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Cutica I, Cincidda C, Oliveri S, Mainetti R, Borghese NA, Pravettoni G. Effectiveness of Serious Games in Improving Genetic Literacy and Genetic Risk Awareness in the General Public: A Pilot Study. Games Health J 2024; 13:75-83. [PMID: 37878321 DOI: 10.1089/g4h.2022.0041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023] Open
Abstract
Background: Genomics is an integral part of medical science; however, European citizens' literacy on basic genetic concepts is still poor. The aim of this study was to evaluate the effectiveness of Serious Games (SGs) in increasing genetic literacy in laypeople and to assess the impact of SGs on participants' perceived self-efficacy (SE) in managing genetic risk implications. Materials and Methods: Two minigames and an adventure game were created, together with leaflets reporting the same information as the SGs. Sixty participants enrolled at baseline and completed a brief sociodemographic questionnaire and an ad hoc questionnaire assessing their genetic knowledge. They were assigned to the SGs group (30 subjects) or to the Leaflets group (30 subjects) by matching age and sex. Both groups had about 40 minutes to play the SGs or to read the leaflets. In the postlearning session, participants completed the same genetic knowledge questionnaires administered at baseline and five items from the Self-Efficacy Scale, whereas the SGs group also filled in the In-Game Experience Questionnaire. Results and Conclusion: Results showed that learning genetic concepts through SGs was comparable to learning through leaflets. Playing SGs was also associated with poor feelings of frustration or annoyance, good engagement in the game challenges and contents, and positive feelings, particularly in subjects under 30 years. Participants perceiving SE increased significantly in both Leaflets and SGs groups, but the effect was higher for SGs players. SGs have the potential to increase genetic literacy in the public by making the learning process more engaging, pleasant and by enhancing SE.
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Affiliation(s)
- Ilaria Cutica
- Department of Oncology and Hemato-Oncology (DIPO), University of Milan, Milan, Italy
| | - Clizia Cincidda
- Department of Oncology and Hemato-Oncology (DIPO), University of Milan, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Serena Oliveri
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Renato Mainetti
- Applied Intelligent Systems Laboratory (AISLab), Department of Computer Science, Università degli Studi di Milano, Milan, Italy
| | - N Alberto Borghese
- Applied Intelligent Systems Laboratory (AISLab), Department of Computer Science, Università degli Studi di Milano, Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology (DIPO), University of Milan, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
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Wang Z, Li K, Guo S, Wen X, He Z, Cai Y. Can Moving More and Sitting Less Improve the Academic Engagement of Adolescents?- A Study Based on Junior High School Students in Shanghai, China. Psychol Res Behav Manag 2023; 16:4155-4168. [PMID: 37868655 PMCID: PMC10588746 DOI: 10.2147/prbm.s427214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 10/09/2023] [Indexed: 10/24/2023] Open
Abstract
Purpose The purpose of this study was to examine the relationships between academic engagement and moderate-to-vigorous physical activity (MVPA), muscle-strengthening exercise (MSE) and sedentary behavior (SB) among adolescents, so as to provide evidence from the perspective of exercising for students to learn efficiently, teachers to improve classroom teaching, and schools to improve educational quality. Methods A questionnaire survey was conducted in 12 junior high schools in Shanghai, China, which were selected by a multi-stage stratified cluster sampling method. Then, with the valid data of 2078 students collected from the survey. A data analysis was performed using SPSS Statistics 26.0. Multiple linear regression models were adopted to analyze the factors affecting adolescent academic engagement and to determine whether MVPA, MSE, and SB play roles in it. Results (1) The differences in academic engagement depended on the exercise adherence to the recommended amount of MVPA, MSE, and screen-based SB. (2) In terms of the three independent variables of total time, MSE (β = 0.206) and MVPA (β = 0.175) showed a significant positive correlation with academic engagement, while SB (β = -0.155) was negatively correlated with academic engagement. (3) From the linear regression model of eight combination groups divided by the exercise adherence to the recommended amount of MVPA, MSE and SB, the group that met none of the recommendations (β = -0.235) showed a significant negative effect on academic engagement, while the groups that met any two or all three of the recommendations demonstrated strong positive correlations with academic engagement (P < 0.001). Conclusion Increasing adolescents' muscle-strengthening exercise and moderate-to-vigorous physical activity and reducing sedentary behavior can effectively promote academic engagement. Therefore, adolescents are suggested to reach the recommended amounts of physical activity, muscle-strengthening exercise, and sedentary behavior so as to improve academic engagement more effectively.
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Affiliation(s)
- Zisu Wang
- School of Physical Education, Shanghai University of Sport, Shanghai, People’s Republic of China
| | - Kai Li
- School of Physical Education, Shanghai University of Sport, Shanghai, People’s Republic of China
| | - Shuangshuang Guo
- Physical education Group, High school Attached to Shanghai Normal University Minhang Campus, Shanghai, People’s Republic of China
| | - Xili Wen
- School of Physical Education, Shanghai University of Sport, Shanghai, People’s Republic of China
| | - Ziyi He
- School of Physical Education, Shanghai University of Sport, Shanghai, People’s Republic of China
| | - Yujun Cai
- School of Physical Education, Shanghai University of Sport, Shanghai, People’s Republic of China
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Sandoval-Hernández I, Molina-Torres G, León-Morillas F, Ropero-Padilla C, González-Sánchez M, Martínez-Cal J. Analysis of different gamification-based teaching resources for physiotherapy students: a comparative study. BMC MEDICAL EDUCATION 2023; 23:675. [PMID: 37723502 PMCID: PMC10506183 DOI: 10.1186/s12909-023-04576-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 08/08/2023] [Indexed: 09/20/2023]
Abstract
BACKGROUND For health professionals, gamification is a new teaching method that has achieved an important role in recent years, with excellent results in learning and knowledge acquisition. Thus, the objective of this study was to analyze the gaming experience through different gamification resources in the classroom with physiotherapy students. METHODS A comparative study on gamification-based teaching resources was carried out during the first semester of the 2021-2022 academic year. A total of 33 physiotherapy students participated in this study. After the theoretical topics were taught, the participants were invited to participate in different gamification resources such as Kahoot!, Physiotherapy Party and Escape Room. The gaming experience with the different gamification resources was measured with the GAMEX scale. RESULTS The Physiotherapy Party showed a higher score in relation to the enjoyment dimension compared to the Kahoot! and Escape Room (p = 0.004). The Escape Room presented higher scores in absorption, creative thinking, activation and dominance compared to Kahoot! and Physiotherapy Party (p < 0.005). CONCLUSIONS Gamification resources promote enjoyment and creativity in the students in the classroom. The use of new teaching methods based on gamification, such as Escape Room as Physiotherapy Party should be considered as first choice in the use of gamification resources due to the benefits they bring to students.
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Affiliation(s)
- Irene Sandoval-Hernández
- Faculty of Health Sciences, Department of Physical Therapy, University of Granada, Melilla, Spain
| | - Guadalupe Molina-Torres
- Faculty of Health Sciences, Department of Nursing, Physiotherapy and Medicine, University of Almeria, Carretera Sacramento S/N, Almeria, 04120, Spain
| | - Felipe León-Morillas
- Faculty of Health Sciences, Department of Physiotherapy, University Catholic of Murcia - UCAM, Murcia, Spain
| | - Carmen Ropero-Padilla
- Faculty of Health Sciences, Department of Nursing, Physiotherapy and Medicine, University of Almeria, Carretera Sacramento S/N, Almeria, 04120, Spain.
