A Gamification Framework for Cognitive Assessment and Cognitive Training: Qualitative Study

Abstract

Background Cognitive tasks designed to measure or train cognition are often repetitive and presented in a monotonous manner, features that lead to participant boredom and disengagement. In this situation, participants do not put forth their best effort to do these tasks well. As a result, neuropsychologists cannot draw accurate conclusions about the data collected, and intervention effects are reduced. It is assumed that greater engagement and motivation will manifest as improved data quality. Gamification, the use of game elements in nongame settings, has been heralded as a potential mechanism for increasing participant engagement in cognitive tasks. Some studies have reported a positive effect of gamification on participant performance, although most studies have shown mixed results. One reason for these contrasting findings is that most studies have applied poor and heterogeneous design techniques to gamify cognitive tasks. Therefore, an appropriate gamification design framework is needed in these tasks. Objective This study aimed to propose a framework to guide the design of gamification in cognitive tasks. Methods We employed a design science research (DSR) approach to provide a framework for gamifying cognitive assessments and training by synthesizing current gamification design frameworks and gamification works in cognitive assessment and training, as well as incorporating field experiences. The prototypes of the framework were iteratively evaluated with 17 relevant experts. Results We proposed a framework consisting of 7 phases: (1) preparation; (2) knowing users; (3) exploring existing tools for assessing or training a targeted cognitive context and determining the suitability of game-up and mapping techniques; (4) ideation; (5) prototyping using the Objects, Mechanics, Dynamics, Emotions (OMDE) design guideline; (6) development; and (7) disseminating and monitoring. Conclusions We found that (1) an intermediate design framework is needed to gamify cognitive tasks, which means that game elements should be selected by considering current cognitive assessment or training context characteristics since game elements may impose an irrelevant cognitive load that, in turn, can jeopardize data quality; (2) in addition to developing a new gamified cognitive task from scratch, 2 gamification techniques are widely used (first, adding game elements to an existing cognitive task and second, mapping an existing game to a cognitive function or impairment to assess or train it); and (3) further research is required to investigate the interplay of cognitive processes and game mechanics.

Developing Serious Video Games to Treat Attention Deficit Hyperactivity Disorder: Tutorial Guide

“…In contrast, serious games for ADHD assessment are rarely more than one mini game, inspired by single tests. This is in keeping with a general recommendation of developing short and discrete tasks for people with ADHD, among others [ 43 ]. The use of mini games provides a clear advantage: the combination of mini games helps to personalize treatment for each patient by being able to distinguish which cognitive processes require more training.…”

“…To avoid boredom, game design components should be included in any serious video game related to objects, mechanics, dynamics, and emotions [ 43 ]. “Juiciness” is a novel concept that refers to adding visual embellishments, sounds, and other types of nonfunctional elements, thus allowing developers to improve players’ experience in their games [ 29 ].…”

“…Mini games can be created by adapting a cognitive task using game-up and mapping techniques [ 43 ] or from scratch. To attract attention, we can introduce design strategies such as gamifying the cognitive task stimuli to try to produce positive sensations.…”

“…However, this process is specific to the disorder for which the treatment is intended. Khaleghi et al [ 43 ] proposed following the Objects, Mechanics, Dynamics, Emotions (OMDE) design guidelines. When designing game mechanics, it is critical to validate the cognitive aspects of the game.…”

“…The exploration stage of the IDEAL-Games framework [ 19 ] ensures that the video game meets the therapeutic objectives by testing the game’s feasibility, usability, reliability, and validity using proof-of-concept and pilot studies [ 39 , 43 ]. If not satisfactory, the development team can go back to the design phase, and revise the objectives, theoretical model, target variables, and players’ experience [ 18 ].…”