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Mitchell G, Rainey D, Healy M, Anderson T, Stark P, Kalu FA, Monaghan C, Linden MA. Employing a serious game intervention to promote adolescent school children's perceptions of nursing and midwifery professions. BMC Nurs 2024; 23:372. [PMID: 38831364 PMCID: PMC11145870 DOI: 10.1186/s12912-024-02045-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 05/27/2024] [Indexed: 06/05/2024] Open
Abstract
AIM To test a serious game intervention about nursing and midwifery perceptions among adolescent school children. BACKGROUND Nursing and midwifery professions face challenges in recruitment, with persistent gender stereotypes and a lack of clarity regarding the roles contributing to this issue. This study addresses the need for innovative approaches to reshape perceptions and encourage career exploration in adolescent school children. DESIGN Employing a pre/post-test design, this study involved 137 post-primary students aged sixteen or seventeen in the United Kingdom. METHODS Data collection occurred between November 2022 to April 2023, involving three post-primary schools. Participants engaged with a digital serious game designed to address misconceptions and promote a more accurate understanding of nursing and midwifery. Participants completed pre- and post-intervention questionnaires, including an adapted version of the Nursing as a Career Choice Questionnaire. Statistical analyses included descriptive statistics, paired t-tests, and independent groups t-tests. RESULTS The serious game intervention resulted in statistically significant improvements in students' perceptions across multiple domains. Overall, participants showed higher mean post-test scores (M = 139.57, SD = 15.10) compared to their mean pre-test score (M = 131.06, SD = 14.73) on the questionnaire. The domains of self-efficacy (p < .001), job prospects (p < .001) and social influences (p < .001) exhibited the most substantial positive changes. Female participants showed higher perceptions than males in pre- and post-tests and students from all-girls schools consistently scored higher than those from all-boys and mixed-gender schools. CONCLUSIONS A serious game about the nursing and midwifery professions appears to be capable of changing perceptions of self-efficacy and job prospects related to nursing and midwifery professions. The study suggests that a serious game intervention may have the potential to change adolescent perceptions of nursing and midwifery professions which may lead to their considering of these when making future career choices.
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Affiliation(s)
- Gary Mitchell
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK.
| | - Debbie Rainey
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Maria Healy
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Tara Anderson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Patrick Stark
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Felicity Agwu Kalu
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Catherine Monaghan
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Mark A Linden
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
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Abraham P, Dubois N, Rimmelé T, Lilot M, Balança B. Enhancing perioperative care through decontextualized simulation: A game-changer for non-technical skills training. J Clin Anesth 2024; 94:111428. [PMID: 38422954 DOI: 10.1016/j.jclinane.2024.111428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 02/11/2024] [Accepted: 02/23/2024] [Indexed: 03/02/2024]
Affiliation(s)
- Paul Abraham
- Department of Anesthesiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Centre Lyonnais d'Enseignement par la Simulation en Santé (CLESS), SimuLyon. Claude Bernard University Lyon 1-Hospices Civils de Lyon, Lyon, France.
| | - Nadège Dubois
- Medical Simulation Center, Public Health Department, Liège University, Liège, Belgium
| | - Thomas Rimmelé
- Centre Lyonnais d'Enseignement par la Simulation en Santé (CLESS), SimuLyon. Claude Bernard University Lyon 1-Hospices Civils de Lyon, Lyon, France; EA 7426, PI3 (Pathophysiology of Injury-Induced Immunosuppression), Claude Bernard University Lyon 1-Biomérieux-Hospices Civils de Lyon, Lyon, France
| | - Marc Lilot
- Centre Lyonnais d'Enseignement par la Simulation en Santé (CLESS), SimuLyon. Claude Bernard University Lyon 1-Hospices Civils de Lyon, Lyon, France; Unit of Pediatric and Congenital Cardio-thoracic Anesthesia and Intensive Care, Medical-Surgical Department of Congenital Cardiology of the Fœtus, Child and Adult. Louis Pradel Hospital, Hospices Civils de Lyon, Lyon, France; Claude Bernard University Lyon 1, Research on Healthcare Performance (RESHAPE), INSERM U1290, Lyon, France
| | - Baptiste Balança
- Centre Lyonnais d'Enseignement par la Simulation en Santé (CLESS), SimuLyon. Claude Bernard University Lyon 1-Hospices Civils de Lyon, Lyon, France; Neurologic Intensive care and Anesthesiology, Hospices Civils de Lyon, Pierre Wertheimer Hospital and Claude Bernard University Lyon 1 - Neuroscience Research Center, Lyon, France
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Abraham O, McCarthy TJ. An Introduction to the OutSMART Cancer Serious Game: Current and Future Directions. JMIR Cancer 2024; 10:e56168. [PMID: 38809587 PMCID: PMC11170044 DOI: 10.2196/56168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/21/2024] [Accepted: 04/24/2024] [Indexed: 05/30/2024] Open
Abstract
Given that cancer is a challenging disease that plagues millions of individuals of all age groups and socioeconomic statuses globally, developmentally appropriate education is often lacking for young people, particularly adolescents. Increasing cancer awareness and prevention education among adolescents using innovative strategies, such as game-based learning, is critical in reducing the burden of this disease. Adolescents are understudied in the field of cancer prevention and control, yet vulnerable as they tackle creating life-long health behavior patterns. Targeting cancer prevention education for adolescents has the potential to support long-term healthy behavior and reduce their risk of cancer. This paper provides an overview of the Collaborative Research on MEdication use and family health (CRoME) Lab's novel game-based cancer prevention education tool. OutSMART Cancer is an innovative, novel educational intervention in the form of a serious game. Serious games are educational tools that seek to impart knowledge and improve behaviors in their players. This game covers information related to breast cancer, colon cancer, and lung cancer. This viewpoint is a summary of the developmental process for the OutSMART Cancer game. We describe in detail the work preceding initial game development, the current version of the game, future directions for the game, and its educational potential. The long-term goal of OutSMART Cancer is to improve cancer awareness and knowledge regarding prevention behaviors in adolescents and support a lifetime of health and wellness.
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Affiliation(s)
- Olufunmilola Abraham
- Social and Administrative Sciences Division, School of Pharmacy, University of Wisconsin-Madison, Madison, WI, United States
| | - Tyler J McCarthy
- Social and Administrative Sciences Division, School of Pharmacy, University of Wisconsin-Madison, Madison, WI, United States
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Zarif-Yeganeh M, Mafinejad MK, Mohebbi N, Kiani M, Rezaei E, Ebrahimpour S, Namazi S. Using Modern Learning Method to Teach Pharmacy Students Psychopharmacotherapy. IRANIAN JOURNAL OF PUBLIC HEALTH 2024; 53:443-452. [PMID: 38894843 PMCID: PMC11182482 DOI: 10.18502/ijph.v53i2.14929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 03/11/2023] [Indexed: 06/21/2024]
Abstract
Background Applying modern educational methods for digital native students seems necessary. Active learning strategies promote students' skills and knowledge. This study was conducted to design and evaluate active learning methods by teaching psychopharmacotherapy to pharmacy students. Methods This was a quasi-experimental study with three randomized study groups (control, game, and multimedia), using a pre-and post-test design, conducted on 155 students of 5-year pharmacy in 2022 at the Faculty of Pharmacy of Tehran University of Medical Sciences, Iran. Overall, 18 clinical cases were designed for the basic structure of interventions. After teaching psychopharmacotherapy contents through lecturing, the pre-test was held. The next steps were playing the educational game, studying the multimedia case-based learning files, and then completing questionnaires, respectively. Then, a post-test was held. Results 65.33% of participants were female and 34.66% were male. The pre-test and post-test scores comparison showed no difference in control group (P=0.409). However, in the serious game and multimedia groups, the average score of pre-test and post-test had a statistically significant difference (P<0.001, P=0.002 respectively), this difference was higher in the serious game group. Questionnaire evaluation showed substantial differences between game and multimedia groups. Conclusion The educational interventions were able to improve student's knowledge and skills so they can better help patients and promote public health. In the sections of Confidence, Social Interactions, Fun, Focused attention, Learnability, Relevance, and Perceived Learning, the serious game far outweighed the multimedia case-based learning.
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Affiliation(s)
- Morvarid Zarif-Yeganeh
- Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahboobeh Khabaz Mafinejad
- Health Professions Education Research Center, Education Development Center, Department of Medical Education, Tehran University of Medical Sciences, Tehran, Iran
| | - Niayesh Mohebbi
- Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Muhammad Kiani
- Department of Medical Education, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Eisa Rezaei
- Department of Educational Technology in Medical Sciences, Smart University of Medical Sciences, Tehran, Iran
| | - Sholeh Ebrahimpour
- Department of Clinical Pharmacy, School of Pharmacy, Alborz University of Medical Sciences, Karaj, Iran
| | - Soha Namazi
- Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran
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Maas B, Van Der Sluis CK, Bongers RM. Assessing the effectiveness of serious game training designed to assist in upper limb prothesis rehabilitation. FRONTIERS IN REHABILITATION SCIENCES 2024; 5:1353077. [PMID: 38348457 PMCID: PMC10859406 DOI: 10.3389/fresc.2024.1353077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 01/16/2024] [Indexed: 02/15/2024]
Abstract
Introduction Controlling a myoelectric upper limb prosthesis is difficult, therefore training is required. Since training with serious games showed promising results, the current paper focuses on game design and its effectivity for transfer between in-game skill to actual prosthesis use for proportional control of hand opening and control of switching between grips. We also examined training duration and individual differences. Method Thirty-six participants were randomly assigned to one of three groups: a task-specific serious game training group, a non-task-specific serious game training group and a control group. Each group performed a pre-test, mid-test and a post-test with five training sessions between each test moment. Test sessions assessed proportional control using the Cylinder test, a test designed to measure scaling of hand aperture during grabbing actions, and the combined use of proportional and switch control using the Clothespin Relocation Test, part of the Southampton Hand Assessment Procedure and Tray Test. Switch control was assessed during training by measuring amplitude difference and phasing of co-contraction triggers. Results Differences between groups over test sessions were observed for proportional control tasks, however there was lack of structure in these findings. Maximum aperture changed with test moment and some participants adjusted maximum aperture for smaller objects. For proportional and switch control tasks no differences between groups were observed. The effect of test moment suggests a testing effect. For learning switch control, an overall improvement across groups was found in phasing of the co-contraction peaks. Importantly, individual differences were found in all analyses. Conclusion As improvements over test sessions were found, but no relevant differences between groups were revealed, we conclude that transfer effects from game training to actual prosthesis use did not take place. Task specificity nor training duration had effects on outcomes. Our results imply testing effects instead of transfer effects, in which individual differences played a significant role. How transfer from serious game training in upper limb prosthesis use can be enhanced, needs further attention.
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Affiliation(s)
- Bart Maas
- Department of Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Corry K. Van Der Sluis
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Raoul M. Bongers
- Department of Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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Lukka L, Palva JM. The Development of Game-Based Digital Mental Health Interventions: Bridging the Paradigms of Health Care and Entertainment. JMIR Serious Games 2023; 11:e42173. [PMID: 37665624 PMCID: PMC10507521 DOI: 10.2196/42173] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 01/24/2023] [Accepted: 07/15/2023] [Indexed: 09/05/2023] Open
Abstract
Game elements are increasingly used to improve user engagement in digital mental health interventions, and specific game mechanics may yield therapeutic effects per se and thereby contribute to digital mental health intervention efficacy. However, only a few commercial game-based interventions are available. We suggest that the key challenge in their development reflects the tension between the 2 underlying paradigms, health care and entertainment, which have disparate goals and processes in digital development. We describe 3 approaches currently used to negotiate the 2 paradigms: the gamification of health care software, designing serious games, and purpose shifting existing entertainment games. We advanced an integrative framework to focus attention on 4 key themes in intervention development: target audience, engagement, mechanisms of action, and health-related effectiveness. On each theme, we show how the 2 paradigms contrast and can complement each other. Finally, we consider the 4 interdependent themes through the new product development phases from concept to production. Our viewpoint provides an integrative synthesis that facilitates the research, design, and development of game-based digital mental health interventions.