| | - Manuel González-Sánchez
- Faculty of Health Sciences, Department of Physiotherapy, University of Malaga, Almeria, Spain
- Biomedical Research Institute of Malaga (IBIMA), Málaga, 29010, Spain
| | - Jesús Martínez-Cal
- Faculty of Health Sciences, Department of Nursing, Physiotherapy and Medicine, University of Almeria, Carretera Sacramento S/N, Almeria, 04120, Spain
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Developing a Video Game as an Awareness and Research Tool Based on SARS-CoV-2 Epidemiological Dynamics and Motivational Perspectives. Transbound Emerg Dis 2023. [DOI: 10.1155/2023/8205408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
In mid-2020, the University of Liège (ULiège, Belgium) commissioned the ULiège Video Game Research Laboratory (Liège Game Lab) and the AR/VR Lab of the HEC-Management School of ULiège to create a serious game to raise awareness of preventive measures for its university community. This project has its origins in two objectives of the institutional policy of ULiège in response to the crisis caused by SARS-CoV-2 to raise awareness among community members of various preventive actions that can reduce the spread of the virus and to inform about the emergence and progression of a pandemic. After almost two years of design, the project resulted in the creation of SARS Wars, a decision-making management game for browsers and smartphones. This article presents the creative process of the game, specifically the integration of an adapted SEIR (susceptible-exposed-infectious-recovered) model, as well as the modeling of intercompartmental circulation dynamics in the game’s algorithm, and the various limitations observed regarding the game’s original missions and possibilities for future work. The SARS-CoV-2 video game project may be considered an innovative way to translate epidemiology into a language that can be used in the scope of citizen sciences. On the one hand, it provides an engaging tool and encourages active participation of the audience. On the other hand, it allows us to have a better understanding of the dynamic changes of a pandemic or an epidemic (crisis preparedness, monitoring, and control) and to anticipate potential consequences in the given parameters at set time (emerging risk identification), while offering insights for impact on some parameters on motivation (social science aspect).
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Nicholson M, Bennett JM, Modesto O, Gould R. Understanding University Students during COVID-19: A Longitudinal Mixed-Methods Analysis of Their Experiences of Online Learning, Mental Health, Academic Engagement, and Academic Self-Efficacy. Psychopathology 2023; 56:342-358. [PMID: 36731439 PMCID: PMC9940262 DOI: 10.1159/000528441] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 11/28/2022] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Research has consistently demonstrated that the COVID-19 pandemic, and resulting sudden shift to online learning (OL), had detrimental impacts on the motivation and mental health of university students. To date however this research has been cross-sectional and quantitative. METHOD This study employed a mixed-methods design to examine the experiences of students at a large national Australian University both at the outset of the pandemic in 2020 (n = 824) and again 6 months later (n = 254) at the conclusion of their academic year. RESULTS Key findings from this study highlighted that despite quantitative findings suggesting poorer attitudes toward learning during the pandemic, qualitatively students perceived both positives and negatives to studying online. The qualitative results further highlighted that this experience was not the same for all and suggests the need to reconsider the standard approaches to offering support for students. CONCLUSION Students reported poor mental health in both time points, but outlined avenues which improved not only their mental health but also their motivation for studying such as increased peer engagement and self-care activities. Students reported that OL negatively impacted on both their engagement with studies and their mental health, highlighting the need for universities to prioritize supporting their students' mental health as much as their development of academic skills.
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Affiliation(s)
| | | | - Oscar Modesto
- School of Behavioural and Health Sciences, Australian Catholic University, Strathfield, New South Wales, Australia
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Use of Screen-Based Simulation in Nursing Schools in France: A National, Descriptive Study. Clin Simul Nurs 2022. [DOI: 10.1016/j.ecns.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Li C, Ning G, Xia Y, Guo K, Liu Q. Does the Internet Bring People Closer Together or Further Apart? The Impact of Internet Usage on Interpersonal Communications. Behav Sci (Basel) 2022; 12:bs12110425. [PMID: 36354402 PMCID: PMC9687672 DOI: 10.3390/bs12110425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/27/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022] Open
Abstract
The complementarity interference (CI) model suggests that the Internet may either inhibit or facilitate interpersonal communications. This paper empirically examines the impact of Internet usage on interpersonal interactions, using a micro dataset from China to answer whether the Internet brings people closer together or further apart. The empirical results demonstrate, first, that Internet usage significantly increases both the time and frequency of people’s communications with their family and friends, rather than causing them to feel more disconnected and isolated. Holding other factors constant, for each one-standard-deviation increase in Internet usage, weekly communications with family members increases by an average of 102.150 min, while there is an average increase of 54.838 min in interactions with friends. These findings as to its positive effects are robust when using other regression models and interpersonal contact measures, as well as the instrumental variable method. Second, Internet usage also contributes to decreased loneliness; it exerts this effect primarily by improving people’s interactions with their family members. However, communications with friends do not significantly mediate such impacts. Third, the positive role of Internet usage on communications is more prominent for people with more frequent online socialization and self-presentation, better online skills, younger age, higher educational level, and who are living in urban areas. In addition, the beneficial effects of Internet usage are larger for communications with family members in the case of migrants. Therefore, in the context of the rapid development of information technology, the network infrastructure should be improved to make better use of the Internet to facilitate interpersonal communications and promote people’s wellness.
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Affiliation(s)
- Chao Li
- Business School, Shandong University, Weihai 264209, China
- Correspondence: (C.L.); (G.N.)
| | - Guangjie Ning
- Business School, Shandong University, Weihai 264209, China
- Correspondence: (C.L.); (G.N.)
| | - Yuxin Xia
- HSBC Business School, Peking University, Shenzhen 518055, China
| | - Kaiyi Guo
- Business School, Shandong University, Weihai 264209, China
| | - Qianqian Liu
- Business School, Shandong University, Weihai 264209, China
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Utilizing educational technology in enhancing undergraduate nursing students' engagement and motivation: A scoping review. J Prof Nurs 2022; 42:262-275. [DOI: 10.1016/j.profnurs.2022.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 07/17/2022] [Accepted: 07/21/2022] [Indexed: 11/19/2022]
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9
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Landis AM, Cieslowski BJ. An Innovative Teaching Modality to Promote Proficient Gender-Affirming Care. Clin Simul Nurs 2022. [DOI: 10.1016/j.ecns.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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10
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Mendoza López M, Albaladejo Ortega S, Pardo Ríos M, Melendreras Ruiz R. Serious Games for Health, una herramienta efectiva para el entrenamiento de los profesionales sanitarios. Aten Primaria 2022; 54:102376. [PMID: 35636022 PMCID: PMC9156874 DOI: 10.1016/j.aprim.2022.102376] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 04/21/2022] [Indexed: 11/19/2022] Open
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Gómez-Urquiza JL, Requena-Palomares I, Gorjón-Peramato E, Gómez-Salgado J, Cañadas-De la Fuente GA, Albendín-García L. Emergency and critical care professionals' opinion on escape room as a health sciences evaluation game: A cross-sectional descriptive study. Medicine (Baltimore) 2022; 101:e29432. [PMID: 35758377 PMCID: PMC9276226 DOI: 10.1097/md.0000000000029432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 04/20/2022] [Indexed: 11/26/2022] Open
Abstract
New teaching and evaluation methods are growing in health sciences. The escape room is a game that is showing benefits for assessing knowledge and important competencies in healthcare professionals. The aim of this study is to analyse the opinion of emergency and critical care professionals on the use of escape rooms as an evaluation game.A quantitative, descriptive, cross-sectional study was conducted using an ad-hoc questionnaire with a Likert-type scale. The study included emergency and critical care professionals who participated in the escape room "The Frustrated Emergency and Critical Care Professional," that took place during an emergency and critical care national congress. Data collection was carried out in June 2019.The sample was composed of n = 50 emergency and critical care professionals, 52% of whom were physicians and 48% were nurses. Professionals believe that this is a good teaching game for evaluation and useful for strengthen knowledge (4.7 points), as well as to improve teamwork and the ability to work under pressure (4.9).The escape room is a useful evaluation game in the context of emergency and critical care units that also allows training the teamwork and working under pressure competencies.
