User Assessment of “InsuOnLine,” a Game to Fight Clinical Inertia in Diabetes: A Pilot Study

Diehl, Leandro Arthur; Souza, Rodrigo Martins de; Gordan, Pedro Alejandro; Esteves, Roberto Zonato; Coelho, Izabel Cristina Meister Martins

doi:10.1089/g4h.2014.0111

Cited by 19 publications

(23 citation statements)

References 16 publications

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“…The amount of time necessary to finish the game was about 4 h in a previous study [37]. Usability, playability, and preliminary educational effectiveness of previous versions of the game were previously assessed and reported [36,37]; development was “frozen” during the trial.…”

Section: Methodsmentioning

confidence: 99%

“…All subscales were previously tested and refined in our pilot study with medical students and residents [36,37]. …”

Section: Methodsmentioning

confidence: 99%

“…Taking into account an expected attrition rate of 40% in the game group (about twice the 17% attrition rate observed in the previous pilot study with students and residents [36,37]) and of 20% in the control group, we decided to enroll at least 90 subjects in the game group and 77 subjects in the control group.…”

Section: Methodsmentioning

confidence: 99%

“…We have previously described the process of design and development of InsuOnline, the first electronic serious game intended for medical education on insulin therapy for diabetes [35] and a formative assessment of usability and playability of its prototype [36]. …”

Section: Introductionmentioning

confidence: 99%

“…A previous pilot study with medical students and residents has shown that InsuOnline was applicable and well accepted as a tool for medical education on insulin therapy, in what we called “real-world conditions” for self-directed distance learning activities: as a stand-alone resource, played in learners’ own equipment, in learners’ own time schedule, with minimal or no external guidance [36,37]. …”

Section: Introductionmentioning

confidence: 99%

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InsuOnline, an Electronic Game for Medical Education on Insulin Therapy: A Randomized Controlled Trial With Primary Care Physicians

Diehl¹,

Souza²,

Gordan³

et al. 2017

J Med Internet Res

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BackgroundMost patients with diabetes mellitus (DM) are followed by primary care physicians, who often lack knowledge or confidence to prescribe insulin properly. This contributes to clinical inertia and poor glycemic control. Effectiveness of traditional continuing medical education (CME) to solve that is limited, so new approaches are required. Electronic games are a good option, as they can be very effective and easily disseminated.ObjectiveThe objective of our study was to assess applicability, user acceptance, and educational effectiveness of InsuOnline, an electronic serious game for medical education on insulin therapy for DM, compared with a traditional CME activity.MethodsPrimary care physicians (PCPs) from South of Brazil were invited by phone or email to participate in an unblinded randomized controlled trial and randomly allocated to play the game InsuOnline, installed as an app in their own computers, at the time of their choice, with minimal or no external guidance, or to participate in a traditional CME session, composed by onsite lectures and cases discussion. Both interventions had the same content and duration (~4 h). Applicability was assessed by the number of subjects who completed the assigned intervention in each group. Insulin-prescribing competence (factual knowledge, problem-solving skills, and attitudes) was self-assessed through a questionnaire applied before, immediately after, and 3 months after the interventions. Acceptance of the intervention (satisfaction and perceived importance for clinical practice) was also assessed immediately after and 3 months after the interventions, respectively.ResultsSubjects’ characteristics were similar between groups (mean age 38, 51.4% [69/134] male). In the game group, 69 of 88 (78%) completed the intervention, compared with 65 of 73 (89%) in the control group, with no difference in applicability. Percentage of right answers in the competence subscale, which was 52% at the baseline in both groups, significantly improved immediately after both interventions to 92% in the game group and to 85% in control (P<.001). After 3 months, it remained significantly higher than that at the baseline in both groups (80% in game, and 76% in control; P<.001). Absolute increase in competence score was better with the game (40%) than with traditional CME (34%; P=.01). Insulin-related attitudes were improved both after the game (significant improvement in 4 of 9 items) and after control activity (3 of 9). Both interventions were very well accepted, with most subjects rating them as “fun or pleasant,” “useful,” and “practice-changing.”ConclusionsThe game InsuOnline was applicable, very well accepted, and highly effective for medical education on insulin therapy. In view of its flexibility and easy dissemination, it is a valid option for large-scale CME, potentially helping to reduce clinical inertia and to improve quality of care for DM patients.Trial RegistrationClinicaltrials.gov NCT001759953; https://clinicaltrials.gov/ct2/show/NCT01759953 (Archived by WebCite at htt...

