Serious Gaming and Gamification Education in Health Professions: Systematic Review

Abstract

Background There is a worldwide shortage of health workers, and this issue requires innovative education solutions. Serious gaming and gamification education have the potential to provide a quality, cost-effective, novel approach that is flexible, portable, and enjoyable and allow interaction with tutors and peers. Objective The aim of this systematic review was to evaluate the effectiveness of serious gaming/gamification for health professions education compared with traditional learning, other types of digital education, or other serious gaming/gamification interventions in terms of patient outcomes, knowledge, skills, professional attitudes, and satisfaction (primary outcomes) as well as economic outcomes of education and adverse events (secondary outcomes). Methods A comprehensive search of MEDLINE, EMBASE, Web of Knowledge, Educational Resources Information Centre, Cochrane Central Register of Controlled Trials, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature was conducted from 1990 to August 2017. Randomized controlled trials (RCTs) and cluster RCTs were eligible for inclusion. Two reviewers independently searched, screened, and assessed the study quality and extracted data. A meta-analysis was not deemed appropriate due to the heterogeneity of populations, interventions, comparisons, and outcomes. Therefore, a narrative synthesis is presented. Results A total of 27 RCTs and 3 cluster RCTs with 3634 participants were included. Two studies evaluated gamification interventions, and the remaining evaluated serious gaming interventions. One study reported a small statistically significant difference between serious gaming and digital education of primary care physicians in the time to control blood pressure in a subgroup of their patients already taking antihypertensive medications. There was evidence of a moderate-to-large magnitude of effect from five studies evaluating individually delivered interventions for objectively measured knowledge compared with traditional learning. There was also evidence of a small-to-large magnitude of effect from 10 studies for improved skills compared with traditional learning. Two and four studies suggested equivalence between interventions and controls for knowledge and skills, respectively. Evidence suggested that serious gaming was at least as effective as other digital education modalities for these outcomes. There was insufficient evidence to conclude whether one type of serious gaming/gamification intervention is more effective than any other. There was limited evidence for the effects of serious gaming/gamification on professional attitudes. Serious gaming/gamification may improve satisfaction, but the evidence was limited. Evidence was of low or very low quality for all outcomes. Quality of evidence was downgraded due to the imprecision, inconsistency, and limitations of the study. Conclusions Serious gaming/gamific...

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

“…Other studies have compared the efficacy of different educational methods but in other healthcare domains (such as trauma, urology, surgery, pharmacy) and have also provided conflicting results for learning [15,18,44,45]. In a recent systematic review, serious games used in health professions seem at least effective as a learning control method and may be more effective in improving knowledge and skills [13]. One major limitation of this review was the high level of heterogeneity.…”

“…One major limitation of this review was the high level of heterogeneity. The existing studies were difficult to compare and generalizability difficult to reach due to the differences in the populations studied, the variety of the serious game assessment methods, the game designs, and the pedagogical objectives [10][11][12][13][14]. The definition itself of a serious game is sometimes ambiguous between e-learning, virtual patient and serious game [46].…”

“…Serious games can promote experiential learning, as described by Kolb [9], when they include a 3D realistic environment close to real life. They can be used to train both technical and non-technical skills [10][11][12][13][14]. We developed a serious game, named LabForGames Warning, which aims to improve nursing students' interprofessional communication behavior and their capabilities to detect patient clinical deterioration.…”

“…We developed a serious game, named LabForGames Warning, which aims to improve nursing students' interprofessional communication behavior and their capabilities to detect patient clinical deterioration. Several studies using serious games in healthcare have already been published and have been included in meta-analyses [10][11][12][13][14], but careful analysis shows that serious games are difficult to compare due to the differences in the populations studied, the variety of game designs, topics included, pedagogical objectives and modalities of assessment. Comparative analysis between the educational value of a serious game and a traditional course is already available for cardiac arrest management, trauma triage and other domains, but it is uncertain whether results obtained in one field apply to the others [13][14][15][16][17][18] .…”

“…Several studies using serious games in healthcare have already been published and have been included in meta-analyses [10][11][12][13][14], but careful analysis shows that serious games are difficult to compare due to the differences in the populations studied, the variety of game designs, topics included, pedagogical objectives and modalities of assessment. Comparative analysis between the educational value of a serious game and a traditional course is already available for cardiac arrest management, trauma triage and other domains, but it is uncertain whether results obtained in one field apply to the others [13][14][15][16][17][18] . In addition, several studies have used a serious game to train nurses in the detection of patient deterioration, but are characterized by a high level of heterogeneity and sometimes provide neutral results [19][20][21][22].…”