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Affiliation(s)
- Jose L. Gómez-Urquiza
- Nursing Department, Faculty of Health Sciences, University of Granada, Granada, Spain
| | | | | | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health. Faculty of Labour Sciences, University of Huelva, Huelva, Spain
- Safety and Health Posgraduate Programme. University Espíritu Santo, Guayaquil, Ecuador
| | | | - Luis Albendín-García
- Nursing Department, Faculty of Health Sciences, University of Granada, Granada, Spain
- La Chana Health Center, Andalusian Health Service, Junta de Andalucia, Granada, Spain
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Revealing the theoretical basis of gamification: A systematic review and analysis of theory in research on gamification, serious games and game-based learning. COMPUTERS IN HUMAN BEHAVIOR 2021. [DOI: 10.1016/j.chb.2021.106963] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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13
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Maheu-Cadotte MA, Dubé V, Cossette S, Lapierre A, Fontaine G, Deschênes MF, Lavoie P. Involvement of End Users in the Development of Serious Games for Health Care Professions Education: Systematic Descriptive Review. JMIR Serious Games 2021; 9:e28650. [PMID: 34129514 PMCID: PMC8414295 DOI: 10.2196/28650] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/11/2021] [Accepted: 06/15/2021] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND On the basis of ethical and methodological arguments, numerous calls have been made to increase the involvement of end users in the development of serious games (SGs). Involving end users in the development process is considered a way to give them power and control over educational software that is designed for them. It can also help identify areas for improvement in the design of SGs and improve their efficacy in targeted learning outcomes. However, no recognized guidelines or frameworks exist to guide end users' involvement in SG development. OBJECTIVE The aim of this study is to describe how end users are involved in the development of SGs for health care professions education. METHODS We examined the literature presenting the development of 45 SGs that had reached the stage of efficacy evaluation in randomized trials. One author performed data extraction using an ad hoc form based on a design and development framework for SGs. Data were then coded and synthesized on the basis of similarities. The coding scheme was refined iteratively with the involvement of a second author. Results are presented using frequencies and percentages. RESULTS End users' involvement was mentioned in the development of 21 of 45 SGs. The number of end users involved ranged from 12 to 36. End users were often involved in answering specific concerns that arose during the SG design (n=6) or in testing a prototype (n=12). In many cases, researchers solicited input from end users regarding the goals to reach (n=10) or the functional esthetics of the SGs (n=7). Most researchers used self-reported questionnaires (n=7). CONCLUSIONS Researchers mentioned end users' involvement in the development of less than half of the identified SGs, and this involvement was also poorly described. These findings represent significant limitations to evaluating the impact of the involvement of end users on the efficacy of SGs and in making recommendations regarding their involvement.
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Affiliation(s)
- Marc-André Maheu-Cadotte
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.,Research Center, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada.,Research Center, Montreal Heart Institute, Montreal, QC, Canada
| | - Véronique Dubé
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.,Research Center, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Sylvie Cossette
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.,Research Center, Montreal Heart Institute, Montreal, QC, Canada
| | | | - Guillaume Fontaine
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.,Research Center, Montreal Heart Institute, Montreal, QC, Canada
| | | | - Patrick Lavoie
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.,Research Center, Montreal Heart Institute, Montreal, QC, Canada
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Zairi I, Dhiab MB, Mzoughi K, Mrad IB, Abdessalem IB, Kraiem S. Serious Game Design with medical students as a Learning Activity for Developing the 4Cs Skills: Communication, Collaboration, Creativity and Critical Thinking: A qualitative research. LA TUNISIE MEDICALE 2021; 99:714-720. [PMID: 35261002 PMCID: PMC8796679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION The impact of technology in education has led to various changes in the way that different stakeholders, like students and teachers work and interact with each other. The use of the serious game design in educational contexts has been related to the development of the 21st century skills such as communication, collaboration, creativity and critical thinking. AIM To analyze a serious game design process by third -year medical students, from the perspective of the 21st century competencies engaged in the game design process. Those outlined key competencies are communication, collaboration, creativity and critical thinking. METHODS This is a qualitative, descriptive, and inductive study that follows a phenomenological approach. Twelve volunteer third-year medical students participated in an activity of designing of serious games. This study, carried out during summer internship in the cardiology department of Habib Thameur Hospital. The course of the designing of serious games with students spread over 4 weeks with 10 hours face-to-face and 10 hours of remote work. RESULTS The participants in our study were twelves third-year medical students. Of these 12 students, 10 were female. The duration of each interview depends on each participant's ability. The analysis of the data, based on the phenomenological method of Giorgi brought out four central themes: theme 1: Critical thinking skills and problems solving skills, theme 2: Communication, theme 3: Creativity, theme 4: Collaboration. The overall essence of the phenomenon is these third medical students who experienced the serious game design outlined key competencies. CONCLUSION Using serious game development-based learning as a learning method to impart multidimensional skills and knowledge suggests a promising approach for developing clinical reasoning, creativity, communication, and collaboration in students.
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Affiliation(s)
- Ihsen Zairi
- 1- Service de cardiologie, Hôpital Habib Thameur, Faculté de médecine de Tunis
| | | | - Khadija Mzoughi
- 1- Service de cardiologie, Hôpital Habib Thameur, Faculté de médecine de Tunis
| | - Imtinen Ben Mrad
- 1- Service de cardiologie, Hôpital Habib Thameur, Faculté de médecine de Tunis
| | - Imen Ben Abdessalem
- 3- Service de cardiologie, Hôpital Farhat Hached, Faculté de médecine de Sousse
| | - Sondos Kraiem
- 1- Service de cardiologie, Hôpital Habib Thameur, Faculté de médecine de Tunis
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Maheu-Cadotte MA, Cossette S, Dubé V, Fontaine G, Lavallée A, Lavoie P, Mailhot T, Deschênes MF. Efficacy of Serious Games in Healthcare Professions Education: A Systematic Review and Meta-analysis. Simul Healthc 2021; 16:199-212. [PMID: 33196609 DOI: 10.1097/sih.0000000000000512] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
SUMMARY STATEMENT Serious games (SGs) are interactive and entertaining software designed primarily with an educational purpose. This systematic review synthesizes evidence from experimental studies regarding the efficacy of SGs for supporting engagement and improving learning outcomes in healthcare professions education. Randomized controlled trials (RCTs) published between January 2005 and April 2019 were included. Reference selection and data extraction were performed in duplicate, independently. Thirty-seven RCTs were found and 29 were included in random-effect meta-analyses. Compared with other educational interventions, SGs did not lead to more time spent with the intervention {mean difference 23.21 minutes [95% confidence interval (CI) = -1.25 to 47.66]}, higher knowledge acquisition [standardized mean difference (SMD) = 0.16 (95% CI = -0.20 to 0.52)], cognitive [SMD 0.08 (95% CI = -0.73 to 0.89)], and procedural skills development [SMD 0.05 (95% CI = -0.78 to 0.87)], attitude change [SMD = -0.09 (95% CI = -0.38 to 0.20)], nor behavior change [SMD = 0.2 (95% CI = -0.11 to 0.51)]. Only a small SMD of 0.27 (95% CI = 0.01 to 0.53) was found in favor of SGs for improving confidence in skills.
