The validation of a serious game for teaching ultrasound skills

Teaching point-of-care ultrasound using a serious game: a randomized controlled trial

BACKGROUND

Point-of-care ultrasound (POCUS) is an important diagnostic tool for internists. However, there are important barriers in learning POCUS, including lack of practice time and lack of experts for supervision. Alternative learning tools may assist in overcoming these barriers. A serious game is being developed specifically for teaching ultrasound. In this study, we assessed the use of a serious game in learning POCUS.

METHODS

Ultrasound-native medical students were randomly assigned to the intervention group (N = 27) or the control group (N = 26). Both groups performed a real ultrasound on a volunteer after a brief introduction, but the intervention group played a serious game in advance. The endpoints were the assessments of the videos by experts (scoring quality of the probe movements) and the research team (counting probe movements), and probe movements measured with an accelerometer.

RESULTS

The intervention group completed the exam faster (247 s vs. 347 s, p = 0.006 (95% CI: [30.20;168.80]) and lifted the probe less frequently from the model (0.54 vs. 3.79, p = 0.001 (95% CI: [1.39;5.11]). Also, we found an in-game learning effect between levels, showing a 48% decrease in total playing time (p < 0.001), 36% reduction in attempts per coin (p = 0.007), a 33% reduction in total probe distance (p = 0.002), and a 61% decrease in contact moments (p < 0.001). However, there was no significant difference in expert score between the two groups.

CONCLUSION

The serious game 'Underwater' is a fun and useful addition to traditional bedside ultrasound learning, which also may overcome one of the most important barriers in learning ultrasound: lack of supervised practice time. We show that the game improves real-practice probe handling with faster and more goal-oriented probe movements.

Game-based learning in medical education

At present, medical education is rapidly evolving. Game-based learning (GBL) has been gradually used for education, and several innovations have emerged. The emergence of serious games and gamification provides alternative approaches for educators to improve the medical teaching process. Both serious games and gamification exert their education-promoting function by providing the possibility of combining learning activities such as feedback, testing, and spaced repetition with active participation and autonomy as well as positive experiences for students. Developing effective GBL modalities has the potential to bring immersive experiences for medical students and improve their study outcomes. Herein, we reviewed recent studies employing GBL in medical education, including serious games and gamification teaching. Furthermore, we also discussed the effectiveness and limitations of GBL to suggest future directions for the development and application of GBL in medical education.