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Section: Methodsmentioning

confidence: 99%

“…All subscales were previously tested and refined in our pilot study with medical students and residents [36,37]. …”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

InsuOnline, an Electronic Game for Medical Education on Insulin Therapy: A Randomized Controlled Trial With Primary Care Physicians

Diehl¹,

Souza²,

Gordan³

et al. 2017

J Med Internet Res

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Game design elements of serious games in the education of medical and healthcare professions: a mixed-methods systematic review of underlying theories and teaching effectiveness

Aster,

Laupichler,

Zimmer

et al. 2024

Adv in Health Sci Educ

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Serious games, as a learning resource, enhance their game character by embedding game design elements that are typically used in entertainment games. Serious games in its entirety have already proven their teaching effectiveness in different educational contexts including medical education. The embedded game design elements play an essential role for a game’s effectiveness and thus they should be selected based on evidence-based theories. For game design elements embedded in serious games used for the education of medical and healthcare professions, an overview of theories for the selection lacks. Additionally, it is still unclear whether and how single game design elements affect the learning effectiveness. Therefore, the main aim of this systematic review is threefold. Firstly, light will be shed on the single game design elements used in serious games in this area. Second, the game design elements’ underlying theories will be worked out, and third, the game design elements’ effectiveness on student learning outcome will be assessed. Two literature searches were conducted in November 2021 and May 2022 in six literature databases with keywords covering the fields of educational game design, serious game, and medical education. Out of 1006 initial records, 91 were included after applying predefined exclusion criteria. Data analysis revealed that the three most common game design elements were points, storyline, and feedback. Only four underlying theories were mentioned, and no study evaluated specific game design elements. Since game design elements should be based on theories to ensure meaningful evaluations, the conceptual GATE framework is introduced, which facilitates the selection of evidence-based game design elements for serious games.

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Use of Gaming in Self-Management of Diabetes in Teens

Swartwout¹,

El-Zein²,

Deyo³

et al. 2016

Curr Diab Rep

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With the growing prevalence of diabetes in teens and frequent concomitant problems with adherence, adolescents are a frequent target for diabetes self-management support and education. Due to widespread use of technology among teens in general, the use of serious games, games used for purposes beyond entertainment with the intention to educate and support health behavior for teens with diabetes self-management, is an emerging and promising practice. This report explores games intended for teens with diabetes, how the use of games may enhance clinical practice, and provides suggestions for future research and better utilization of these technologies. Current research on the use of gaming for promoting diabetes management in teens is fairly limited, with some initial support for improvements in both behavioral and clinical outcomes among teens. More research is clearly needed in order to further determine how gaming can best be utilized to impact health outcomes in these teens, as well as potential mechanisms of change.

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User Assessment of “InsuOnLine,” a Game to Fight Clinical Inertia in Diabetes: A Pilot Study

Abstract: "InsuOnLine" was rated by users as easy to play, fun, and useful for learning. Further studies will assess its educational effectiveness. "InsuOnLine" is a promising tool for large-scale continuing medical education on insulin, helping to fight clinical inertia in diabetes.

Cited by 19 publications

References 16 publications

InsuOnline, an Electronic Game for Medical Education on Insulin Therapy: A Randomized Controlled Trial With Primary Care Physicians

InsuOnline, an Electronic Game for Medical Education on Insulin Therapy: A Randomized Controlled Trial With Primary Care Physicians

Game design elements of serious games in the education of medical and healthcare professions: a mixed-methods systematic review of underlying theories and teaching effectiveness

Use of Gaming in Self-Management of Diabetes in Teens

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