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Affiliation(s)
- Marc-André Maheu-Cadotte
- From the Faculty of Nursing of the Université de Montréal (S.C., V.D., G.F., A.L., P.L., M.-F.D.); Montreal Heart Institute Research Center (S.C., P.L., T.M.); Research Center of the Université de Montréal Hospital Center (V.D.); CHU Ste-Justine Research Center (AL), Montreal, Quebec, Canada; Department of Pharmacy and Health Systems Sciences, Bouvé College of Health Sciences (T.M.), Boston, MA; and Center for Innovation in Nursing Education (M.-F.D.), Montreal, Quebec, Canada
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Raupach T, de Temple I, Middeke A, Anders S, Morton C, Schuelper N. Effectiveness of a serious game addressing guideline adherence: cohort study with 1.5-year follow-up. BMC MEDICAL EDUCATION 2021; 21:189. [PMID: 33785000 PMCID: PMC8008024 DOI: 10.1186/s12909-021-02591-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 02/28/2021] [Indexed: 06/10/2023]
Abstract
BACKGROUND Patients presenting with acute shortness of breath and chest pain should be managed according to guideline recommendations. Serious games can be used to train clinical reasoning. However, only few studies have used outcomes beyond student satisfaction, and most of the published evidence is based on short-term follow-up. This study investigated the effectiveness of a digital simulation of an emergency ward regarding appropriate clinical decision-making. METHODS In this prospective trial that ran from summer 2017 to winter 2018/19 at Göttingen Medical University Centre, a total of 178 students enrolled in either the fourth or the fifth year of undergraduate medical education took six 90-min sessions of playing a serious game ('training phase') in which they managed virtual patients presenting with various conditions. Learning outcome was assessed by analysing log-files of in-game activity (including choice of diagnostic methods, differential diagnosis and treatment initiation) with regard to history taking and patient management in three virtual patient cases: Non-ST segment elevation myocardial infarction (NSTEMI), pulmonary embolism (PE) and hypertensive crisis. Fourth-year students were followed up for 1.5 years, and their final performance was compared to the performance of students who had never been exposed to the game but had otherwise taken the same five-year undergraduate course. RESULTS During the training phase, overall performance scores increased from 57.6 ± 1.1% to 65.5 ± 1.2% (p < 0.001; effect size 0.656). Performance remained stable over 1.5 years, and the final assessment revealed a strong impact of ever-exposure to the game on management scores (72.6 ± 1.2% vs. 63.5 ± 2.1%, p < 0.001; effect size 0.811). Pre-exposed students were more than twice as likely to correctly diagnose NSTEMI and PE and showed significantly greater adherence to guideline recommendations (e.g., troponin measurement and D-dimer testing in suspected PE). CONCLUSIONS The considerable difference observed between previously exposed and unexposed students suggests a long-term effect of using the game although retention of specific virtual patient cases rather than general principles might partially account for this effect. Thus, the game may foster the implementation of guideline recommendations.
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Affiliation(s)
- Tobias Raupach
- Department of Cardiology and Pneumology, Göttingen University Medical Centre, Robert-Koch-Straße 40, 37075 Göttingen, Germany
- Department of Medical Education, University Hospital Bonn, Venusberg-Campus 1, Gebäude 33, 53127 Bonn, Germany
| | - Insa de Temple
- Department of Cardiology and Pneumology, Göttingen University Medical Centre, Robert-Koch-Straße 40, 37075 Göttingen, Germany
| | - Angélina Middeke
- Department of Cardiology and Pneumology, Göttingen University Medical Centre, Robert-Koch-Straße 40, 37075 Göttingen, Germany
| | - Sven Anders
- Department of Legal Medicine, University Medical Centre Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Germany
| | - Caroline Morton
- Nuffield Department of Primary Care Health Sciences, Medical Sciences Division, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG UK
| | - Nikolai Schuelper
- Medius KLINIK Ostfildern-Ruit, Hedelfinger Straße 166, 73760 Ostfildern-Ruit, Germany
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Kimura K, Moussavi Z. Do Older and Young Adults Learn to Integrate Geometry While Navigating in an Environment of a Serious Game? Neurosci Insights 2021; 16:2633105520988861. [PMID: 33709080 PMCID: PMC7841238 DOI: 10.1177/2633105520988861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 12/31/2020] [Indexed: 11/24/2022] Open
Abstract
We evaluated the outcomes of an intervention using a serious game designed to be
played on iPads for improving spatial reorientation by training users to
integrate geometry of the environment, instead of relying solely on featural
cues. Using data logged online through a clinical study of using this game, the
effect of training among 16 older adults (69.3 ± 6.4 years, 4 males), who played
the game repeatedly (self-administered) over a period of 8 weeks, was
investigated. The game contains a hexagonal room with 3 objects, textured walls,
and grids on the floor, which are removed one by one as the participant played
the game. In each level, the room also rotates such that the viewpoint of the
user is different from that of the previous level. Participants cannot play a
higher level unless they make no mistake during the trials of the lower test
level. In addition to data of older adults available from that clinical trial,
we recruited 16 young adults (27.3 ± 5.6 years, 4 males) to play the game for 5
sessions and compared their results with those of the older adults. We evaluated
the error type made in each test level and the scores for each session among
older adults. Further, we compared the frequency of each error type between
young and older adults during the test levels that a landmark adjacent to the
target was removed over the first 5 sessions. The results of older adults’
performance suggest they learned to make fewer mistakes over the sessions. Also,
both young and older adults learned to integrate the geometrical cues rather
than relying on the landmark cue adjacent to the target to find the target.
Overall, the results indicate the designed hexagonal room game can enhance
spatial cognition among all age groups of adults.
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Affiliation(s)
- Kazushige Kimura
- Graduate Program in Biomedical Engineering, University of Manitoba, Winnipeg, MB, Canada
| | - Zahra Moussavi
- Graduate Program in Biomedical Engineering, University of Manitoba, Winnipeg, MB, Canada
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18
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Investing in Engagement: Integrating Virtual Learning Experiences across an Undergraduate Nursing Program. Clin Simul Nurs 2021. [DOI: 10.1016/j.ecns.2020.12.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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19
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Gamifying quantitative face-to-face interviews in rural India: An empirical evaluation based on the basic psychological needs theory. PLoS One 2021; 16:e0244077. [PMID: 33507924 PMCID: PMC7842934 DOI: 10.1371/journal.pone.0244077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 12/02/2020] [Indexed: 12/03/2022] Open
Abstract
Objective Standardized face-to-face interviews are widely used in low and middle-income countries to collect data for social science and health research. Such interviews can be long and tedious. In an attempt to improve the respondents’ experience of interviews, we developed a concept of gamified interview format by including a game element. Gamification is reported to increase engagement in tasks, but results from rigorously developed research are equivocal, and a theory of gamification is still needed. Materials & methods We evaluated the proposed gamification with a randomized controlled trial based on self-determination theory, specifically on the basic psychological needs theory. In total, 1266 respondents were interviewed. Single and multiple mediation analyses were used to understand the effects of the gamified interview format. Results Our evaluation showed that the gamification we had developed did not improve the outcome, the experience of the interview reported by respondent. The effect of the gamified interview format depended on the ability of respondents: gamification can be counterproductive if it overburdens the respondents. However, the basic psychological needs theory explained the mechanisms of action of gamification well: feeling competent and related to others improved the reported experience of the interview. Conclusion We emphasize the need to develop context-specific gamification and invite researchers to conduct equivalently rigorous evaluations of gamification in future studies.
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20
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Differentiating the Design Principles of Virtual Simulations and Serious Games to Enhance Nurses' Clinical Reasoning. Clin Simul Nurs 2020. [DOI: 10.1016/j.ecns.2020.04.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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21
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Benda NC, Kellogg KM, Hoffman DJ, Fairbanks RJ, Auguste T. Lessons Learned From an Evaluation of Serious Gaming as an Alternative to Mannequin-Based Simulation Technology: Randomized Controlled Trial. JMIR Serious Games 2020; 8:e21123. [PMID: 32985993 PMCID: PMC7551111 DOI: 10.2196/21123] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 07/28/2020] [Accepted: 08/03/2020] [Indexed: 01/19/2023] Open
Abstract
Background The use of new technology like virtual reality, e-learning, and serious gaming can offer novel, more accessible options that have been demonstrated to improve learning outcomes. Objective The aim of this study was to compare the educational effectiveness of serious game–based simulation training to traditional mannequin-based simulation training and to determine the perceptions of physicians and nurses. We used an obstetric use case, namely electronic fetal monitoring interpretation and decision making, for our assessment. Methods This study utilized a mixed methods approach to evaluate the effectiveness of the new, serious game–based training method and assess participants’ perceptions of the training. Participants were randomized to traditional simulation training in a center with mannequins or serious game training. They then participated in an obstetrical in-situ simulation scenario to assess their learning. Participants also completed a posttraining perceptions questionnaire. Results The primary outcome measure for this study was the participants’ performance in an in-situ mannequin-based simulation scenario, which occurred posttraining following a washout period. No significant statistical differences were detected between the mannequin-based and serious game–based groups in overall performance, although the study was not sufficiently powered to conclude noninferiority. The survey questions were tested for significant differences in participant perceptions of the educational method, but none were found. Qualitative participant feedback revealed important areas for improvement, with a focus on game realism. Conclusions The serious game training tool developed has potential utility in providing education to those without access to large simulation centers; however, further validation is needed to demonstrate if this tool is as effective as mannequin-based simulation.