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Affiliation(s)
- Lauri Lukka
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland
| | - J Matias Palva
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland
- Neuroscience Center, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
- Centre for Cognitive Neuroimaging, School of Psychology and Neuroscience, University of Glasgow, Glasgow, United Kingdom
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Smith AU, Khawly GM, Jann J, Zetina APM, Padilla J, Schnall R. A Review of Serious Gaming as an Intervention for HIV Prevention. Curr HIV/AIDS Rep 2023; 20:181-205. [PMID: 37213045 PMCID: PMC11177625 DOI: 10.1007/s11904-023-00659-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2023] [Indexed: 05/23/2023]
Abstract
PURPOSEOF REVIEW Young people face the highest number of new HIV infections globally. With today's increasing access to smartphones, serious games have been viewed as an effective means of improving knowledge and behavioral outcomes. This systematic review describes current HIV prevention serious games and their relationship with HIV-related knowledge and behavioral outcomes. RECENT FINDINGS A search of HIV prevention serious games was conducted using PubMed, CINAL, IEEE, Web of Science, and Google Scholar. A total of 31 papers were identified, which consist of 20 studies and 11 protocols. Results for knowledge, attitudes, intentions, and behaviors were mixed. Two interventions reported improvement in PrEP usage and optimal dosing. Gaming appears to be a viable and engaging method to improve knowledge, attitudes, and behavioral outcomes to promote HIV prevention among diverse groups of adolescents and young adults globally. However, additional research is needed to understand how to implement this modality effectively.
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Affiliation(s)
- Ariel U Smith
- College of Nursing - Population Health Systems Science, University of Illinois at Chicago, Chicago, IL, USA.
| | - Gabriella M Khawly
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Janna Jann
- College of Nursing - Population Health Systems Science, University of Illinois at Chicago, Chicago, IL, USA
| | - Ana Paola Mata Zetina
- Division of Scholarship and Research, Columbia University School of Nursing, New York, NY, USA
| | - Janeth Padilla
- Division of Scholarship and Research, Columbia University School of Nursing, New York, NY, USA
| | - Rebecca Schnall
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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Calik A, Cakmak B, Kapucu S, Inkaya B. The effectiveness of serious games designed for infection prevention and promotion of safe behaviors of senior nursing students during the COVID-19 pandemic. Am J Infect Control 2022; 50:1360-1367. [PMID: 35231565 PMCID: PMC8881815 DOI: 10.1016/j.ajic.2022.02.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 02/12/2022] [Accepted: 02/12/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Reminding health care workers, especially senior students, of the critical role they play in preventing COVID-19 transmission is more important than ever, therefore it is vital to reinforce graduate students' intrinsic motivation to implement infection prevention and control guidelines. Serious games are an interesting intervention that could improve adherence to COVID-19 safe behaviors to lower the high prevalence of nosocomial infections. These games, as a type of technology-enhanced simulation, can increase student satisfaction and engagement while still conveying vital ideas. For this reason, this study aimed to develop a serious game and evaluate its effectiveness to prevent the spread of infection and develop safe behaviors during the COVID-19 pandemic. METHODS In total, 62 nursing students completed a socio-demographic questionnaire, COVID-19 information form, and game usability form, with the students' responses analyzed pre-test and post-test. RESULTS Serious game implementation significantly increased senior students' knowledge of infection and safe behaviors concerning COVID-19. The students also considered the practice of serious games an effective teaching strategy. Favorite aspects of the serious game according to students' statements; It was reported as reflecting the real hospital environment, including the nursing care process and roles, being informative, being compatible by phone, and each stage of the game tested a new knowledge. CONCLUSION Employing serious games for nursing skills development is an appropriate teaching method for infection prevention and promotion of safe behaviors among senior nursing students during the COVID-19 pandemic. This game can be obtained free of charge for research and educational purposes.
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Affiliation(s)
- Afra Calik
- University of Hacettepe, Ankara, Turkey,Address correspondence to Afra Calik, MSc, RN, University of Hacettepe, the Faculty of Nursing, Adnan Saygun Street, D-Block, 1. Floor, Samanpazarı, Ankara, Turkey
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Yang SY, Oh YH. The effects of neonatal resuscitation gamification program using immersive virtual reality: A quasi-experimental study. NURSE EDUCATION TODAY 2022; 117:105464. [PMID: 35914345 PMCID: PMC9259066 DOI: 10.1016/j.nedt.2022.105464] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 06/12/2022] [Accepted: 06/30/2022] [Indexed: 06/03/2023]
Abstract
BACKGROUND Clinical practice in neonatal intensive care units for nursing college students has been restricted due to the COVID-19 pandemic outbreak; thus, the gamification program has emerged as an alternative learning method. Consequently, there is a need to examine the effectiveness of such alternative learning methods to enhance the response to high-risk newborn emergencies. OBJECTIVES To examine the effects (neonatal resuscitation nursing knowledge, problem-solving and clinical reasoning ability, self-confidence in practical performance, degree of anxiety, and learning motivation) of a neonatal resuscitation gamification program using immersive virtual reality based on Keller's ARCS model. DESIGN A non-randomized controlled simulation study with a pretest-posttest design. SETTING Lab and lecture rooms of two universities in South Korea, from June to November 2021. PARTICIPANTS Prelicensure nursing students. METHODS The virtual reality group (n = 29) underwent a neonatal resuscitation gamification program using virtual reality based on Keller's ARCS model. The simulation group (n = 28) received high-fidelity neonatal resuscitation simulations and online neonatal resuscitation program lectures. The control group (n = 26) only received online neonatal resuscitation program lectures. Changes in scores among these groups were compared using analysis of variance and analysis of covariance with SPSS for Windows version 27.0. RESULTS Post intervention, neonatal resuscitation knowledge [F(2) = 3.83, p = .004] and learning motivation [F(2) = 1.79, p = .025] were significantly higher in the virtual reality and simulation groups than in the control group, whereas problem-solving ability [F(2) = 2.07, p = .038] and self-confidence [F(2) = 6.53, p < .001] were significantly higher in the virtual reality group than in the simulation and control groups. Anxiety [F(2) = 16.14, p < .001] was significantly lower in the simulation group than in the virtual reality and control groups. CONCLUSIONS The neonatal resuscitation gamification program using immersive virtual reality was found to be effective in increasing neonatal resuscitation knowledge, problem-solving ability, self-confidence, and learning motivation of the nursing students who participated in the trial application process.
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Affiliation(s)
- Sun-Yi Yang
- College of Nursing, Konyang University, Daejeon Medical Campus, 158, Gwanjeodong-ro, Seo-gu, Daejeon 35365, South Korea.
| | - Yun-Hee Oh
- Department of Nursing, Cheju Halla University, 38, Halladaehak-ro, Jeju-si, Jeju 63092, South Korea
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Fernandes CS, Magalhães B, Gomes JA, Lima A, Santos C. Exergames to improve rehabilitation after knee arthroplasty: a systematic review and grade evidence synthesis. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2022. [DOI: 10.1080/21679169.2022.2126518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Carla Sílvia Fernandes
- Nursing School of Porto, Porto, Portugal
- Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
| | - Bruno Magalhães
- Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
- Santa Maria Health School, Porto, Portugal
| | | | - Andreia Lima
- Health School of Fernando Pessoa, Porto, Portugal
| | - Célia Santos
- Nursing School of Porto, Porto, Portugal
- Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
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Mena-Moreno T, Munguía L, Granero R, Lucas I, Sánchez-Gómez A, Cámara A, Compta Y, Valldeoriola F, Fernandez-Aranda F, Sauvaget A, Menchón JM, Jiménez-Murcia S. Cognitive Behavioral Therapy Plus a Serious Game as a Complementary Tool for a Patient With Parkinson Disease and Impulse Control Disorder: Case Report. JMIR Serious Games 2022; 10:e33858. [PMID: 36083621 PMCID: PMC9508668 DOI: 10.2196/33858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 04/03/2022] [Accepted: 04/22/2022] [Indexed: 11/17/2022] Open
Abstract
Background Impulse control disorders (ICDs) are commonly developed among patients who take dopamine agonist drugs as a treatment for Parkinson disease (PD). Gambling disorder and hypersexuality are more frequent in male patients with PD, with a prevalence over 4% in dopamine agonists users. Although impulsive-compulsive behaviors are related to antiparkinsonian medication, and even though ICD symptomatology, such as hypersexuality, often subsides when the dopaminergic dose is reduced, sometimes ICD persists in spite of drug adjustment. Consequently, a multidisciplinary approach should be considered to address these comorbidities and to explore new forms of complementary interventions, such as serious games or therapies adapted to PD. Objective The aim of this study is to present the case of a patient with ICD (ie, hypersexuality) triggered by dopaminergic medication for PD. A combined intervention was carried out using cognitive behavioral therapy (CBT) for ICD adapted to PD, plus an intervention using a serious game—e-Estesia—whose objective is to improve emotion regulation and impulsivity. The aim of the combination of these interventions was to reduce the harm of the disease. Methods After 20 CBT sessions, the patient received the e-Estesia intervention over 15 sessions. Repeated measures, before and after the combined intervention, were administered to assess emotion regulation, general psychopathology, and emotional distress and impulsivity. Results After the intervention with CBT techniques and e-Estesia, the patient presented fewer difficulties to regulate emotion, less emotional distress, and lower levels of impulsivity in comparison to before the treatment. Moreover, the frequency and severity of the relapses also decreased. Conclusions The combined intervention—CBT and a serious game—showed positive results in terms of treatment outcomes.
