of the patient was engaging (91.5%) and felt realistic (85.1%). The most frequent heuristics represented in the qualitative analysis included feedback, visibility, match, and control. Additional themes of educational value, enjoyment, and ease-of-use highlighted participants' perspectives on the usability of ENTRUST. CONCLUSIONS ENTRUST demonstrates high usability in this population. Usability was independent of ENTRUST score performance and there were no differences in usability identified in this analysis based on demographic subgroups. Qualitative analysis highlighted the acceptability of ENTRUST and will inform ongoing development of the platform. The ENTRUST platform holds potential as a tool for the assessment of EPAs in surgical residency programs.
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Affiliation(s)
- Melissa C Lee
- Stanford University School of Medicine, Stanford, California
| | - Edward F Melcer
- Department of Computational Media, University of California-Santa Cruz, Baskin School of Engineering, Santa Cruz, California
| | | | - Lye-Yeng Wong
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, California
| | - Samuel Shields
- Department of Computational Media, University of California-Santa Cruz, Baskin School of Engineering, Santa Cruz, California
| | - Hyrum Eddington
- Stanford-Surgery Policy Improvement Research and Education Center (S-SPIRE), Palo Alto, California
| | - Amber W Trickey
- Stanford-Surgery Policy Improvement Research and Education Center (S-SPIRE), Palo Alto, California
| | - Jason Tsai
- Department of Computational Media, University of California-Santa Cruz, Baskin School of Engineering, Santa Cruz, California; Department of Surgery, Stanford University School of Medicine, Stanford, California
| | - James R Korndorffer
- Department of Surgery, Stanford University School of Medicine, Stanford, California; VA Palo Alto Health Care System, Surgical Services, Palo Alto, California
| | - Dana T Lin
- Department of Surgery, Stanford University School of Medicine, Stanford, California
| | - Cara A Liebert
- Department of Surgery, Stanford University School of Medicine, Stanford, California; VA Palo Alto Health Care System, Surgical Services, Palo Alto, California.
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Agha B, Helal NMS, Al-Khafaji TJ, Farie GA, Basri O, Fleming PS. Knowledge assessment on cleft lip and palate among recently graduated dentists: a cross-sectional study. BMC Oral Health 2023; 23:689. [PMID: 37749556 PMCID: PMC10521468 DOI: 10.1186/s12903-023-03388-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 09/04/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND The complex presentation, associated co-morbidities and multi-disciplinary requirements dictate the requirement for in-depth knowledge in order to effectively manage patients with cleft lip and palate (CLP). We aimed to develop a validated questionnaire for cleft lip and palate knowledge assessment and to evaluate the knowledge of cleft lip and palate among a group of recently-graduated dentists. MATERIALS AND METHODS A multiple-site, cross-sectional questionnaire-based study was conducted. The study population included recently graduated dentists involved in a dental internship program. A bespoke questionnaire was developed and validated, with internal consistency assessed using Cronbach's alpha and factor analysis performed. A 47-item prototype was distilled into a 15-item questionnaire. This was distributed to the participants with a response rate of 67% obtained. RESULTS The overall proportion of correct responses among dental interns was moderate (73%). The best results were found in relation to CLP treatment including the effect of unfavorable surgical outcomes on speech (89.5%) and the impact of CLP on the occlusion (87.6%). The lowest rate of correct responses (26.7%) was identified in relation to the association between CLP and smoking. CONCLUSION A validated CLP questionnaire was developed, permitting evaluation of the knowledge of cleft lip and palate and its management among recently graduated dentists. There is limited appreciation among dental interns of the risk factors for CLP as well as post-surgical complications. Given that general dentists are often the gatekeepers for the management of patients with cleft lip and palate, it is important that the findings of this survey are used to inform the curriculum and teaching of cleft lip and palate.
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Affiliation(s)
- Bahn Agha
- Department of Pedodontics, Orthodontics and Preventive Dentistry, College of Dentistry, Mustansiriyah University, Baghdad, Iraq.
| | | | - Thaer Jaber Al-Khafaji
- Pedodontics, Orthodontics and Preventive Dentistry Department, College of Dentistry, University of Babylon, Babylon, Iraq
| | - Ghada Abdullah Farie
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Osama Basri
- Department of Dentistry, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Padhraig S Fleming
- Dublin Dental University Hospital, The University of Dublin, Trinity College Dublin, Dublin, Ireland
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Xu M, Luo Y, Zhang Y, Xia R, Qian H, Zou X. Game-based learning in medical education. Front Public Health 2023; 11:1113682. [PMID: 36935696 PMCID: PMC10020233 DOI: 10.3389/fpubh.2023.1113682] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 02/06/2023] [Indexed: 03/06/2023] Open
Abstract
At present, medical education is rapidly evolving. Game-based learning (GBL) has been gradually used for education, and several innovations have emerged. The emergence of serious games and gamification provides alternative approaches for educators to improve the medical teaching process. Both serious games and gamification exert their education-promoting function by providing the possibility of combining learning activities such as feedback, testing, and spaced repetition with active participation and autonomy as well as positive experiences for students. Developing effective GBL modalities has the potential to bring immersive experiences for medical students and improve their study outcomes. Herein, we reviewed recent studies employing GBL in medical education, including serious games and gamification teaching. Furthermore, we also discussed the effectiveness and limitations of GBL to suggest future directions for the development and application of GBL in medical education.