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Affiliation(s)
- Natalie C Benda
- National Center for Human Factors in Healthcare, MedStar Institute for Innovation, MedStar Health, Washington, DC, United States.,Division of Health Informatics, Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, United States
| | - Kathryn M Kellogg
- Emergency Medicine, Georgetown University School of Medicine, Washington, DC, United States.,Quality and Safety, MedStar Health, Columbia, MD, United States
| | - Daniel J Hoffman
- National Center for Human Factors in Healthcare, MedStar Institute for Innovation, MedStar Health, Washington, DC, United States
| | - Rollin J Fairbanks
- Emergency Medicine, Georgetown University School of Medicine, Washington, DC, United States.,Quality and Safety, MedStar Health, Columbia, MD, United States
| | - Tamika Auguste
- Women's and Infants' Services, MedStar Washington Hospital Center, Washington, DC, United States.,Obstetrics and Gynecology, Georgetown University School of Medicine, Washington, DC, United States.,Simulation Training & Education Lab (SiTEL), MedStar Health, Washington, DC, United States
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22
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IJgosse WM, van Goor H, Rosman C, Luursema JM. The Fun Factor: Does Serious Gaming Affect the Volume of Voluntary Laparoscopic Skills Training? World J Surg 2020; 45:66-71. [PMID: 32989581 PMCID: PMC7752875 DOI: 10.1007/s00268-020-05800-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2020] [Indexed: 01/22/2023]
Abstract
Background The availability of validated laparoscopic simulators has not resulted in sustainable high-volume training. We investigated whether the validated laparoscopic serious game Underground would increase voluntary training by residents. We hypothesized that by removing intrinsic barriers and extrinsic barriers, residents would spend more time on voluntary training with Underground compared to voluntary training with traditional simulators. Methods After 1 year, we compared amount of voluntary time spent on playing Underground to time spent on all other laparoscopic training modalities and to time spent on performing laparoscopic procedures in the OR for all surgical residents. These data were compared to resident’ time spent on laparoscopic activities over the prior year before the introduction of Underground. Results From March 2016 until March 2017, 63 residents spent on average 20 min on voluntary serious gaming, 17 min on voluntary simulator training, 2 h and 44 min on mandatory laparoscopic training courses, and 14 h and 49 min on laparoscopic procedures in the OR. Voluntary activities represented 3% of laparoscopic training activities which was similar in the prior year wherein fifty residents spent on average 33 min on voluntary simulator training, 3 h and 28 min on mandatory laparoscopic training courses, and 11 h and 19 min on laparoscopic procedures. Conclusion Serious gaming has not increased total voluntary training volume. Underground did not mitigate intrinsic and extrinsic barriers to voluntary training. Mandatory, scheduled training courses remain needed. Serious gaming is flexible and affordable and could be an important part of such training courses.
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Affiliation(s)
- Wouter Martijn IJgosse
- Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands. .,Radboud University Medical Center, PO Box 9101 (960), 6500 HB, Nijmegen, The Netherlands.
| | - Harry van Goor
- Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Camiel Rosman
- Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Jan-Maarten Luursema
- Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
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23
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Fontaine G, Zagury-Orly I, de Denus S, Lordkipanidzé M, Beauchesne MF, Maheu-Cadotte MA, White M, Thibodeau-Jarry N, Lavoie P. Effects of reading media on reading comprehension in health professional education: a systematic review protocol. JBI Evid Synth 2020; 18:2633-2639. [PMID: 32813413 DOI: 10.11124/jbisrir-d-19-00348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE To evaluate the effect of digital-based reading versus paper-based reading on reading comprehension among students, trainees, and residents participating in health professional education. INTRODUCTION Several reviews have examined the effects of reading media on reading comprehension; however, none have considered health professional education specifically. The growing use of electronic media in health professional education, as well as recent data on the consequences of digital-based reading on learning, justify the necessity to review the current literature to provide research and educational recommendations. INCLUSION CRITERIA Studies conducted with health professions students, trainees, and residents individually receiving educational material written in their first language in a paper-based or a digital-based format will be considered. Studies conducted among participants with cognitive impairment or reading difficulties will be excluded. Observational, experimental and quasi-experimental studies that assess reading comprehension measured by previously validated or researcher-generated tests will be considered. METHODS Relevant studies will be sought from CINAHL, Embase, ERIC, Google Scholar, MEDLINE, PsycINFO, and Web of Science (SCI and SSCI), without date or language restrictions. Two independent reviewers will perform title and abstract screening, full-text review, critical appraisal, and data extraction. Disagreements will be resolved through discussion or with a third independent reviewer. Synthesis will occur at four levels (i.e., study, participant, intervention, and outcome levels) in a table format. Data will be synthesized descriptively and with meta-analyses if appropriate. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42020154519.
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Affiliation(s)
- Guillaume Fontaine
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada.,Research Center, Montreal Heart Institute, Montréal, QC, Canada
| | - Ivry Zagury-Orly
- Research Center, Montreal Heart Institute, Montréal, QC, Canada.,Faculty of Medicine, Université de Montréal, Montréal, QC, Canada.,Harvard Medical School, Boston, MA, USA
| | - Simon de Denus
- Research Center, Montreal Heart Institute, Montréal, QC, Canada.,Faculty of Pharmacy, Université de Montréal, Montréal, QC, Canada
| | - Marie Lordkipanidzé
- Research Center, Montreal Heart Institute, Montréal, QC, Canada.,Faculty of Pharmacy, Université de Montréal, Montréal, QC, Canada
| | | | - Marc-André Maheu-Cadotte
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada.,Research Center, Montreal Heart Institute, Montréal, QC, Canada.,Research Center, Université de Montréal Hospital Center, Montréal, QC, Canada
| | - Michel White
- Research Center, Montreal Heart Institute, Montréal, QC, Canada.,Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Nicolas Thibodeau-Jarry
- Research Center, Montreal Heart Institute, Montréal, QC, Canada.,Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Patrick Lavoie
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada.,Research Center, Montreal Heart Institute, Montréal, QC, Canada
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24
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Aubeux D, Blanchflower N, Bray E, Clouet R, Remaud M, Badran Z, Prud'homme T, Gaudin A. Educational gaming for dental students: Design and assessment of a pilot endodontic-themed escape game. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2020; 24:449-457. [PMID: 32142189 DOI: 10.1111/eje.12521] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 01/28/2020] [Accepted: 03/01/2020] [Indexed: 06/10/2023]
Abstract
INTRODUCTION The concept of escape games dedicated to dental students is a new learning experience that has not yet been extensively explored. The aim of this pilot study was to assess the impact and perceived value of an endodontic-themed escape game as assessed by fourth-year dental students. METHODS This study was conducted at the University of Nantes, Faculty of Dental Surgery using a cross-sectional pre- and post-test research design to assess students' changes in performance. Students in the fourth year of dental surgery study (n = 18) were divided in four groups for this study. The answers to the pre-test/post-test were 50 true/false questions. Moreover, a 20-question perception survey was given to all the participants after completion of the escape game. The study data were collected in May 2019. An unpaired t test analysed the mean differences between the groups. RESULTS The results showed a statistically significant increase in post-test results (75.33% ± 10.17% of correct answers) compared to the pre-test results (67.33% ± 5.94% of correct answers) P < .05. Analysis of variance revealed that this change in score was not significantly different between the four groups. The students perceived the endodontic-themed escape game to be relevant. A one-sample t test indicated that students' mean (SD) perception 4.4 (0.7) was statistically significantly higher than the mean value of the evaluation scale P < .001. The students found this educational game to be a useful experience that helped them recall/apply knowledge whilst promoting teamwork. CONCLUSION Therefore, this type of game can enhance students' learning and motivation.