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Affiliation(s)
- Teresa Mena-Moreno
- Department of Psychiatry, Bellvitge University Hospital, Hospitalet de Llobregat, Spain.,Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, Madrid, Spain.,Instituto de Investigación Biomédica de Bellvitge, Hospitalet de Llobregat, Spain
| | - Lucero Munguía
- Department of Psychiatry, Bellvitge University Hospital, Hospitalet de Llobregat, Spain.,Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, Madrid, Spain.,Instituto de Investigación Biomédica de Bellvitge, Hospitalet de Llobregat, Spain
| | - Rosario Granero
- Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, Madrid, Spain.,Department of Psychobiology and Methodology, Autonomous University of Barcelona, Barcelona, Spain
| | - Ignacio Lucas
- Department of Psychiatry, Bellvitge University Hospital, Hospitalet de Llobregat, Spain.,Instituto de Investigación Biomédica de Bellvitge, Hospitalet de Llobregat, Spain
| | - Almudena Sánchez-Gómez
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Hospital Clínic, Institut D'Investigacions Biomediques August Pi i Sunyer, Institut de Neurociències Universitat de Barcelona (Maria de Maeztu Excellence Center), Barcelona, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
| | - Ana Cámara
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Hospital Clínic, Institut D'Investigacions Biomediques August Pi i Sunyer, Institut de Neurociències Universitat de Barcelona (Maria de Maeztu Excellence Center), Barcelona, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
| | - Yaroslau Compta
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Hospital Clínic, Institut D'Investigacions Biomediques August Pi i Sunyer, Institut de Neurociències Universitat de Barcelona (Maria de Maeztu Excellence Center), Barcelona, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
| | - Francesc Valldeoriola
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Hospital Clínic, Institut D'Investigacions Biomediques August Pi i Sunyer, Institut de Neurociències Universitat de Barcelona (Maria de Maeztu Excellence Center), Barcelona, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
| | - Fernando Fernandez-Aranda
- Department of Psychiatry, Bellvitge University Hospital, Hospitalet de Llobregat, Spain.,Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, Madrid, Spain.,Instituto de Investigación Biomédica de Bellvitge, Hospitalet de Llobregat, Spain.,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Anne Sauvaget
- Movement, Interactions, Performance, University of Nantes, Nantes, France
| | - José M Menchón
- Department of Psychiatry, Bellvitge University Hospital, Hospitalet de Llobregat, Spain.,Instituto de Investigación Biomédica de Bellvitge, Hospitalet de Llobregat, Spain.,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital, Hospitalet de Llobregat, Spain.,Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, Madrid, Spain.,Instituto de Investigación Biomédica de Bellvitge, Hospitalet de Llobregat, Spain.,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
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Evaluating a game-based randomized experiment to increase melanoma identification among adults living in the U.S. Soc Sci Med 2022; 310:115281. [PMID: 36001916 DOI: 10.1016/j.socscimed.2022.115281] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 07/26/2022] [Accepted: 08/09/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Although cutaneous melanoma diagnoses are rising, morbidity and mortality can be reduced through early detection. This investigation seeks to improve melanoma identification accuracy, attitudes, and intentions among a lay population by comparing the effectiveness of different melanoma identification training strategies and the effect of real-time decisional feedback on a melanoma identification task. We developed an innovative, game-based approach and hypothesize differences among frequently used melanoma identification training modalities (i.e, the Asymmetry/Border/Color/Diameter [ABCD] rule, the Ugly Duckling Rule [UDS], and a modality that combines them both, ABCDF (where the F stands for 'funny looking"), and investigate differences in types of immediate feedback on a melanoma identification task. METHODS We conducted a national online randomized experiment to test a 4 (melanoma training strategies: ABCD, UDS, ABCD-F, control) × 3 (feedback: Dermatological, Dermatological + Motivational, control) factorial design on melanoma identification, skin cancer beliefs (perceived susceptibility, severity, response efficacy, self-efficacy), attitudes, and prevention intentions. RESULTS ABCD training (p < .001) and UDS training (p = .05) resulted in significantly higher melanoma identification than the control. All training types resulted in significantly higher self-efficacy than the control (p = .02). Both Dermatological (p = .02) and Dermatological + Motivational feedback (p = .01) elicited significantly lower melanoma identification than the control condition, although this effect may be due to differences observed among participants who received UDS training. There was a significant main effect of feedback on self-efficacy (p = .002), where both Dermatological and Dermatological + Motivational feedback elicited higher levels of self-efficacy than the control. CONCLUSIONS Our results suggest that game-based ABCD and UDS training strategies could increase melanoma identification accuracy. Real-time feedback reduced accuracy, but was associated with increased self-efficacy related to melanoma detection outcomes.
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An Immersive Virtual Reality Training Game for Power Substations Evaluated in Terms of Usability and Engagement. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12020711] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Safety-focused training is essential for the operation and maintenance concentrated on the reliability of critical infrastructures, such as power grids. This paper introduces and evaluates a system for power substation operational training by exploring and interacting with realistic models in virtual worlds using serious games. The virtual reality (VR) simulator used building information modelling (BIM) from a 115 kV substation to develop a scenario with high technical detail suitable for professional training. This system created interactive models that could be explored using a first-person-perspective serious game in a cave automatic virtual environment (CAVE). Different operational missions could be carried out in the serious game, allowing several skills to be coached. The suitability for vocational training carried out by utility companies was evaluated in terms of usability and engagement. The evaluation used a System Usability Scale (SUS) and a Game Engagement Questionnaire (GEQ) filled by 16 power substation operators demonstrating marginally acceptable usability, with improvement opportunities and high acceptance (by utility technicians) of this system for operation training focused on safety in such hazardous tasks.
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Steadman RH, Huang YM, Iseli MR, Lee JJ, Tillou A, Rudolph MDD, Lewin R, Koenig AD, Khan R, Raia F, Smith SM, Juo YY, Rice C, Poorsattar SP, Webb NM. Screen-Based Simulation for Training and Automated Assessment of Teamwork Skills: Comparing 2 Modes With Different Interactivity. Simul Healthc 2021; 16:318-326. [PMID: 33086370 DOI: 10.1097/sih.0000000000000510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The need for teamwork training is well documented; however, teaching these skills is challenging given the logistics of assembling individual team members together to train in person. We designed 2 modes of screen-based simulation for training teamwork skills to assess whether interactivity with nonplayer characters was necessary for in-game performance gains or for player satisfaction with the experience. METHODS Mixed, randomized, repeated measures study with licensed healthcare providers block-stratified and randomized to evaluation-participant observes and evaluates the team player in 3 scenarios-and game play-participant is immersed as the leader in the same 3 scenarios. Teamwork construct scores (leadership, communication, situation monitoring, mutual support) from an ontology-based, Bayesian network assessment model were analyzed using mixed randomized repeated measures analyses of variance to compare performance, across scenarios and modes. Learning was measured by pretest and posttest quiz scores. User experience was evaluated using χ2 analyses. RESULTS Among 166 recruited and randomized participants, 120 enrolled in the study and 109 had complete data for analysis. Mean composite teamwork Bayesian network scores improved for successive scenarios in both modes, with evaluation scores statistically higher than game play for every teamwork construct and scenario (r = 0.73, P = 0.000). Quiz scores improved from pretest to posttest (P = 0.004), but differences between modes were not significant. CONCLUSIONS For training teamwork skills using screen-based simulation, interactivity of the player with the nonplayer characters is not necessary for in-game performance gains or for player satisfaction with the experience.
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Affiliation(s)
- Randolph H Steadman
- From the Department of Anesthesiology and Critical Care (R.H.S.), Houston Methodist Hospital, Houston, TX; Department of Anesthesiology and Perioperative Medicine (Y.M.H.), David Geffen School of Medicine at UCLA; UCLA Simulation Center (Y.M.H.); National Center for Research on Evaluation, Standards, and Student Testing (CRESST) (M.R.I.); CRESST (J.J.L., A.D.K.), Los Angeles, CA; Department of Surgery (A.T.), David Geffen School of Medicine at UCLA; UCLA Center for Advanced Surgical & Interventional Technology Accredited Education Institute (A.T.), Los Angeles; Consultant, (M.D.D.R.) Claremont, CA; UCLA Graduate School of Education and Information Studies (R.L.); David Geffen School of Medicine at UCLA Dean's Office/UCLA Simulation Center (R.K.); UCLA Graduate School of Education and Information Studies (F.R.); Department of Medicine (F.R.), David Geffen School of Medicine at UCLA, Los Angeles, CA; Department of Culture & Communication (S.M.S.), Linköping Universitet, Linköping, Sweden; Department of Surgery (Y.-Y.J.), David Geffen School of Medicine at UCLA, Los Angeles; Community Memorial Health System (C.R.), Ventura; Department of Anesthesiology and Perioperative Medicine (S.P.P.), David Geffen School of Medicine at UCLA; and UCLA Graduate School of Education and Information Studies (N.M.W.), Los Angeles, CA
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Stavropoulos V, Motti-Stefanidi F, Griffiths MD. Risks and Opportunities for Youth in the Digital Era. EUROPEAN PSYCHOLOGIST 2021. [DOI: 10.1027/1016-9040/a000451] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Abstract. Due to continued groundbreaking digital advancements, Internet use has increased significantly. This has led to a heated debate in relation to weighing the many advantages of the technology against its potentially deleterious effects. To address such questions, experts converge on the need for greater knowledge around the way individual differences, partly shaped by an individual’s unique experiences of engaging with the medium, and partly by other real-life experiences, lead to different developmental trajectories. Consequently, the goals of the present review are to (i) broadly describe differences in digital media applications, users, and usage; (ii) introduce the Cyber-Developmental Framework (CDF), as an overarching framework for understanding individual differences in adaptive and maladaptive digital media use among youth; (iii) delineate the cyber-component of this framework in relation to users’ experience of the digital context, their activity within it, as well as their digital self-presence, which may have an impact on their digital media use; and (iv) summarize priorities and future directions through the lens of this CDF. Within this context, this review particularly emphasizes the effect of digital media use on youth’s psychological well-being. It is argued that the trajectory youth will follow in their use of the Internet is a function of the interplay between their characteristics, their proximate and distal contexts, and the particular features of the digital application(s) that the individual is engaged in. The review points to the need to conduct research focusing on better understanding the developmental and digital-context-related influences on youth’s trajectories of Internet use.
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Affiliation(s)
- Vasileios Stavropoulos
- National & Kapodistrian University of Athens, Greece
- Department of Psychology, Victoria University Australia, Melbourne, VIC, Australia
| | | | - Mark D. Griffiths
- International Gaming Research Unit, Nottingham Trent University, United Kingdom
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Cercel MO. Gamification in diplomacy studies as an effective tool for knowledge transfer. Simulation game of a diplomatic organization (Preprint). JMIR Serious Games 2021; 10:e32996. [PMID: 35468081 PMCID: PMC9086880 DOI: 10.2196/32996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 03/13/2022] [Accepted: 03/16/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Mihai Ovidiu Cercel
- Department of International Relations and European Integration, National University of Political Studies and Public Administration, Bucharest, Romania
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Ihsan SN, Kadir TAA, Abdullah AR. Serious Games and Preventive Self-Care for Diabetes: A Conceptual Framework. 2021 INTERNATIONAL CONFERENCE ON SOFTWARE ENGINEERING & COMPUTER SYSTEMS AND 4TH INTERNATIONAL CONFERENCE ON COMPUTATIONAL SCIENCE AND INFORMATION MANAGEMENT (ICSECS-ICOCSIM) 2021. [DOI: 10.1109/icsecs52883.2021.00071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Affiliation(s)
- Siti Normaziah Ihsan
- Universiti Malaysia Pahang,Faculty of Computing, College of Computing and Applied Science,Pekan Pahang,Malaysia,26600
| | - Tuty Asmawaty Abd Kadir
- Universiti Malaysia Pahang,Faculty of Computing, College of Computing and Applied Science,Pekan Pahang,Malaysia,26600
| | - Abdul Rafiq Abdullah
- Universiti Malaysia Pahang,Faculty of Computing, College of Computing and Applied Science,Pekan Pahang,Malaysia,26600
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Perron JE, Coffey MJ, Lovell-Simons A, Dominguez L, King ME, Ooi CY. Resuscitating Cardiopulmonary Resuscitation Training in a Virtual Reality: Prospective Interventional Study. J Med Internet Res 2021; 23:e22920. [PMID: 34326040 PMCID: PMC8367149 DOI: 10.2196/22920] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/16/2020] [Accepted: 03/11/2021] [Indexed: 12/12/2022] Open
Abstract
Background Simulation-based technologies are emerging to enhance medical education in the digital era. However, there is limited data for the use of virtual reality simulation in pediatric medical education. We developed Virtual Doc as a highly immersive virtual reality simulation to teach pediatric cardiopulmonary resuscitation skills to medical students. Objective The primary objectives of this study were to evaluate participant satisfaction and perceived educational efficacy of Virtual Doc. The secondary aim of this study was to assess the game play features of Virtual Doc. Methods We conducted a prospective closed beta-testing study at the University of New South Wales (Sydney, Australia) in 2018. All medical students from the 6-year undergraduate program were eligible to participate and were recruited through voluntary convenience sampling. Participants attended a 1-hour testing session and attempted at least one full resuscitation case using the virtual reality simulator. Following this, participants were asked to complete an anonymous postsession questionnaire. Responses were analyzed using descriptive statistics. Results A total of 26 participants were recruited, consented to participate in this study, and attended a 1-hour in-person closed beta-testing session, and 88% (23/26) of participants completed the anonymous questionnaire and were included in this study. Regarding participant satisfaction, Virtual Doc was enjoyed by 91% (21/23) of participants, with 74% (17/23) intending to recommend the simulation to a colleague and 66% (15/23) intending to recommend the simulation to a friend. In assessment of the perceived educational value of Virtual Doc, 70% (16/23) of participants agreed they had an improved understanding of cardiopulmonary resuscitation, and 78% (18/23) agreed that Virtual Doc will help prepare for and deal with real-life clinical scenarios. Furthermore, 91% (21/23) of participants agreed with the development of additional Virtual Doc cases as beneficial for learning. An evaluation of the game play features as our secondary objective revealed that 70% (16/23) of participants agreed with ease in understanding how to use Virtual Doc, and 74% (17/23) found the game play elements useful in understanding cardiopulmonary resuscitation. One-third (7/23, 30%) found it easy to work with the interactive elements. In addition, 74% (17/23) were interested in interacting with other students within the simulation. Conclusions Our study demonstrates a positive response regarding trainee satisfaction and perceived educational efficacy of Virtual Doc. The simulation was widely accepted by the majority of users and may have the potential to improve educational learning objectives.