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Affiliation(s)
- Maosen Xu
- Division of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yong Luo
- Department of Head and Neck Oncology, West China Hospital, Sichuan University, Chengdu, China
| | - Yu Zhang
- Division of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Ruolan Xia
- Division of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Hong Qian
- Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Hong Qian
| | - Xiuhe Zou
- Department of Thyroid Surgery, West China Hospital, Sichuan University, Chengdu, China
- Xiuhe Zou
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Marques C, Correia E, Dinis LT, Vilela A. An Overview of Sensory Characterization Techniques: From Classical Descriptive Analysis to the Emergence of Novel Profiling Methods. Foods 2022; 11:foods11030255. [PMID: 35159407 PMCID: PMC8834440 DOI: 10.3390/foods11030255] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/05/2022] [Accepted: 01/12/2022] [Indexed: 12/12/2022] Open
Abstract
Sensory science provides objective information about the consumer understanding of a product, the acceptance or rejection of stimuli, and the description of the emotions evoked. It is possible to answer how consumers perceive a product through discriminative and descriptive techniques. However, perception can change over time, and these fluctuations can be measured with time-intensity methods. Instrumental sensory devices and immersive techniques are gaining headway as sensory profiling techniques. The authors of this paper critically review sensory techniques from classical descriptive analysis to the emergence of novel profiling methods. Though research has been done in the creation of new sensory methods and comparison of those methods, little attention has been given to the timeline approach and its advantages and challenges. This study aimed to gather, explain, simplify, and discuss the evolution of sensory techniques.
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Affiliation(s)
- Catarina Marques
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro, Apartado 1013, 5001-801 Vila Real, Portugal; (C.M.); (L.-T.D.)
| | - Elisete Correia
- Center for Computational and Stochastic Mathematics (CEMAT), Department of Mathematics, University of Trás-os-Montes and Alto Douro, Apartado 1013, 5001-801 Vila Real, Portugal;
| | - Lia-Tânia Dinis
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro, Apartado 1013, 5001-801 Vila Real, Portugal; (C.M.); (L.-T.D.)
| | - Alice Vilela
- Chemistry Research Centre (CQ-VR), Department of Biology and Environment, School of Life Science and Environment, University of Trás-os-Montes e Alto Douro, Apartado 1013, 5001-801 Vila Real, Portugal
- Correspondence:
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Mehrotra D, Markus A. Emerging simulation technologies in global craniofacial surgical training. J Oral Biol Craniofac Res 2021; 11:486-499. [PMID: 34345584 PMCID: PMC8319526 DOI: 10.1016/j.jobcr.2021.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 06/22/2021] [Indexed: 12/14/2022] Open
Abstract
The last few decades have seen an exponential growth in the development and adoption of novel technologies in medical and surgical training of residents globally. Simulation is an active and innovative teaching method, and can be achieved via physical or digital models. Simulation allows the learners to repeatedly practice without the risk of causing any error in an actual patient and enhance their surgical skills and efficiency. Simulation may also allow the clinical instructor to objectively test the ability of the trainee to carry out the clinical procedure competently and independently prior to trainee's completion of the program. This review aims to explore the role of emerging simulation technologies globally in craniofacial training of students and residents in improving their surgical knowledge and skills. These technologies include 3D printed biomodels, virtual and augmented reality, use of google glass, hololens and haptic feedback, surgical boot camps, serious games and escape games and how they can be implemented in low and middle income countries. Craniofacial surgical training methods will probably go through a sea change in the coming years, with the integration of these new technologies in the surgical curriculum, allowing learning in a safe environment with a virtual patient, through repeated exercise. In future, it may also be used as an assessment tool to perform any specific procedure, without putting the actual patient on risk. Although these new technologies are being enthusiastically welcomed by the young surgeons, they should only be used as an addition to the actual curriculum and not as a replacement to the conventional tools, as the mentor-mentee relationship can never be replaced by any technology.
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Affiliation(s)
- Divya Mehrotra
- Department of Oral and Maxillofacial Surgery KGMU, Lucknow, India
| | - A.F. Markus
- Emeritus Consultant Maxillofacial Surgeon, Poole Hospital University of Bournemouth, University of Duisburg-Essen, Trinity College, Dublin, Ireland
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