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Affiliation(s)
- Davy Aubeux
- Department of Endodontics and Restorative Dentistry, Faculty of Dental Surgery, University of Nantes, Nantes, France
| | | | - Estelle Bray
- Department of Pedodontics, Faculty of Dental Surgery, University of Nantes, Nantes, France
| | | | - Mathieu Remaud
- Department of Endodontics and Restorative Dentistry, Faculty of Dental Surgery, University of Nantes, Nantes, France
| | - Zahi Badran
- CHU Nantes, Nantes, France
- Department of Periodontology, Faculty of Dental Surgery, University of Nantes, Nantes, France
- Inserm, UMR 1229, RMeS, Regenerative Medicine and skeleton, University of Nantes, ONIRIS, Nantes, France
| | - Tony Prud'homme
- CHU Nantes, Nantes, France
- Department of Pedodontics, Faculty of Dental Surgery, University of Nantes, Nantes, France
| | - Alexis Gaudin
- Department of Endodontics and Restorative Dentistry, Faculty of Dental Surgery, University of Nantes, Nantes, France
- CHU Nantes, Nantes, France
- Inserm, UMR 1229, RMeS, Regenerative Medicine and skeleton, University of Nantes, ONIRIS, Nantes, France
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25
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Tuti T, Winters N, Edgcombe H, Muinga N, Wanyama C, English M, Paton C. Evaluation of Adaptive Feedback in a Smartphone-Based Game on Health Care Providers' Learning Gain: Randomized Controlled Trial. J Med Internet Res 2020; 22:e17100. [PMID: 32628115 PMCID: PMC7380991 DOI: 10.2196/17100] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 03/13/2020] [Accepted: 04/08/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Although smartphone-based emergency care training is more affordable than traditional avenues of training, it is still in its infancy, remains poorly implemented, and its current implementation modes tend to be invariant to the evolving learning needs of the intended users. In resource-limited settings, the use of such platforms coupled with gamified approaches remains largely unexplored, despite the lack of traditional training opportunities, and high mortality rates in these settings. OBJECTIVE The primary aim of this randomized experiment is to determine the effectiveness of offering adaptive versus standard feedback, on the learning gains of clinicians, through the use of a smartphone-based game that assessed their management of a simulated medical emergency. A secondary aim is to examine the effects of learner characteristics and learning spacing with repeated use of the game on the secondary outcome of individualized normalized learning gain. METHODS The experiment is aimed at clinicians who provide bedside neonatal care in low-income settings. Data were captured through an Android app installed on the study participants' personal phones. The intervention, which was based on successful attempts at a learning task, included adaptive feedback provided within the app to the experimental arm, whereas the control arm received standardized feedback. The primary end point was completion of the second learning session. Of the 572 participants enrolled between February 2019 and July 2019, 247 (43.2%) reached the primary end point. The primary outcome was standardized relative change in learning gains between the study arms as measured by the Morris G effect size. The secondary outcomes were the participants individualized normalized learning gains. RESULTS The effect of adaptive feedback on care providers' learning gain was found to be g=0.09 (95% CI -0.31 to 0.46; P=.47). In exploratory analysis, using normalized learning gains, when subject-treatment interaction and differential time effect was controlled for, this effect increased significantly to 0.644 (95% CI 0.35 to 0.94; P<.001) with immediate repetition, which is a moderate learning effect, but reduced significantly by 0.28 after a week. The overall learning change from the app use in both arms was large and may have obscured a direct effect of feedback. CONCLUSIONS There is a considerable learning gain between the first two rounds of learning with both forms of feedback and a small added benefit of adaptive feedback after controlling for learner differences. We suggest that linking the adaptive feedback provided to care providers to how they space their repeat learning session(s) may yield higher learning gains. Future work might explore in more depth the feedback content, in particular whether or not explanatory feedback (why answers were wrong) enhances learning more than reflective feedback (information about what the right answers are). TRIAL REGISTRATION Pan African Clinical Trial Registry (PACTR) 201901783811130; https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=5836. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/13034.
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Affiliation(s)
- Timothy Tuti
- Kellogg College, University of Oxford, Oxford, United Kingdom.,KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya.,Department of Education, University of Oxford, Oxford, United Kingdom
| | - Niall Winters
- Kellogg College, University of Oxford, Oxford, United Kingdom.,Department of Education, University of Oxford, Oxford, United Kingdom
| | - Hilary Edgcombe
- Nuffield Division of Anaesthetics, University of Oxford, Oxford, United Kingdom
| | - Naomi Muinga
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
| | | | - Mike English
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya.,Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Chris Paton
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
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Carlson ER. COVID-19 and Educational Engagement. J Oral Maxillofac Surg 2020; 78:1049-1051. [PMID: 32371146 PMCID: PMC7195013 DOI: 10.1016/j.joms.2020.04.033] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 04/19/2020] [Accepted: 04/20/2020] [Indexed: 11/24/2022]
Affiliation(s)
- Eric R Carlson
- Professor and Kelly L. Krahwinkel Chairman, Department of Oral and Maxillofacial Surgery, and Director, Oral/Head and Neck Oncologic Fellowship Program, University of Tennessee Graduate School of Medicine, Knoxville, TN.
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27
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Glover K, Bodzin A. Learner Analysis to Inform the Design and Development of a Serious Game for Nongaming Female Emerging Health Care Preprofessionals: Qualitative Sample Study. JMIR Serious Games 2020; 8:e16003. [PMID: 32027312 PMCID: PMC7055850 DOI: 10.2196/16003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 11/13/2019] [Accepted: 12/15/2019] [Indexed: 01/30/2023] Open
Abstract
Background Overall, 75% of health care practitioners are women, but half of all females do not play digital games of any kind. There is no consensus in the literature regarding optimal design elements to maximize the efficacy of serious games. To capitalize on the promise of serious games in health care education, it is important for instructional designers to understand the underlying learners’ values, attitudes, and beliefs that might motivate nongaming female health care preprofessional students to independently choose to persistently play serious games to mastery. Objective Specifically, the aim of this study was to seek answers to 2 questions. First, what values, attitudes, and beliefs contribute to the nongaming behaviors of 12th-grade female emerging health care preprofessionals? Second, how do the values, attitudes, and beliefs of 12th-grade female emerging health care preprofessionals align with important design features of serious games? Methods In this study, a learner analysis was conducted using semistructured interviews with 8 12th-grade college-bound female health science students to better understand learners’ values, attitudes, and beliefs to inform the design and development of a serious game. These interviewees represented a diverse subset of the female emerging health care preprofessionals who self-identified themselves as not playing games at all, not very often, or infrequently. Results The findings suggest that the study participants exhibited a complex fusion of desire for both accomplishment and affiliation. The participants were all independent, competitive, and prosocial leaders. They thought strategically and consciously self-limited their leisure time to achieve personally meaningful long-term goals. They embraced overcoming expected failures and aimed to achieve relevant high-stakes wins in all academic, athletic, extracurricular, and leisure activities they valued while consciously avoiding what they considered to be non–goal-oriented activities. Conclusions The results of this study reinforce the need for a robust learner analysis to identify the multifaceted behavioral characteristics of targeted learners before the design and development of serious games. The common characteristics of the 12th-grade female health science students in this study suggest that they will choose to invest their limited leisure time playing a personally meaningful, preprofessionally authentic serious game if the collective design elements are aligned with the students’ self-conceptualization of their present or future selves.