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Affiliation(s)
- Janaya Elizabeth Perron
- Discipline of Paediatrics, School of Women's and Children's Health, University of New South Wales, Randwick, Australia
| | - Michael Jonathon Coffey
- Discipline of Paediatrics, School of Women's and Children's Health, University of New South Wales, Randwick, Australia
| | - Andrew Lovell-Simons
- Medicine Education Development Unit, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Luis Dominguez
- Educational Delivery Services, Office of the Pro Vice-Chancellor (Education), University of New South Wales, Sydney, Australia
| | - Mark E King
- Educational Delivery Services, Office of the Pro Vice-Chancellor (Education), University of New South Wales, Sydney, Australia
| | - Chee Y Ooi
- Discipline of Paediatrics, School of Women's and Children's Health, University of New South Wales, Randwick, Australia
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The International Pharmacy Game: A Comparison of Implementation in Seven Universities World-Wide. PHARMACY 2021; 9:pharmacy9030125. [PMID: 34287364 PMCID: PMC8293378 DOI: 10.3390/pharmacy9030125] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 07/07/2021] [Accepted: 07/09/2021] [Indexed: 11/21/2022] Open
Abstract
The utilization of serious games and simulations in health professional education has increased. The Pharmacy Game is one such concept that intersects gamification and simulation, in which pharmacy student teams competitively manage simulated pharmacies; a concept included in the pharmacy curricula of seven international universities. This study aimed to compare the implementation and conduct of the Pharmacy Game of participant universities and their students’ performance in the same educational task. Data were collected via a questionnaire completed by academic staff in April 2020, and the collation of results of the same patient case was conducted at each university (April 2020 to March 2021). The main results reflected differences in the game frequencies and the curricular approach (standalone or integrated course) and in the learning outcomes for the Pharmacy Game. Other differences were identified in the extent to which students of other professions were part of the game such as medical students or pharmacy assistants. Student case outcomes revealed similar strengths across the universities in patient communication and focus on safety, with variations identified as areas for improvement. Collation of the international utilization of the Pharmacy Game identified a broad spectrum of similar learning outcomes, inspiring a model of international core and aspirational learning outcomes. While the Pharmacy Game has been implemented with flexibility regarding the numbers of teams (4–10) and the duration of activity (12–36 days), all universities reported positive experiences and student outcomes, suggesting that the intervention represents a potential tool to deliver capstone learning experiences, promote interprofessional education, reinforce patient safety, and prepare pharmacy graduates for future practice.
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Mansoory MS, Khazaei MR, Azizi SM, Niromand E. Comparison of the effectiveness of lecture instruction and virtual reality-based serious gaming instruction on the medical students' learning outcome about approach to coma. BMC MEDICAL EDUCATION 2021; 21:347. [PMID: 34130676 PMCID: PMC8207643 DOI: 10.1186/s12909-021-02771-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 05/27/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND New approaches to e-learning and the use of virtual reality technology and serious game in medical education are on the rise. Therefore, the purpose of this study was to compare the effectiveness of lecture method and virtual reality-based serious gaming (VRBSG) method on students learning outcomes about the approach to coma. METHODS We adopted a randomized trial method for this study and selected 50 medical students dividing them into experimental and control groups. Students' learning outcome was measured with a 10-item test. Serious game usability scale was used to evaluate the usability of the serious game. Descriptive and inferential statistics were used for data analysis by SPSS-22 software. RESULTS Students' familiarity with e-learning and VRBSG was low. The mean usability of a VRBSG was 126.78 ± 10.34 out of 150. The majority of students were eager to be instructed through VRBSG. The mean score of learning outcomes in the experimental group was significantly higher than the control group (t = - 2.457, P = 0.019). CONCLUSION Students' learning outcomes in the VRBSG group in the test approach to coma were significantly better than the lecture group. The usability of the serious game instruction method was high. Taken together, instruction through VRBSG had an effective role in medical students' learning.
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Affiliation(s)
- Meysam Siyah Mansoory
- Department of Biomedical Engineering, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Rasool Khazaei
- Fertility and Infertility Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Seyyed Mohsen Azizi
- Medical Education and Development Center, Arak University of Medical Sciences, Arak, Iran
| | - Elham Niromand
- Fertility and Infertility Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Suppan M, Abbas M, Catho G, Stuby L, Regard S, Achab S, Harbarth S, Suppan L. Impact of a Serious Game (Escape COVID-19) on the Intention to Change COVID-19 Control Practices Among Employees of Long-term Care Facilities: Web-Based Randomized Controlled Trial. J Med Internet Res 2021; 23:e27443. [PMID: 33685854 PMCID: PMC7996198 DOI: 10.2196/27443] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/07/2021] [Accepted: 03/07/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Most residents of long-term care facilities (LTCFs) are at high risk of complications and death following SARS-CoV-2 infection. In these facilities, viral transmission can be facilitated by shortages of human and material resources, which can lead to suboptimal application of infection prevention and control (IPC) procedures. To improve the dissemination of COVID-19 IPC guidelines, we developed a serious game called "Escape COVID-19" using Nicholson's RECIPE for meaningful gamification, as engaging serious games have the potential to induce behavioral change. OBJECTIVE As the probability of executing an action is strongly linked to the intention of performing it, the objective of this study was to determine whether LTCF employees were willing to change their IPC practices after playing "Escape COVID-19." METHODS This was a web-based, triple-blind, randomized controlled trial, which took place between November 5 and December 4, 2020. The health authorities of Geneva, Switzerland, asked the managers of all LTCFs under their jurisdiction to forward information regarding the study to all their employees, regardless of professional status. Participants were unaware that they would be randomly allocated to one of two different study paths upon registration. In the control group, participants filled in a first questionnaire designed to gather demographic data and assess baseline knowledge before accessing regular online IPC guidelines. They then answered a second questionnaire, which assessed their willingness to change their IPC practices and identified the reasons underlying their decision. They were then granted access to the serious game. Conversely, the serious game group played "Escape COVID-19" after answering the first questionnaire but before answering the second one. This group accessed the control material after answering the second set of questions. There was no time limit. The primary outcome was the proportion of LTCF employees willing to change their IPC practices. Secondary outcomes included the factors underlying participants' decisions, the domains these changes would affect, changes in the use of protective equipment items, and attrition at each stage of the study. RESULTS A total of 295 answer sets were analyzed. Willingness to change behavior was higher in the serious game group (82% [119/145] versus 56% [84/150]; P<.001), with an odds ratio of 3.86 (95% CI 2.18-6.81; P<.001) after adjusting for professional category and baseline knowledge, using a mixed effects logistic regression model with LTCF as a random effect. For more than two-thirds (142/203) of the participants, the feeling of playing an important role against the epidemic was the most important factor explaining their willingness to change behavior. Most of the participants unwilling to change their behavior answered that they were already applying all the guidelines. CONCLUSIONS The serious game "Escape COVID-19" was more successful than standard IPC material in convincing LTCF employees to adopt COVID-19-safe IPC behavior. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/25595.
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Affiliation(s)
- Mélanie Suppan
- Division of Anesthesiology, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Mohamed Abbas
- Infection Control Programme and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Gaud Catho
- Infection Control Programme and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | | | - Simon Regard
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
- Division of the Surgeon General, Geneva Directorate of Health, Geneva, Switzerland
| | - Sophia Achab
- Specialized Facility in Behavioral Addictions ReConnecte, University of Geneva Hospitals, Geneva, Switzerland
- WHO Collaborating Center in Training and Research in Mental Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Stephan Harbarth
- Infection Control Programme and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Laurent Suppan
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
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Zhang C, Baalsrud Hauge J, Härenstam KP, Meijer S. Game Experience and Learning Effects of a Scoring-Based Mechanic for Logistical Aspects of Pediatric Emergency Medicine: Development and Feasibility Study. JMIR Serious Games 2021; 9:e21988. [PMID: 33704081 PMCID: PMC7995068 DOI: 10.2196/21988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 11/27/2020] [Accepted: 02/12/2021] [Indexed: 01/11/2023] Open
Abstract
Background Using serious games for learning in operations management is well established. However, especially for logistics skills in health care operations, there is little work on the design of game mechanics for learning engagement and the achievement of the desired learning goals. Objective This contribution presents a serious game design representing patient flow characteristics, systemic resource configurations, and the roles of the players based on a real Swedish emergency ward. The game was tested in a set of game-based learning practices in the modalities of a physical board game and an online multiplayer serious game that implemented the same game structure. Methods First, survey scores were collected using the Game Experience Questionnaire Core and Social Presence Modules to evaluate the experience and acceptance of the proposed design to gamify real processes in emergency care. Second, lag sequential analysis was applied to analyze the impact of the game mechanics on learning behavior transitions. Lastly, regression analysis was used to understand whether learning engagement attributes could potentially serve as significant predicting variables for logistical performance in a simulated learning environment. Results A total of 36 students from courses in engineering and management at KTH Royal Institute of Technology participated in both game-based learning practices during the autumn and spring semesters of 2019 and 2020. For the Core Module, significant differences were found for the scores for negative affect and tension compared with the rest of the module. For the Social Presence Module, significant differences were found in the scores for the psychological involvement – negative feelings dimension compared with the rest of the module. During the process of content generation, the participant had access to circulating management resources and could edit profiles. The standard regression analysis output yielded a ΔR2 of 0.796 (F14,31=2725.49, P<.001) for the board version and 0.702 (F24,31=2635.31, P<.001) for the multiplayer online version after the learning engagement attributes. Conclusions The high scores of positive affect and immersion compared to the low scores of negative feelings demonstrated the motivating and cognitive involvement impact of the game. The proposed game mechanics have visible effects on significant correlation parameters between the majority of scoring features and changes in learning engagement attributes. Therefore, we conclude that for enhancing learning in logistical aspects of health care, serious games that are steered by well-designed scoring mechanisms can be used.
