Courting Apocalypse: Creating a Zombie-Themed Evidence-Based Medicine Game

A meta-narrative review of choose-your-own-adventure style patient case activities in pharmacy education

BACKGROUND

The objective of this review was to characterize the methods of delivery and assessment of Choose Your Own Adventure (CYOA)-style activities in pharmacy education. A secondary objective was to utilize available data to determine best practices for educators interested in developing similar activities.

METHODS

A meta-narrative approach according to the guidance of the RAMESES standards was used for this review. A broad literature search was conducted using PubMed and Embase. Studies published on the use of a CYOA-style patient case format in pharmacy education were identified and appraised individually for their relevance.

RESULTS

Thirteen studies from the pharmacy education literature were included in the review. Activities were delivered for 25 unique topics, largely in small groups during class via patient simulation or interactive data collection software. Overall, students have a positive perception of CYOA-style activities, with positive results regarding knowledge development and student engagement. The most commonly reported challenge to implementing CYOA-style patient case activities was the up-front time commitment to develop activities.

IMPLICATIONS

This review provides a snapshot of the small but expanding body of literature on CYOA-style patient case activities in pharmacy education. CYOA-style activities are recommended for expanded use in pharmacy education as the preponderance of studies that assessed knowledge development showed significant improvement in knowledge after participation in CYOA-style activities. Additionally, students have a positive perception of CYOA-style activities and reported that they were enjoyable, improved their confidence, and helped them learn course material.

Ready Patient One: How to Turn an In-Person Critical Care Simulation Scenario Into an Online Serious Game

Introduction

Serious gaming has become popular in healthcare education as an engaging way to train learners. When coronavirus disease 2019 (COVID-19) forced the cancellation of in-person simulation sessions, we designed a serious game to deliver content in an interactive format with no out-of-pocket expense. We describe the design process and game reception so that others may replicate it.

Methods

We designed an online game using Choose-Your-Own-Adventure (CYOA) and Escape Room concepts. Using online survey software, we presented an interactive story based on an existing simulation scenario and included interactive puzzles as roadblocks to scenario progression. Each puzzle represented a critical care concept, and many contained hyperlinks to prior basic science lecture material to reinforce learning. A post-game survey assessed students’ experience.

Results

All (N=88) students enrolled in a scheduled simulation session participated in the game, and 75% (66/88) responded to a post-participation survey. All respondents (100%) were able to complete the game. The majority (57.6%) completed the game in 30 minutes to 1 hour. Most students strongly agreed or agreed that the game enhanced their understanding of critical care concepts (93.9-97.0%), and that they were interested in doing more CYOA games (90.9%).

Conclusion

The game was well-received, delivered critical care content, and challenged students to apply basic science principles to medical decision-making from the safety of their own homes. The game was self-guided, requiring minimal active facilitator involvement. We plan to expand the use of the game to other settings and explore its use in formative/summative assessment and remediation.

Increasing student engagement using an Amazing Race-style competition

Background:

Game-based learning is a successful strategy for teaching various concepts to students, from general orientations to more in-depth material. Pharmacy students in a first-year lab course were introduced to library and drug information resources through a lecture-style class in their first week of school, which was ineffective in terms of engagement. To combat this issue, the pharmacy liaison librarian advocated for moving this class session later in the semester and proposed a game-based activity to replace the lecture.

Case Presentation:

“The Amazing Race: Drug Information Edition” was inspired by a well-known TV competition that involves completing several stages (called “legs”) of challenges to finish the race. The librarian developed questions designed to make students use various parts of the library website as well as two drug information databases. Students competed in teams, and the first three teams to complete the race were awarded small prizes. The race was first implemented in 2018, and modifications were made to the 2019 iteration based on student feedback.

Conclusions:

Despite several challenges, the race was well received by both the students and the course instructors and increased engagement with introductory library and drug information material. The activity has enhanced the librarian's relationship and collaboration with the course faculty and made a positive impression on the students.

Teaching Medical Students to Create Anesthetic Plans Using a Branched-Chain Learning Module

It is challenging to include medical students in the anesthetic decision-making process during their introductory clinical rotation in anesthesiology. Furthermore, the rotation is often too brief to even expose students to the variety inherent in anesthesia practice. We created a web-based, branched-chain learning module (BCLM) for medical students with alternate narratives and patient outcomes based on their anesthetic choices. In semistructured group interviews, students described how the BCLM met its educational objectives and gave constructive feedback on several ways to improve their experience with it, guiding the future use of BCLMs in medical education.

Choose your own murder: Non-linear narratives enhance student understanding in forensic science education

Higher education teaching in the forensic sciences tends to follow a traditional format of lectures followed by practical laboratory sessions. Sometimes this approach is not possible or viewed as not innovative enough. The free, open access software Twine was used with final year undergraduates in forensic and crime scene science in a UK university in order to create an interactive learning experience based around the creation of non-linear stories. Evaluation of this approach demonstrated the positive impact on student understanding when compared to the traditional lecture model. Students found the experience engaging and were keen to use Twine again.

Teaching the information literacy Framework

Purpose

The purpose of this paper is to outline the concept and creation of choose-your-own-adventure flip-books for use in teaching information literacy in higher education.

Design/methodology/approach

This is a conceptual paper that examines how to use choose-your-own-adventure style flip-books to teach knowledge practices from the Framework for Information Literacy for Higher Education. Using constructivist theory and active learning methods, the authors discuss how flip-books offer a hands-on learning strategy to build on students’ knowledge and experiences while promoting learner-centered interactions.

Findings

As academic libraries evolve from teaching bibliographic instruction via lecture to information literacy through student-centered learning, activities such as the one discussed in this paper provide a way for librarians to better engage with students. Creating curriculum based on educational theory and learner-centered approaches is necessary for librarians to use to optimize classroom time.

Practical implications

This paper provides a practical and pragmatic evaluation of how to incorporate narrative flip-books into information literacy instruction, providing an additional instructional tool for information literacy practitioners.

Originality/value

The choose-your-own-adventure story narrative has been used as a learning tool through all levels of education, including in university settings, but there is a lack of research on their use in information literacy instruction. This paper provides insight on how this teaching method and teaching tool can be used by librarians in the information literacy classroom.

Engaging Students in Searching the Literature

In 2014, the library curriculum for the College of Pharmacy was revised, with the number of sessions increased from one per term for two terms to one per term for three terms, instruction was scaffolded, and the flipped classroom model was employed, with active learning and assessments used throughout. This article will describe how the active learning portion of one session was gamified: why a "serious game" was the correct tool to use to improve student learning, how the game was created, and what was the theory underlying this transformation.

Gamification of a Mobile Applications Lecture in a Pharmacy Course

This report describes a librarian's development of an interactive and competitive trivia game using Poll Everywhere, an audience response system software. The trivia game was implemented during a live lecture session on drug information mobile applications taught to first-year pharmacy students. To add a fun and engaging reference for students, the librarian decided to model the game after HQ, a free trivia gaming app. Development of the session, student response, changes to future iterations, and lessons learned by the librarian are described.