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Affiliation(s)
- Kevin Glover
- Lehigh University College of Education, Bethlehem, PA, United States
| | - Alec Bodzin
- Lehigh University College of Education, Bethlehem, PA, United States
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Tsopra R, Courtine M, Sedki K, Eap D, Cabal M, Cohen S, Bouchaud O, Mechaï F, Lamy JB. AntibioGame®: A serious game for teaching medical students about antibiotic use. Int J Med Inform 2020; 136:104074. [PMID: 31926355 DOI: 10.1016/j.ijmedinf.2020.104074] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 12/07/2019] [Accepted: 01/02/2020] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Measures for controlling antimicrobial resistance are urgently required. We describe here AntibioGame®, a serious game for improving the training of medical students in antibiotic use in primary care. OBJECTIVE We aimed to design a serious game for antibiotics teaching and to evaluate its usability and playability by medical students. METHODS We used various gamification techniques (e.g. use of mascots, avatars, rewards, leader board) and cartoon graphics in the design of AntibioGame®. This game implements clinical case templates built from a list of learning goals defined by a medical team through an analysis of clinical practice guidelines. The game was evaluated by asking medical students to rate their satisfaction and the usability and playability of the game on an electronic form and through group discussions. The electronic form was derived from the MEEGA + scale, a five-point Likert scale including 32 items for assessing both usability and playability. RESULTS AntibioGame® is a case-based game in which students play the role of a doctor meeting patients in consultation and helping other health professionals to solve their problems, as in real life. The scenarios are realistic and cover situations frequently encountered in primary care. The 57 medical students enrolled found the game attractive, usable, fun, and appropriate for learning. Game quality was considered "good" (score = 60 on the MEEGA + scale). All the students said they would recommend the game, 96 % liked it and 81 % would use it for revision. CONCLUSION AntibioGame® is a promising tool for improving knowledge in antibiotic prescription that could easily be included in multifaceted programs for training medical students.
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Affiliation(s)
- Rosy Tsopra
- INSERM, Centre de Recherche des Cordeliers, UMRS 1138, Université Paris-Descartes, Université Sorbonne Paris Cité, France; Department of Medical Informatics, Hôpital Européen Georges-Pompidou, AP-HP, Paris, France; INSERM, UMR 1099, LTSI Team Health Big Data, Université Rennes 1, Rennes, France; Université Paris 13, SMBH, Bobigny, France.
| | - Mélanie Courtine
- LIMICS, Université Paris 13, Sorbonne Université, Inserm, 93017 Bobigny, France
| | - Karima Sedki
- LIMICS, Université Paris 13, Sorbonne Université, Inserm, 93017 Bobigny, France
| | - David Eap
- Université Paris 13, SMBH, Bobigny, France
| | | | | | - Olivier Bouchaud
- AP-HP, Hôpital Avicenne, Service de Maladies Infectieuses, F93000 Bobigny, France
| | - Frédéric Mechaï
- AP-HP, Hôpital Avicenne, Service de Maladies Infectieuses, F93000 Bobigny, France; IAME - UMR 1137, Paris, France
| | - Jean-Baptiste Lamy
- LIMICS, Université Paris 13, Sorbonne Université, Inserm, 93017 Bobigny, France
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Theoretical foundations of educational strategies used in e-learning environments for developing clinical reasoning in nursing students: A scoping review. Nurse Educ Pract 2019; 41:102632. [PMID: 31634697 DOI: 10.1016/j.nepr.2019.102632] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 03/28/2019] [Accepted: 09/29/2019] [Indexed: 11/23/2022]
Abstract
E-learning environments expand opportunities for the use of educational strategies that may contribute to the development of clinical reasoning in nursing students. The purposes of this scoping review were the following: 1) to map the principles of cognitive companionship and the theoretical foundations underlying the design and implementation of educational strategies used in e-learning environments for developing clinical reasoning in nursing students; and 2) to identify the types of educational strategies used in e-learning environments for developing or assessing clinical reasoning in nursing students. A scoping review was conducted and was based on the Joanna Briggs Institute Framework. Bibliographical databases were searched for studies published between January 2010 to July 2017. Out of 1202 screened articles, 18 met eligibility criteria and were included in this review. Principles of cognitive companionship in e-learning environments provide key clues from a learning support perspective, such as integrated feedback, interactive group discussion, gaming, and questioning. However, theoretical foundations underlying educational strategies in e-learning environments are poorly documented and insufficiently associated with cognitive learning models. E-learning environments must have solid theoretical foundations to provide support for the development of CR in nursing students.
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Tuti T, Winters N, Muinga N, Wanyama C, English M, Paton C. Evaluation of Adaptive Feedback in a Smartphone-Based Serious Game on Health Care Providers' Knowledge Gain in Neonatal Emergency Care: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2019; 8:e13034. [PMID: 31350837 PMCID: PMC6688438 DOI: 10.2196/13034] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 05/10/2019] [Accepted: 06/17/2019] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Although smartphone-based clinical training to support emergency care training is more affordable than traditional avenues of training, it is still in its infancy and remains poorly implemented. In addition, its current implementations tend to be invariant to the evolving learning needs of the intended users. In resource-limited settings, the use of such platforms coupled with serious-gaming approaches remain largely unexplored and underdeveloped, even though they offer promise in terms of addressing the health workforce skill imbalance and lack of training opportunities associated with the high neonatal mortality rates in these settings. OBJECTIVE This randomized controlled study aims to assess the effectiveness of offering adaptive versus standard feedback through a smartphone-based serious game on health care providers' knowledge gain on the management of a neonatal medical emergency. METHODS The study is aimed at health care workers (physicians, nurses, and clinical officers) who provide bedside neonatal care in low-income settings. We will use data captured through an Android smartphone-based serious-game app that will be downloaded to personal phones belonging to the study participants. The intervention will be adaptive feedback provided within the app. The data captured will include the level of feedback provided to participants as they learn to use the mobile app, and performance data from attempts made during the assessment questions on interactive tasks participants perform as they progress through the app on emergency neonatal care delivery. The primary endpoint will be the first two complete rounds of learning within the app, from which the individuals' "learning gains" and Morris G intervention effect size will be computed. To minimize bias, participants will be assigned to an experimental or a control group by a within-app random generator, and this process will be concealed to both the study participants and the investigators until the primary endpoint is reached. RESULTS This project was funded in November 2016. It has been approved by the Central University Research Ethics Committee of the University of Oxford and the Scientific and Ethics Review Unit of the Kenya Medical Research Institute. Recruitment and data collection began from February 2019 and will continue up to July 31, 2019. As of July 18, 2019, we enrolled 541 participants, of whom 238 reached the primary endpoint, with a further 19 qualitative interviews conducted to support evaluation. Full analysis will be conducted once we reach the end of the study recruitment period. CONCLUSIONS This study will be used to explore the effectiveness of adaptive feedback in a smartphone-based serious game on health care providers in a low-income setting. This aspect of medical education is a largely unexplored topic in this context. In this randomized experiment, the risk of performance bias across arms is moderate, given that the active ingredient of the intervention (ie, knowledge) is a latent trait that is difficult to comprehensively control for in a real-world setting. However, the influence of any resulting bias that has the ability to alter the results will be assessed using alternative methods such as qualitative interviews. TRIAL REGISTRATION Pan African Clinical Trials Registry PACTR201901783811130; https://pactr.samrc.ac.za/TrialDisplay. aspx?TrialID=5836. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/13034.