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Affiliation(s)
- Cevin Zhang
- School of Media and Design, Beijing Technology and Business University, Beijing, China.,Department of Biomedical Engineering and Health Systems, Kungliga Tekniska Högskolan, Huddinge, Sweden
| | - Jannicke Baalsrud Hauge
- Department of Sustainable Production Development, Kungliga Tekniska Högskolan, Södertalje, Sweden
| | - Karin Pukk Härenstam
- Pediatric Emergency Department, Karolinska University Hospital, Stockholm, Sweden
| | - Sebastiaan Meijer
- Department of Biomedical Engineering and Health Systems, Kungliga Tekniska Högskolan, Huddinge, Sweden
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Lateef F, Lim RE, Loh MWY, Pang KYC, Wong M, Lew KX, Madhavi S. Taking Serious Games Forward in Curriculum and Assessment: Starting Infusions Right Every Time. J Emerg Trauma Shock 2021; 14:232-239. [PMID: 35125790 PMCID: PMC8780635 DOI: 10.4103/jets.jets_82_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 07/15/2021] [Indexed: 11/04/2022] Open
Abstract
Technology-driven educational modalities are increasingly utilized today in a variety of forms. Different combinations of the spectrum of simulation-based learning, the use of virtual reality, augmented reality, mixed reality, and serious gaming continue to gain traction on various educational platforms. In this paper, we share the formation of our project team to plan and execute a serious game on starting infusions and the use of infusion pump for nursing and health-care staff. The incorporation of element of assessment is also discussed. The various phases we went through included: Learning needs assessment and conceptualizationAssembly of project teamTransfer of medical conceptsStoryboard and content productionLearners' experiential mappingTesting of the prototypeBeta testing and release of the final product The collaborative work and coordination between the subject-matter experts together with the technical production team is critical. Issues such as assessment and debriefing in serious gaming were also addressed, not forgetting the need to ensure that, above all, learning must take place.
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Affiliation(s)
- Fatimah Lateef
- Department of Emergency Medicine, Singapore General Hospital, Singapore,Yong Loo Lin School of Medicine, National University of Singapore, Lee Kong Chian Medical School, Nanyang Technological University and Duke NUS Graduate Medical School, Singapore,SingHealth Duke NUS Institute of Medical Simulation, Singapore,Address for correspondence: Prof. Fatimah Lateef, Department of Emergency Medicine, Singapore General Hospital, 1 Hospital Drive, Outram Road, 169608 Singapore. E-mail:
| | - Rong Ee Lim
- Department of Emergency Medicine, Singapore General Hospital, Singapore
| | | | | | - Mark Wong
- MSC Computer-aided Graphical Technology Application
| | - Kai Xiong Lew
- SingHealth Duke NUS Institute of Medical Simulation, Singapore
| | - Suppiah Madhavi
- SingHealth Duke NUS Institute of Medical Simulation, Singapore
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Fonteneau T, Billion E, Abdoul C, Le S, Hadchouel A, Drummond D. Simulation Game Versus Multiple Choice Questionnaire to Assess the Clinical Competence of Medical Students: Prospective Sequential Trial. J Med Internet Res 2020; 22:e23254. [PMID: 33325833 PMCID: PMC7773513 DOI: 10.2196/23254] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/10/2020] [Accepted: 11/12/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The use of simulation games (SG) to assess the clinical competence of medical students has been poorly studied. OBJECTIVE The objective of this study was to assess whether an SG better reflects the clinical competence of medical students than a multiple choice questionnaire (MCQ). METHODS Fifth-year medical students in Paris (France) were included and individually evaluated on a case of pediatric asthma exacerbation using three successive modalities: high-fidelity simulation (HFS), considered the gold standard for the evaluation of clinical competence, the SG Effic'Asthme, and an MCQ designed for the study. The primary endpoint was the median kappa coefficient evaluating the correlation of the actions performed by the students between the SG and HFS modalities and the MCQ and HFS modalities. Student satisfaction was also evaluated. RESULTS Forty-two students were included. The actions performed by the students were more reproducible between the SG and HFS modalities than between the MCQ and HFS modalities (P=.04). Students reported significantly higher satisfaction with the SG (P<.01) than with the MCQ modality. CONCLUSIONS The SG Effic'Asthme better reflected the actions performed by medical students during an HFS session than an MCQ on the same asthma exacerbation case. Because SGs allow the assessment of more dimensions of clinical competence than MCQs, they are particularly appropriate for the assessment of medical students on situations involving symptom recognition, prioritization of decisions, and technical skills. TRIAL REGISTRATION ClinicalTrials.gov NCT03884114; https://clinicaltrials.gov/ct2/show/NCT03884114.
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Affiliation(s)
- Tristan Fonteneau
- Department of Paediatric Pulmonology and Allergology, University Hospital Necker-Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Elodie Billion
- Department of Paediatric Pulmonology and Allergology, University Hospital Necker-Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Cindy Abdoul
- Department of Paediatric Pulmonology and Allergology, University Hospital Necker-Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Sebastien Le
- Department of Paediatric Pulmonology and Allergology, University Hospital Necker-Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Alice Hadchouel
- Department of Paediatric Pulmonology and Allergology, University Hospital Necker-Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France.,iLumens Simulation Department, University of Paris, Paris, France
| | - David Drummond
- Department of Paediatric Pulmonology and Allergology, University Hospital Necker-Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France.,iLumens Simulation Department, University of Paris, Paris, France
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Suppan L, Abbas M, Catho G, Stuby L, Regard S, Harbarth S, Achab S, Suppan M. Impact of a Serious Game on the Intention to Change Infection Prevention and Control Practices in Nursing Homes During the COVID-19 Pandemic: Protocol for a Web-Based Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e25595. [PMID: 33296329 PMCID: PMC7744143 DOI: 10.2196/25595] [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: 11/10/2020] [Revised: 12/02/2020] [Accepted: 12/08/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Nursing home residents are at high risk of complications and death due to COVID-19. Lack of resources, both human and material, amplifies the likelihood of contamination in these facilities where a single employee can contaminate dozens of residents and colleagues. Improving the dissemination of and adhesion to infection prevention and control (IPC) guidelines is therefore essential. Serious games have been shown to be effective in developing knowledge and in increasing engagement, and could motivate nursing home employees to change their IPC practices. OBJECTIVE Our aim is to assess the impact of "Escape COVID-19," a serious game designed to enhance knowledge and application of IPC procedures, on the intention of nursing home employees to change their IPC practices. METHODS We will carry out a web-based randomized controlled trial following the CONSORT-EHEALTH (Consolidated Standards of Reporting Trials of Electronic and Mobile Health Applications and Online Telehealth) guidelines and incorporating relevant elements of CHERRIES (Checklist for Reporting Results of Internet E-Surveys). Participants will be randomized to either the control or the serious game (intervention) group. First, both groups will be asked to answer a questionnaire designed to gather demographic data and assess baseline knowledge. The control group will then receive a quick reminder of the current national guidelines and links to IPC guidelines for health care professionals, while the other group will play the game. Both groups will then have to answer a second questionnaire designed to assess their willingness to change their IPC practices after having followed their respective material. After completing this questionnaire, they will be granted access to the material presented to the group they were not assigned to and receive a course completion certificate. The primary outcome will be the proportion of participants willing to change their IPC practices according to group. Secondary outcomes will include the analysis of specific questions detailing the exact changes considered by the participants. Factors associated with participant willingness or reluctance to change behavior will also be assessed. Attrition will also be assessed at each stage of the study. RESULTS The study protocol has been presented to our regional ethics committee (Req-2020-01262), which issued a declaration of no objection as such projects do not fall within the scope of the Swiss federal law on human research. Data collection began on November 5, 2020, and should be completed by December 4, 2020. CONCLUSIONS This study should determine whether "Escape COVID-19," a serious game designed to improve compliance with COVID-19 safe practices, modifies the intention to follow IPC guidelines among nursing home employees. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/25595.
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Affiliation(s)
- Laurent Suppan
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Mohamed Abbas
- Infection Control Programme, WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Gaud Catho
- Infection Control Programme, WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | | | - Simon Regard
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.,Division of General Surgeon, Geneva Directorate of Health, Geneva, Switzerland
| | - Stephan Harbarth
- Infection Control Programme, WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Sophia Achab
- Specialized Facility in Behavioral Addictions ReConnecte, Geneva University Hospitals, Geneva, Switzerland.,WHO Collaborating Center in Training and Research in Mental Health, University of Geneva, Geneva, Switzerland
| | - Mélanie Suppan
- Division of Anesthesiology, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
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Suppan M, Catho G, Robalo Nunes T, Sauvan V, Perez M, Graf C, Pittet D, Harbarth S, Abbas M, Suppan L. A Serious Game Designed to Promote Safe Behaviors Among Health Care Workers During the COVID-19 Pandemic: Development of "Escape COVID-19". JMIR Serious Games 2020; 8:e24986. [PMID: 33242312 PMCID: PMC7717924 DOI: 10.2196/24986] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/12/2020] [Accepted: 11/26/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND As many countries fear and even experience the emergence of a second wave of COVID-19, reminding health care workers (HCWs) and other hospital employees of the critical role they play in preventing SARS-CoV-2 transmission is more important than ever. Building and strengthening the intrinsic motivation of HCWs to apply infection prevention and control (IPC) guidelines to avoid contaminating their colleagues, patients, friends, and relatives is a goal that must be energetically pursued. A high rate of nosocomial infections during the first COVID-19 wave was detected by IPC specialists and further cemented their belief in the need for an engaging intervention that could improve compliance with COVID-19 safe behaviors. OBJECTIVE Our aim was to develop a serious game that would promote IPC practices with a specific focus on COVID-19 among HCWs and other hospital employees. METHODS The first 3 stages of the SERES framework were used to develop this serious game. A brainswarming session between developers and IPC specialists was used to identify the target audience and acquisition objectives. Nicholson's RECIPE mnemonic (reflection, engagement, choice, information, play, exposition) for meaningful gamification was used to guide the general design. A common and simple terminology was used to suit the broad target audience. The game was tested on various platforms (smartphones, tablets, laptops, desktop computers) by different users during each development loop and before its final release. RESULTS The game was designed to target all hospital staff who could be in direct contact with patients within the Geneva University Hospitals. In total, 10 acquisition objectives were defined by IPC specialists and implemented into the game according to the principles of meaningful gamification. A simple storyboard was first created using Microsoft PowerPoint and was progressively refined through multiple iteration loops. Articulate Storyline was then used to create two successive versions of the actual game. In the final version, a unique graphic atmosphere was created with help from a professional graphic designer. Feedback mechanisms were used extensively throughout the game to strengthen key IPC messages. CONCLUSIONS The SERES framework was successfully used to create "Escape COVID-19," a serious game designed to promote safe IPC practices among HCWs and other hospital employees during the COVID-19 pandemic. This game can be obtained free of charge for research and educational purposes. A SCORM (shareable content object reference model) package is available to facilitate results and completion tracking on most current learning management systems.
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Affiliation(s)
- Mélanie Suppan
- Division of Anesthesiology, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Gaud Catho
- Infection Control Program, WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Tomás Robalo Nunes
- Infection Control Program, WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
- Infectious Diseases Department, Hospital Garcia de Orta, EPE, Almada, Portugal
| | - Valérie Sauvan
- Infection Control Program, WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Monique Perez
- Infection Control Program, WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Christophe Graf
- Department of Rehabilitation and Geriatrics, Geneva University Hospital, Geneva, Switzerland
| | - Didier Pittet
- Infection Control Program, WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Stephan Harbarth
- Infection Control Program, WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Mohamed Abbas
- Infection Control Program, WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Laurent Suppan
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
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Younie S, Mitchell C, Bisson MJ, Crosby S, Kukona A, Laird K. Improving young children's handwashing behaviour and understanding of germs: The impact of A Germ's Journey educational resources in schools and public spaces. PLoS One 2020; 15:e0242134. [PMID: 33227004 PMCID: PMC7682880 DOI: 10.1371/journal.pone.0242134] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 10/28/2020] [Indexed: 01/17/2023] Open
Abstract
CONTEXT Effective handwashing can prevent the spread of germs, including Covid-19. However, young children can lack a fundamental understanding of germ transfer. A Germ's Journey educational resources were designed to support young children in learning about germs and handwashing. These resources include a book, website, song, online games and glo-gel activities that are informed by a behaviour change model. RESEARCH GAP Prior research has not evaluated the impacts of these resources on behavioural outcomes. PURPOSE OF THE STUDY Two intervention studies evaluated the impacts of these resources on both knowledge and behavioural outcomes. METHOD In Study 1, children (n = 225) were recruited from four schools and randomly assigned by classrooms to participate in a multicomponent intervention (vs. control). In Study 2, children (n = 104) were recruited from a museum and randomly assigned to participate in a song intervention (vs. control). Trained observers recorded participants' engagement in six handwashing behaviours and their understanding of germs. These behavioural and knowledge outcomes were analysed using regression and related analyses. RESULTS In Study 1, significant improvements were observed between baseline and follow up in the intervention group for both behavioural scores (Est = 0.48, SE = 0.14, t = 3.30, p = 0.001) and knowledge scores (Est = 2.14, SE = 0.52, z = 4.11, p < 0.001), whereas these improvements were not observed in the control group (ts < 1). In Study 2, the intervention group had significantly higher behavioural scores compared to the control group (Est. = -0.71, SE = 0.34, t = -2.07, p = 0.04). CONCLUSION This research demonstrates that specifically designed hand hygiene educational resources can improve handwashing practice and understanding in young children, and could lead to the reduction of the transmission of disease within this group.
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Affiliation(s)
- Sarah Younie
- Institute for Research in Criminology, Community, Education and Social Justice, De Montfort University, Leicester, United Kingdom
| | - Chloe Mitchell
- Institute for Psychological Science, De Montfort University, Leicester, United Kingdom
- * E-mail:
| | - Marie-Josee Bisson
- Institute for Psychological Science, De Montfort University, Leicester, United Kingdom
| | - Sapphire Crosby
- Institute for Research in Criminology, Community, Education and Social Justice, De Montfort University, Leicester, United Kingdom
| | - Anuenue Kukona
- Institute for Psychological Science, De Montfort University, Leicester, United Kingdom
| | - Katie Laird
- Infectious Disease Research Group, Leicester Institute for Pharmaceutical Innovation, De Montfort University, Leicester, United Kingdom
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Abstract
Simulation-based education improves health care professionals' performance in managing critical events. Limitations to widespread uptake of high-fidelity simulation include barriers related to training, technology, and time. Alternatives to high-fidelity simulation that overcome these barriers include in situ simulation, classroom-based simulation, telesimulation, observed simulation, screen-based simulation, and game-based simulation. Some settings have limited access to onsite expert facilitation to design, implement, and guide participants through simulation-based education. Alternatives to onsite expert debriefing in these settings include teledebriefing, scripted debriefing, and within-group debriefing. A combination of these alternatives promotes successful implementation and maintenance of simulation-based education for managing critical health care events.
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Affiliation(s)
- Megan Delisle
- Department of Surgery, University of Manitoba, 347-825 Sherbrook Street, Winnipeg, Manitoba R3T 2N2, Canada
| | - Alexander A Hannenberg
- Ariadne Labs, Tufts University School of Medicine, 401 Park Drive, 3 West, Boston, MA 02115, USA.
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Espinosa-Curiel IE, Pozas-Bogarin EE, Martínez-Miranda J, Pérez-Espinosa H. Relationship Between Children's Enjoyment, User Experience Satisfaction, and Learning in a Serious Video Game for Nutrition Education: Empirical Pilot Study. JMIR Serious Games 2020; 8:e21813. [PMID: 32940609 PMCID: PMC7530690 DOI: 10.2196/21813] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/21/2020] [Accepted: 09/01/2020] [Indexed: 01/25/2023] Open
Abstract
Background The design and use of serious video games for children have increased in recent years. To maximize the effects of these games, it is essential to understand the children’s experiences through playing. Previous studies identified that enjoyment and user experience satisfaction of the players are principal factors that can influence the success of serious video games and the learning of their players. However, research about the relationship between enjoyment and user experience satisfaction with learning in children 8 to 10 years old is sparse. Objective We examined the relationship of enjoyment and user experience satisfaction with the learning of children aged 8 to 10 years while playing a serious video game for health, FoodRateMaster. This serious video game teaches children about the characteristics of healthy and unhealthy foods and how to identify them in their environment. Methods Children aged 8 to 10 years were recruited from a primary school in Mexico. Participants completed 12 individual gaming sessions with FoodRateMaster in 6 weeks. A food knowledge questionnaire was administered before and after game play to assess the players’ food knowledge. In addition, after the gaming sessions, the children’s enjoyment and user experience satisfaction were evaluated using the EGameFlow questionnaire and the Game User Experience Satisfaction Scale (GUESS) questionnaire. Results We found significant positive associations for children’s (n=60) posttest knowledge with enjoyment (r58=0.36, P=.005) and user experience satisfaction (r58=0.27, P=.04). The children’s posttest knowledge scores were also positively correlated with challenge (r58=0.38, P=.003), knowledge improvement (r58=0.38, P=.003), and goal clarity (r58=0.29, P=.02) EGameFlow subscales and with narrative (r58=0.35, P=.006), creative freedom (r58=0.26, P=.04), and visual esthetics (r58=0.32, P=.01) GUESS subscales. Regression analysis indicated that the EGameFlow (F7,52=2.74, P=.02, R2=0.27) and the GUESS (F8,51=2.20, P=.04, R2=0.26) ratings significantly predicted the children’s posttest knowledge scores. EGameFlow challenge (β=0.40, t52=2.17, P=.04) and knowledge improvement (β=0.29, t52=2.06, P=.04) subscales significantly contributed to predicting children’s learning. None of the GUESS subscales significantly contributed to predicting children’s learning. Conclusions The findings of this study suggest that both enjoyment and user experience satisfaction for children aged 8 to 10 years were positively correlated with their learning and that were significant predictors of it. Challenge, knowledge improvement, narrative, creative freedom, and visual esthetics subscales correlated positively with children’s learning. In addition, challenge and knowledge improvement contributed to predicting their learning. These results are relevant to consider during the design stages of serious games developed for young children’s learning purposes.
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Affiliation(s)
- Ismael Edrein Espinosa-Curiel
- Centro de Investigación Científica y de Educación Superior de Ensenada, Unidad de Transferencia Tecnológica Tepic, Tepic, Nayarit, Mexico
| | - Edgar Efrén Pozas-Bogarin
- Centro de Investigación Científica y de Educación Superior de Ensenada, Unidad de Transferencia Tecnológica Tepic, Tepic, Nayarit, Mexico
| | - Juan Martínez-Miranda
- Consejo Nacional de Ciencia y Tecnología, Centro de Investigación Científica y de Educación Superior de Ensenada, Unidad de Transferencia Tecnológica Tepic, Tepic, Nayarit, Mexico
| | - Humberto Pérez-Espinosa
- Consejo Nacional de Ciencia y Tecnología, Centro de Investigación Científica y de Educación Superior de Ensenada, Unidad de Transferencia Tecnológica Tepic, Tepic, Nayarit, Mexico
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Yoshida-Montezuma Y, Ahmed M, Ezezika O. Does gamification improve fruit and vegetable intake in adolescents? a systematic review. Nutr Health 2020; 26:347-366. [PMID: 32703067 DOI: 10.1177/0260106020936143] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Nutrition and diet-related non-communicable diseases are a major cause of death worldwide. Food preferences and eating behaviours are likely to be established during adolescence, making it an important period to promote healthy behaviours. AIM To review the effectiveness of gamification to improve fruit and vegetable intake in adolescents. METHODS A systematic search was conducted using eight databases and grey literature sources for articles published to date on the effectiveness of gamification on fruit and vegetable intake in adolescents. Search criteria included articles that were complete and peer reviewed, conducted empirical research, described gamified elements used, focused on individuals between 10 and 24 years, and were available in English. RESULTS Out of 402 studies identified by the search, 7 were included in the review. Overall, short-term gamified interventions showed promise in improving fruit and vegetable intake in those aged 10 to 24 years old. Gamification was primarily facilitated through extrinsic motivation (i.e. points, badges, vouchers, leaderboard, narration, avatars, challenges) rather than intrinsic motivation (i.e. team-based competition). Studies were moderate in quality and key methodological issues related to non-randomized study design, lack of comparison group, inadequate control for confounding, and small sample size. CONCLUSIONS Gamification can be an effective tool in changing nutrition-related behaviour in adolescents over the short term. Future research should consider gamified interventions that are of longer duration, incorporate additional intrinsic gamified elements, tailor game elements for population subgroups, and address methodological issues.
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Affiliation(s)
| | - Mustafa Ahmed
- Faculty of Health Sciences, 468151University of Ontario Institute of Technology, Canada
| | - Obidimma Ezezika
- Dalla Lana School of Public Health, 274071University of Toronto, Canada.,Faculty of Health Sciences, 468151University of Ontario Institute of Technology, Canada.,Department of Health and Society, 33530University of Toronto Scarborough, Canada
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Suppan M, Gartner B, Golay E, Stuby L, White M, Cottet P, Abbas M, Iten A, Harbarth S, Suppan L. Teaching Adequate Prehospital Use of Personal Protective Equipment During the COVID-19 Pandemic: Development of a Gamified e-Learning Module. JMIR Serious Games 2020; 8:e20173. [PMID: 32516115 PMCID: PMC7295001 DOI: 10.2196/20173] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/06/2020] [Accepted: 06/09/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The coronavirus disease (COVID-19) pandemic has led to increased use of personal protective equipment (PPE). Adequate use of this equipment is more critical than ever because the risk of shortages must be balanced against the need to effectively protect health care workers, including prehospital personnel. Specific training is therefore necessary; however, the need for social distancing has markedly disrupted the delivery of continuing education courses. Electronic learning (e-learning) may provide significant advantages because it requires neither the physical presence of learners nor the repetitive use of equipment for demonstration. OBJECTIVE Inclusion of game mechanics, or "gamification," has been shown to increase knowledge and skill acquisition. The objective of this research was to develop a gamified e-learning module to interactively deliver concepts and information regarding the correct choice and handling of PPE. METHODS The SERES framework was used to define and describe the development process, including scientific and design foundations. After we defined the target audience and learning objectives by interviewing the stakeholders, we searched the scientific literature to establish relevant theoretical bases. The learning contents were validated by infection control and prehospital experts. Learning mechanics were then determined according to the learning objectives, and the content that could benefit from the inclusion of game mechanics was identified. RESULTS The literature search resulted in the selection and inclusion of 12 articles. In addition to gamification, pretesting, feedback, avoiding content skipping, and demonstrations using embedded videos were used as learning mechanics. Gamification was used to enhance the interactivity of the PPE donning and doffing sequences, which presented the greatest learning challenges. The module was developed with Articulate Storyline 3 to ensure that it would be compatible with a wide array of devices, as this software generates HTML5-compatible output that can be accessed on smartphones, tablets, and regular computers as long as a recent browser is available. CONCLUSIONS A gamified e-learning module designed to promote better knowledge and understanding of PPE use among prehospital health care workers was created by following the SERES framework. The impact of this module should now be assessed by means of a randomized controlled trial.