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Affiliation(s)
- Timothy Tuti
- Department of Education, University of Oxford, Oxford, United Kingdom.,Kellogg College, University of Oxford, Oxford, United Kingdom.,KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Niall Winters
- Department of Education, University of Oxford, Oxford, United Kingdom.,Kellogg College, University of Oxford, Oxford, United Kingdom
| | - Naomi Muinga
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
| | | | - Mike English
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya.,Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Chris Paton
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
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Castro-Sánchez E, Sood A, Rawson TM, Firth J, Holmes AH. Forecasting Implementation, Adoption, and Evaluation Challenges for an Electronic Game-Based Antimicrobial Stewardship Intervention: Co-Design Workshop With Multidisciplinary Stakeholders. J Med Internet Res 2019; 21:e13365. [PMID: 31165712 PMCID: PMC6746106 DOI: 10.2196/13365] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 03/26/2019] [Accepted: 04/09/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Serious games have been proposed to address the lack of engagement and sustainability traditionally affecting interventions aiming to improve optimal antibiotic use among hospital prescribers. OBJECTIVE The goal of the research was to forecast gaps in implementation, adoption and evaluation of game-based interventions, and co-design solutions with antimicrobial clinicians and digital and behavioral researchers. METHODS A co-development workshop with clinicians and academics in serious games, antimicrobials, and behavioral sciences was organized to open the International Summit on Serious Health Games in London, United Kingdom, in March 2018. The workshop was announced on social media and online platforms. Attendees were asked to work in small groups provided with a laptop/tablet and the latest version of the game On call: Antibiotics. A workshop leader guided open group discussions around implementation, adoption, and evaluation threats and potential solutions. Workshop summary notes were collated by an observer. RESULTS There were 29 participants attending the workshop. Anticipated challenges to resolve reflected implementation threats such as an inadequate organizational arrangement to scale and sustain the use of the game, requiring sufficient technical and educational support and a streamlined feedback mechanism that made best use of data arriving from the game. Adoption threats included collective perceptions that a game would be a ludic rather than professional tool and demanding efforts to integrate all available educational solutions so none are seen as inferior. Evaluation threats included the need to combine game metrics with organizational indicators such as antibiotic use, which may be difficult to enable. CONCLUSIONS As with other technology-based interventions, deploying game-based solutions requires careful planning on how to engage and support clinicians in their use and how best to integrate the game and game outputs onto existing workflows. The ludic characteristics of the game may foster perceptions of unprofessionalism among gamers, which would need buffering from the organization.
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Affiliation(s)
- Enrique Castro-Sánchez
- National Institute for Health Research Health Protection Research Unit in Healthcare-Associated Infection and Antimicrobial Resistance, Imperial College London, London, United Kingdom
| | - Anuj Sood
- National Institute for Health Research Health Protection Research Unit in Healthcare-Associated Infection and Antimicrobial Resistance, Imperial College London, London, United Kingdom
| | - Timothy Miles Rawson
- National Institute for Health Research Health Protection Research Unit in Healthcare-Associated Infection and Antimicrobial Resistance, Imperial College London, London, United Kingdom
| | - Jamie Firth
- Jamie Firth Consultancy Ltd, London, United Kingdom
| | - Alison Helen Holmes
- National Institute for Health Research Health Protection Research Unit in Healthcare-Associated Infection and Antimicrobial Resistance, Imperial College London, London, United Kingdom
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Gómez-Urquiza JL, Gómez-Salgado J, Albendín-García L, Correa-Rodríguez M, González-Jiménez E, Cañadas-De la Fuente GA. The impact on nursing students' opinions and motivation of using a "Nursing Escape Room" as a teaching game: A descriptive study. NURSE EDUCATION TODAY 2019; 72:73-76. [PMID: 30453202 DOI: 10.1016/j.nedt.2018.10.018] [Citation(s) in RCA: 97] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 08/02/2018] [Accepted: 10/31/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND According to previous studies on nursing education, although the use of games can produce positive results, the vast majority are based on questions and answers or on clinical situations. As an alternative, the 'Escape Room' teaching game is a much more dynamic option to asses theoretical and practical knowledge, and it may also promote teamwork and the ability to perform under pressure. OBJECTIVES To analyse nursing students' opinions and study motivations after using the nursing 'Escape Room' teaching game. DESIGN Cross-sectional descriptive study. PARTICIPANTS Second-year nursing students enrolled in the 'Adult Nursing 1' subject. METHOD After completing the teaching game, the students who had taken part in it were asked to fill in an ad-hoc questionnaire on the matter. In this game, students have 30 min in which they must solve the riddles and puzzles presented, and thus escape. In doing so, they must demonstrate both theoretical and practical knowledge, and a teacher will remain in the classroom to assess whether the nursing techniques in question are correctly performed. RESULTS The nursing students who took part in the game strongly believed that this 'helped them learn the subject' (4.8 points) and that 'more games of this type should be included in their nursing studies' (4.8 points). Overall, they considered that 'the game was enjoyable' (4.6 points), 'helped them in the exam' (4.6 points), and 'motivated them to study' (4.5 points). CONCLUSIONS The 'Escape Room' is a useful game; it stimulates learning, is fun to play, and motivates studying.
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Affiliation(s)
- Jose L Gómez-Urquiza
- Faculty of Health Sciences, University of Granada, Avenida de la Ilustración S/N, Postal Code: 18016 Granada, Spain.
| | - Juan Gómez-Salgado
- Department of Nursing, University of Huelva, Avenida Tres de Marzo, S/N, Postal Code: 21071 Huelva, Spain; University Espíritu Santo, Guayaquil, Ecuador
| | - Luis Albendín-García
- Faculty of Health Sciences, University of Granada, Avenida de la Ilustración S/N, Postal Code: 18016 Granada, Spain.
| | - María Correa-Rodríguez
- Faculty of Health Sciences, University of Granada, Avenida de la Ilustración S/N, Postal Code: 18016 Granada, Spain.
| | - Emilio González-Jiménez
- Faculty of Health Sciences, University of Granada, Avenida de la Ilustración S/N, Postal Code: 18016 Granada, Spain.
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A Framework for Improving the Engagement of Medical Practitioners in an E-Training Platform for Tuberculosis Care and Prevention. FUTURE INTERNET 2018. [DOI: 10.3390/fi11010006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We propose a new framework to improve the engagement of medical practitioners in a planned e-training platform for the successful identification and effective management of presumptive cases of tuberculosis (TB) in Pakistan. Our work is aligned with the World Health Organization’s TB-DOTS (Directly Observed Treatment Short-course) strategy for promoting the effective management of tuberculosis. We start by presenting previous work done at Mercy Corps Pakistan for training medical practitioners, then present the results of a recent survey we administered to a random sample of medical practitioners in Pakistan to learn about their requirements and readiness to embrace a new e-training platform and methodology. Informed by feedback from the survey, we formulated a detailed requirement analysis of the five key learning areas (or phases) that we believe are fundamental to the success of a TB e-training platform. Moreover, survey results revealed that an on-spot, on-demand, and competency-based learning tool can potentially improve the engagement of medical practitioners in the process. Building on the insights gained from the survey, we finally describe our initial UX (user experience) prototypes for phase 1, which corresponds to the identification of presumptive tuberculosis cases.
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Hoffmann S, Wilson S. The role of serious games in the iManageCancer project. Ecancermedicalscience 2018; 12:850. [PMID: 30079112 PMCID: PMC6057654 DOI: 10.3332/ecancer.2018.850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Indexed: 11/06/2022] Open
Abstract
Within the iManageCancer project, two serious games were developed, one for adults and one for children and adolescents. The adult's game was developed by the University of Bedfordshire (UK), the kid's game by Promotion Software GmbH (Germany). The aim was to support adult and young cancer patients with serious games to manage the impact of the disease on their psychological status, such as negative emotions, anxiety or depression, and motivate them to stay positive and to participate in social life [Patterson and Garwick (1994) Ann Behav Med16 131-142; Brennan et al. (2002) J Consul Clin Psychol70 1075-1085; Robinson et al. (2007) J Pediatr Psychol32 400-410]. Early demonstrators showed how important it is that players understand the meaning behind the game design. Improvements in the design of the games addressed that issue. Also, technical and use case issues were found that had a significant impact on the outcome. Both games interact with the iManageCancer platform, record game results and make them available for research. Two pilots are on the way and another evaluation cycle will follow.
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Affiliation(s)
| | - Stephen Wilson
- University of Bedfordshire, Bedfordshire, Luton LU1 3JU, UK
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Henderson J. How to teach medicine in the present times to kids who are online all the time? Pediatr Pulmonol 2018; 53:S5-S7. [PMID: 29906342 DOI: 10.1002/ppul.24029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- John Henderson
- Faculty of Health Sciences, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
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