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Affiliation(s)
- Mélanie Suppan
- Division of Anesthesiology, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Birgit Gartner
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Eric Golay
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | | | - Marion White
- Division of Anesthesiology, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Philippe Cottet
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Mohamed Abbas
- Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Anne Iten
- Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Stephan Harbarth
- Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Laurent Suppan
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
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Noveletto F, Soares AV, Eichinger FLF, Domenech SC, Hounsell MDS, Filho PB. Biomedical Serious Game System for Lower Limb Motor Rehabilitation of Hemiparetic Stroke Patients. IEEE Trans Neural Syst Rehabil Eng 2020; 28:1481-1487. [PMID: 32305932 DOI: 10.1109/tnsre.2020.2988362] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Hemiparesis resulting from a stroke has a direct impact on patients' daily activities. New approaches for motor rehabilitation include Serious Games (SG) because they include (in a motivating way) the three fundamental elements for rehabilitation: intensive, repetitive and task-oriented training. This study aims to evaluate the therapeutic effects of a biomedical SG and a scoring system developed for lower limb motor rehabilitation of hemiparetic stroke patients. The SG was inspired by the classic videogame called Pong, where the goal is to control a tennis racquet, but using muscular strength. A knee extensor apparatus was adapted with a load cell and mechanical adjustments for measuring the muscular strength of the quadriceps femoris (QFG) and hamstrings (HSG). A scoring system was proposed to evaluate muscular control. Eleven hemiparetic stroke patients participated in an exercise program using the SG twice a week for ten weeks and only the paretic side was trained. Significant Effect Sizes ( d ) were found for QFG strength ( d=0.5;p=0.021 ), QFG control ( ), HSG strength ( d=1.1; p = 0.001 ), HSG control ( d=1.5; p = 0.003 ), functional mobility ( ), gait speed ( d=0.4; p=0.007 ) and motor recovery ( ). Results indicate that the intervention of a SG with both proper apparatus and evaluation system may effectively promote lower limb motor rehabilitation of hemiparetic stroke patients.
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Blanié A, Amorim MA, Benhamou D. Comparative value of a simulation by gaming and a traditional teaching method to improve clinical reasoning skills necessary to detect patient deterioration: a randomized study in nursing students. BMC MEDICAL EDUCATION 2020; 20:53. [PMID: 32075641 PMCID: PMC7031947 DOI: 10.1186/s12909-020-1939-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 01/16/2020] [Indexed: 05/17/2023]
Abstract
BACKGROUND Early detection and response to patient deterioration influence patient prognosis. Nursing education is therefore essential. The objective of this randomized controlled trial was to compare the respective educational value of simulation by gaming (SG) and a traditional teaching (TT) method to improve clinical reasoning (CR) skills necessary to detect patient deterioration. METHODS In a prospective multicenter study, and after consent, 2nd year nursing students were randomized into two groups: Simulation by gaming "SG": the student played individually with a serious game consisting of 2 cases followed by a common debriefing with an instructor;Traditional Teaching "TT": the student worked on the same cases in text paper format followed by a traditional teaching course with a PowerPoint presentation by an instructor. CR skill was measured by script concordance tests (80 SCTs, score 0-100) immediately after the session (primary outcome) and on month later. Other outcomes included students' satisfaction, motivation and professional impact. RESULTS One hundred forty-six students were randomized. Immediately after training, the SCTs scores were 59 ± 9 in SG group (n = 73) and 58 ± 8 in TT group (n = 73) (p = 0.43). One month later, the SCTs scores were 59 ± 10 in SG group (n = 65) and 58 ± 8 in TT group (n = 54) (p = 0.77). Global satisfaction and motivation were highly valued in both groups although significantly greater in the SG group (p < 0.05). The students declared that the training course would have a positive professional impact, with no difference between groups. CONCLUSIONS In this study assessing nursing student CR to detect patient deterioration, no significant educational difference (SCT), neither immediate nor 1 month later, was observed between training by SG and the TT course. However, satisfaction and motivation were found to be greater with the use of SG. TRIAL REGISTRATION ClinicalTrials.gov; NCT03428269. Registered 30 january 2018.
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Affiliation(s)
- Antonia Blanié
- Centre de simulation LabForSIMS, Faculté de médecine Paris Saclay, 94275, Le Kremlin Bicêtre, France.
- Département d'Anesthésie-Réanimation, CHU Bicêtre, 78, rue du Général Leclerc, 94275, Le Kremlin Bicêtre, France.
- CIAMS, Univ. Paris-Sud, Université Paris-Saclay, 91405, Orsay, Cedex, France.
- CIAMS, Université d'Orléans, 45067, Orléans, France.
| | - Michel-Ange Amorim
- CIAMS, Univ. Paris-Sud, Université Paris-Saclay, 91405, Orsay, Cedex, France
- CIAMS, Université d'Orléans, 45067, Orléans, France
| | - Dan Benhamou
- Centre de simulation LabForSIMS, Faculté de médecine Paris Saclay, 94275, Le Kremlin Bicêtre, France
- Département d'Anesthésie-Réanimation, CHU Bicêtre, 78, rue du Général Leclerc, 94275, Le Kremlin Bicêtre, France
- CIAMS, Univ. Paris-Sud, Université Paris-Saclay, 91405, Orsay, Cedex, France
- CIAMS, Université d'Orléans, 45067, Orléans, France
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Berthod F, Bouchoud L, Grossrieder F, Falaschi L, Senhaji S, Bonnabry P. Learning good manufacturing practices in an escape room: Validation of a new pedagogical tool. J Oncol Pharm Pract 2019; 26:853-860. [PMID: 31566110 DOI: 10.1177/1078155219875504] [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] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Chemotherapies are handled using Good Manufacturing Practices, which ensure asepsis and high-quality production. Continuous education is compulsory and usually includes theoretical and practical exercises. OBJECTIVES This work aimed to validate an innovative method of teaching good manufacturing practices based on an escape room mixing simulation and gaming. METHOD Pairs of learners were locked in a simulated clean room (Esclean Room) and had 1 hour to produce a chemotherapy and escape by finding solutions to 23 "Good Manufacturing Practices mysteries" linked to combination locks. To measure the experiment's impact on teaching, questionnaires including the 23 mysteries (in different orders) were filled in before, just after and one month after escape from the Esclean Room. Pharmacy staff' degrees of certainty were noted for each question. A satisfaction survey was completed. RESULTS Seventy-two learners (29% senior pharmacists, 14% junior pharmacists, and 57% pharmacy technicians) escaped the Esclean Room and 56 answered every questionnaire. The educational intervention resulted in increases in correct answers and certainty. Correct answers rose from 57% in the first questionnaire to 80% in the third (p < 0.001). Certainty scores rose from 50% before the experiment to 70% one month afterwards (p < 0.001). Despite 68% of learners having never taken part in an escape room game before, 79% liked this educational method. CONCLUSION This study built and tested a pedagogical escape room involving a high risk, professional, pharmacy process. The use of this pharmacy technology simulation had a positive impact on pharmacy staff theoretical knowledge.
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Affiliation(s)
- Faustine Berthod
- Pharmacy, Geneva University Hospitals, Geneva, Switzerland.,School of Pharmaceutical Sciences, Universities of Geneva and Lausanne, Lausanne, Switzerland
| | - Lucie Bouchoud
- Pharmacy, Geneva University Hospitals, Geneva, Switzerland
| | | | | | - Salim Senhaji
- Pharmacy, Geneva University Hospitals, Geneva, Switzerland
| | - Pascal Bonnabry
- Pharmacy, Geneva University Hospitals, Geneva, Switzerland.,School of Pharmaceutical Sciences, Universities of Geneva and Lausanne, Lausanne, Switzerland
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Alyami H, Alawami M, Lyndon M, Alyami M, Coomarasamy C, Henning M, Hill A, Sundram F. Impact of Using a 3D Visual Metaphor Serious Game to Teach History-Taking Content to Medical Students: Longitudinal Mixed Methods Pilot Study. JMIR Serious Games 2019; 7:e13748. [PMID: 31573895 PMCID: PMC6788337 DOI: 10.2196/13748] [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: 02/18/2019] [Revised: 06/17/2019] [Accepted: 07/17/2019] [Indexed: 11/23/2022] Open
Abstract
Background History taking is a key component of clinical practice; however, this skill is often poorly performed by students and doctors. Objective The study aimed to determine whether Metaphoria, a 3D serious game (SG), is superior to another electronic medium (PDF text file) in learning the history-taking content of a single organ system (cardiac). Methods In 2015, a longitudinal mixed methods (quantitative and qualitative) pilot study was conducted over multiple sampling time points (10 weeks) on a group of undergraduate medical students at The University of Auckland Medical School, New Zealand. Assessors involved in the study were blinded to group allocation. From an initial sample of 83, a total of 46 medical students were recruited. Participants were assigned to either a PDF group (n=19) or a game group (n=27). In total, 1 participant left the PDF group after allocation was revealed and was excluded. A total of 24 students in the game group and 14 students in the PDF group completed follow-up 7 weeks later.
Using an iterative design process for over a year, with input from a variety of clinical disciplines, a cardiac history-taking game and PDF file were designed and informed by Cognitive Load Theory. Each group completed its intervention in 40 min. A total of 3 levels of Kirkpatrick training evaluation model were examined using validated questionnaires: affective (perception and satisfaction), cognitive (knowledge gains and cognitive load), and behavioral attitudes (Objective Structured Clinical Exam) as well as qualitative assessment. A priori hypotheses were formulated before data collection. Results Compared with baseline, both groups showed significant improvement in knowledge and self-efficacy longitudinally (P<.001). Apart from the game group having a statistically significant difference in terms of satisfaction (P<.001), there were no significant differences between groups in knowledge gain, self-efficacy, cognitive load, ease of use, acceptability, or objective structured clinical examination scores. However, qualitative findings indicated that the game was more engaging and enjoyable, and it served as a visual aid compared with the PDF file. Conclusions Students favored learning through utilization of an SG with regard to cardiac history taking. This may be relevant to other areas of medicine, and this highlights the importance of innovative methods of teaching the next generation of medical students.
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Affiliation(s)
- Hussain Alyami
- South Auckland Clinical Campus, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.,College of Medicine, Taif University, Taif, Saudi Arabia
| | | | - Mataroria Lyndon
- South Auckland Clinical Campus, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Mohsen Alyami
- South Auckland Clinical Campus, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | | | - Marcus Henning
- South Auckland Clinical Campus, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Andrew Hill
- South Auckland Clinical Campus, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Frederick Sundram
- South Auckland Clinical Campus, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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Ward M, Ní Shé É, De Brún A, Korpos C, Hamza M, Burke E, Duffy A, Egan K, Geary U, Holland C, O'Grady J, Robinson K, Smith A, Watson A, McAuliffe E. The co-design, implementation and evaluation of a serious board game 'PlayDecide patient safety' to educate junior doctors about patient safety and the importance of reporting safety concerns. BMC MEDICAL EDUCATION 2019; 19:232. [PMID: 31238936 PMCID: PMC6593521 DOI: 10.1186/s12909-019-1655-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 06/06/2019] [Indexed: 06/01/2023]
Abstract
BACKGROUND We believe junior doctors are in a unique position in relation to reporting of incidents and safety culture. They are still in training and are also 'fresh eyes' on the system providing valuable insights into what they perceive as safe and unsafe behaviour. The aim of this study was to co-design and implement an embedded learning intervention - a serious board game - to educate junior doctors about patient safety and the importance of reporting safety concerns, while at the same time shaping a culture of responsiveness from senior medical staff. METHODS A serious game based on the PlayDecide framework was co-designed and implemented in two large urban acute teaching hospitals. To evaluate the educational value of the game voting on the position statements was recorded at the end of each game by a facilitator who also took notes after the game of key themes that emerged from the discussion. A sample of players were invited on a voluntary basis to take part in semi-structured interviews after playing the game using Flanagan's Critical Incident Technique. A paper-based questionnaire on 'Safety Concerns' was developed and administered to assess pre-and post-playing the game reporting behaviour. Dissemination workshops were held with senior clinicians to promote more inclusive leadership behaviours and responsiveness to junior doctors raising of safety concerns from senior clinicians. RESULTS The game proved to be a valuable patient safety educational tool and proved effective in encouraging deep discussion on patient safety. There was a significant change in the reporting behaviour of junior doctors in one of the hospitals following the intervention. CONCLUSION In healthcare, limited exposure to patient safety training and narrow understanding of safety compromise patients lives. The existing healthcare system needs to value the role that junior doctors and others could play in shaping a positive safety culture where reporting of all safety concerns is encouraged. Greater efforts need to be made at hospital level to develop a more pro-active safe and just culture that supports and encourages junior doctors and ultimately all doctors to understand and speak up about safety concerns.
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Affiliation(s)
- Marie Ward
- School of Nursing, Midwifery and Health Systems, College of Health Sciences, University College Dublin, Belfield, Dublin 4, Ireland
| | - Éidín Ní Shé
- School of Nursing, Midwifery and Health Systems, College of Health Sciences, University College Dublin, Belfield, Dublin 4, Ireland
| | - Aoife De Brún
- School of Nursing, Midwifery and Health Systems, College of Health Sciences, University College Dublin, Belfield, Dublin 4, Ireland
| | - Christian Korpos
- School of Nursing, Midwifery and Health Systems, College of Health Sciences, University College Dublin, Belfield, Dublin 4, Ireland
| | - Moayed Hamza
- School of Nursing, Midwifery and Health Systems, College of Health Sciences, University College Dublin, Belfield, Dublin 4, Ireland
| | | | - Ann Duffy
- Clinical Risk, State Claims Agency, Grand Canal Street, Dublin 2, Ireland
| | - Karen Egan
- Patient Representative, Patient and Public Involvement in Healthcare at Health Service, Dublin 2, Ireland
| | - Una Geary
- St. James's Hospital, Dublin 8, Ireland
| | - Catherine Holland
- Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
| | | | - Karen Robinson
- Health Sciences Centre, School of Nursing, Midwifery and Health Systems, College of Health Sciences, University College Dublin, Belfield, Dublin 4, Ireland
| | - Alan Smith
- St. Vincent's University Hospital, Dublin 4, Ireland
| | - Alan Watson
- St. Vincent's University Hospital, Dublin 4, Ireland
| | - Eilish McAuliffe
- Health Sciences Centre, School of Nursing, Midwifery and Health Systems, College of Health Sciences, University College Dublin, Belfield, Dublin 4, Ireland.
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Richard A, Bempong NE, Flahault A. Geneva Health Forum: The First International Conference on Precision Global Health. Am J Public Health 2019; 109:863-865. [DOI: 10.2105/ajph.2019.305063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Aude Richard
- All of the authors are with the Institute of Global Health, Faculty of Medicine, University of Geneva, Switzerland
| | - Nefti-Eboni Bempong
- All of the authors are with the Institute of Global Health, Faculty of Medicine, University of Geneva, Switzerland
| | - Antoine Flahault
- All of the authors are with the Institute of Global Health, Faculty of Medicine, University of Geneva, Switzerland
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Verschueren S, Buffel C, Vander Stichele G. Developing Theory-Driven, Evidence-Based Serious Games for Health: Framework Based on Research Community Insights. JMIR Serious Games 2019; 7:e11565. [PMID: 31045496 PMCID: PMC6521217 DOI: 10.2196/11565] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 01/03/2019] [Accepted: 01/25/2019] [Indexed: 12/22/2022] Open
Abstract
Background The idea of using serious games to effectuate better outcomes in health care has gained significant traction among a growing community of researchers, developers, and health care professionals. Many now recognize the importance of creating evidence-based games that are purposefully designed to address physical and mental health challenges faced by end users. To date, no regulatory resources have been established to guide the development of serious games for health (SGH). Developers must therefore look elsewhere for guidance. Although a more robust level of evidence exists in the research literature, it is neither structured nor is there any clear consensus. Developers currently use a variety of approaches and methodologies. The establishment of a well-defined framework that represents the consensus views of the SGH research community would help developers improve the efficiency of internal development processes, as well as chances of success. A consensus framework would also enhance the credibility of SGH and help provide quality evidence of their effectiveness. Objective This research aimed to (1) identify and evaluate the requirements, recommendations, and guidelines proposed by the SGH community in the research literature, and; (2) develop a consensus framework to guide developers, designers, researchers, and health care professionals in the development of evidence-based SGH. Methods A critical review of the literature was performed in October to November 2018. A 3-step search strategy and a predefined set of inclusion criteria were used to identify relevant articles in PubMed, ScienceDirect, Institute of Electrical and Electronics Engineers Xplore, CiteSeerX, and Google Scholar. A supplemental search of publications from regulatory authorities was conducted to capture their specific requirements. Three researchers independently evaluated the identified articles. The evidence was coded and categorized for analysis. Results This review identified 5 categories of high-level requirements and 20 low-level requirements suggested by the SGH community. These advocate a methodological approach that is multidisciplinary, iterative, and participatory. On the basis of the requirements identified, we propose a framework for developing theory-driven, evidence-based SGH. It comprises 5 stages that are informed by various stakeholders. It focuses on building strong scientific and design foundations that guide the creative and technical development. It includes quantitative trials to evaluate whether the SGH achieve the intended outcomes, as well as efforts to disseminate trial findings and follow-up monitoring after the SGH are rolled out for use. Conclusions This review resulted in the formulation of a framework for developing theory-driven, evidence-based SGH that represents many of the requirements set out by SGH stakeholders in the literature. It covers all aspects of the development process (scientific, technological, and design) and is transparently described in sufficient detail to allow SGH stakeholders to implement it in a wide variety of projects, irrespective of discipline, health care segments, or focus.
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Chee EJM, Prabhakaran L, Neo LP, Carpio GAC, Tan AJQ, Lee CCS, Liaw SY. Play and Learn with Patients-Designing and Evaluating a Serious Game to Enhance Nurses' Inhaler Teaching Techniques: A Randomized Controlled Trial. Games Health J 2019; 8:187-194. [PMID: 30649974 DOI: 10.1089/g4h.2018.0073] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: To describe the development and evaluation of a nurse-patient interactive serious game in improving nurses' self-efficacy and performances in teaching the correct inhaler technique. Materials and Methods: The technology, pedagogy, and content knowledge (TPACK) framework was applied to guide the development of the serious game. The learning effectiveness of the serious game was evaluated through a randomized controlled trial that involved 46 registered nurses. Participants in the experimental group were asked to teach the inhaler technique to a standardized patient using the serious game as a teaching tool, whereas participants in the control group were asked to provide their own usual teaching to a standardized patient without the serious game. The performances of both groups were assessed based on their feedback to a standardized patient who made several errors while demonstrating the inhaler technique. Self-efficacy levels of teaching the inhaler technique were examined before and after the intervention. Results: A significantly higher number of participants from the experimental group obtained perfect performance scores than those in the control group (65.21% vs. 21.74%, χ2 = 15.18, P < 0.01). The posttest self-efficacy mean scores for the experimental group improved significantly (P < 0.001) after the intervention, and significantly higher (P < 0.05) compared to the posttest mean scores of the control group. Conclusion: The study provided evidence on the effectiveness of a serious game in improving the self-efficacy and immediate postintervention performances of nurses teaching the inhaler technique. This game provides a practical and accessible learning tool to help nurses ensure effective patient education.
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Affiliation(s)
| | - Lathy Prabhakaran
- 1 Department of Nursing, Tan Tock Seng Hospital, Singapore, Singapore
| | - Lay Ping Neo
- 1 Department of Nursing, Tan Tock Seng Hospital, Singapore, Singapore
| | - Guiller Augustin C Carpio
- 2 Centre for Learning Environment and Assessment Development, Singapore Institute of Technology, Singapore, Singapore
| | - Apphia Jia Qi Tan
- 3 Department of Nursing, National University Hospital, Singapore, Singapore
| | | | - Sok Ying Liaw
- 5 Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Noveletto F, Soares AV, Mello BA, Sevegnani CN, Eichinger FLF, Hounsell MDS, Bertemes-Filho P. Biomedical Serious Game System for Balance Rehabilitation of Hemiparetic Stroke Patients. IEEE Trans Neural Syst Rehabil Eng 2018; 26:2179-2188. [PMID: 30334802 DOI: 10.1109/tnsre.2018.2876670] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Hemiparetic stroke patients can have several muscular and postural disorders which compromise their balance. Serious games (SG) emerged as a new approach to enhance conventional treatment by making it a motivating method to meet individual needs. This paper evaluated the therapeutic effects of a biomedical SG system developed for balance evaluation and training of hemiparetic stroke patients. The system consists of a balance board with inertial sensors and a computer system that runs the game. A novel scoring system for balance evaluation, which extracts metric information regarding patients' performance while gaming, was proposed. A quasi-experimental study was performed with six hemiparetic patients in an exercise program using the SG twice per week for 10 weeks. Twelve healthy subjects were recruited for determining the baseline score for balance by using the proposed system. Significant effect sizes (ES) were observed for dynamic balance (ES = 0.9), functional mobility (ES = 0.4), and center of pressure displacement of the balance board (ES = 1.9).Significant correlations between game scores and clinical scales suggest that the use of the scoring system for balance evaluation is feasible. The results of this paper support the clinical potential of a biomedical SG for balance rehabilitation of hemiparetic stroke patients.
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Klaassen R, Bul KCM, Op den Akker R, van der Burg GJ, Kato PM, Di Bitonto P. Design and Evaluation of a Pervasive Coaching and Gamification Platform for Young Diabetes Patients. SENSORS (BASEL, SWITZERLAND) 2018; 18:E402. [PMID: 29385750 PMCID: PMC5855521 DOI: 10.3390/s18020402] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Revised: 01/08/2018] [Accepted: 01/17/2018] [Indexed: 12/12/2022]
Abstract
Self monitoring, personal goal-setting and coaching, education and social support are strategies to help patients with chronic conditions in their daily care. Various tools have been developed, e.g., mobile digital coaching systems connected with wearable sensors, serious games and patient web portals to personal health records, that aim to support patients with chronic conditions and their caregivers in realizing the ideal of self-management. We describe a platform that integrates these tools to support young patients in diabetes self-management through educational game playing, monitoring and motivational feedback. We describe the design of the platform referring to principles from healthcare, persuasive system design and serious game design. The virtual coach is a game guide that can also provide personalized feedback about the user's daily care related activities which have value for making progress in the game world. User evaluations with patients under pediatric supervision revealed that the use of mobile technology in combination with web-based elements is feasible but some assumptions made about how users would connect to the platform were not satisfied in reality, resulting in less than optimal user experiences. We discuss challenges with suggestions for further development of integrated pervasive coaching and gamification platforms in medical practice.
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Affiliation(s)
- Randy Klaassen
- Human Media Interaction, Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands.
| | - Kim C M Bul
- Centre for Innovative Research across the Life Course, Faculty of Health and Life Sciences, Coventry University, CV1 5FB Coventry, UK.
| | - Rieks Op den Akker
- Human Media Interaction, Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands.
| | | | - Pamela M Kato
- School of Computing, Electronics and Mathematics, Faculty of Engineering, Environment and Computing, Coventry University, CV1 5FB Coventry, UK.
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