A Systematic Review of Serious Games in Training Health Care Professionals

Summary Statement Serious games are computer-based games designed for training purposes. They are poised to expand their role in medical education. This systematic review, conducted in accordance with PRISMA guidelines, aimed to synthesize current serious gaming trends in health care training, especially those pertaining to developmental methodologies and game evaluation. PubMed, EMBASE, and Cochrane databases were queried for relevant documents published through December 2014. Of the 3737 publications identified, 48 of them, covering 42 serious games, were included. From 2007 to 2014, they demonstrate a growth from 2 games and 2 genres to 42 games and 8 genres. Overall, study design was heterogeneous and methodological quality by MERQSI score averaged 10.5/18, which is modest. Seventy-nine percent of serious games were evaluated for training outcomes. As the number of serious games for health care training continues to grow, having schemas that organize how educators approach their development and evaluation is essential for their success.

[1]  Adam Dubrowski,et al.  A Serious Game for Off-Pump Coronary Artery Bypass Surgery Procedure Training , 2011, MMVR.

[2]  Dana T Lin,et al.  Validity evidence for Surgical Improvement of Clinical Knowledge Ops: a novel gaming platform to assess surgical decision making. , 2015, American journal of surgery.

[3]  A. Ziv,et al.  Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review , 2005, Medical teacher.

[4]  Adam Dubrowski,et al.  Z-DOC: A Serious Game for Z-Plasty Procedure Training , 2013, MMVR.

[5]  Cord Spreckelsen,et al.  eMedOffice: A web-based collaborative serious game for teaching optimal design of a medical practice , 2012, BMC medical education.

[6]  Johan Creutzfeldt,et al.  Effects of pre-training using serious game technology on CPR performance – an exploratory quasi-experimental transfer study , 2012, Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.

[7]  H. O. Cate Hoedemaker,et al.  Construct and concurrent validity of a Nintendo Wii video game made for training basic laparoscopic skills , 2013, Surgical Endoscopy.

[8]  M. Roizen,et al.  Technology-enhanced simulation for health professions education: a systematic review and meta-analysis , 2012 .

[9]  B Price Kerfoot,et al.  The use of gamification to boost residents' engagement in simulation training. , 2014, JAMA surgery.

[10]  E. Akl,et al.  An educational game for teaching clinical practice guidelines to Internal Medicine residents: development, feasibility and acceptability , 2008, BMC medical education.

[11]  Jason H. Szostek,et al.  Comparative effectiveness of instructional design features in simulation-based education: Systematic review and meta-analysis , 2013, Medical teacher.

[12]  Jetse Goris,et al.  Training basic laparoscopic skills using a custom-made video game , 2014, Perspectives on medical education.

[13]  Petra Kaufmann,et al.  Experimental And Quasi Experimental Designs For Research , 2016 .

[14]  Andrew J. Haig,et al.  Poster 152 BackQuack™: An On‐Line Computer Game that Teaches Doctors and Patients to Mess Up , 2012 .

[15]  B. Edrees,et al.  Comparison of jeopardy game format versus traditional lecture format as a teaching methodology in medical education. , 2011, Saudi medical journal.

[16]  Michael D. Proctor,et al.  Helicopter Flight Training Through Serious Aviation Gaming , 2007 .

[17]  David Fleiszer,et al.  Learning While Having Fun: The Use of Video Gaming to Teach Geriatric House Calls to Medical Students , 2008, Journal of the American Geriatrics Society.

[18]  Samantha A Adams,et al.  Use of "serious health games" in health care: a review. , 2010, Studies in health technology and informatics.

[19]  Adam Dubrowski,et al.  a serious game for ToTal Knee arThroplasTy proCedure , eduCaTion and Training , 2011 .

[20]  Carlos Alberto Seixas,et al.  Development of the e-Baby Serious Game With Regard to the Evaluation of Oxygenation in Preterm Babies: Contributions of the Emotional Design , 2014, Computers, informatics, nursing : CIN.

[21]  Ewan MacArthur,et al.  The role of technology and digital gaming in nurse education. , 2013, Nursing standard (Royal College of Nursing (Great Britain) : 1987).

[22]  Alexander Turchin,et al.  An Online Spaced-Education Game Among Clinicians Improves Their Patients’ Time to Blood Pressure Control: A Randomized Controlled Trial , 2014, Circulation. Cardiovascular quality and outcomes.

[23]  M. Schijven,et al.  Systematic review of serious games for medical education and surgical skills training , 2012, The British journal of surgery.

[24]  William C McGaghie,et al.  A critical review of simulation‐based mastery learning with translational outcomes , 2014, Medical education.

[25]  J Blake,et al.  Computer-based learning: games as an instructional strategy. , 1999, The ABNF journal : official journal of the Association of Black Nursing Faculty in Higher Education, Inc.

[26]  Tonya Rutherford-Hemming,et al.  Implementing the Standards of Best Practice for Simulation , 2015, Nurse educator.

[27]  Luca Chittaro,et al.  Evaluation of a 3D serious game for advanced life support retraining , 2013, Int. J. Medical Informatics.

[28]  Maurits Graafland,et al.  How to Systematically Assess Serious Games Applied to Health Care , 2014, JMIR serious games.

[29]  Clayton M. Christensen,et al.  Disruptive Technologies: Catching the Wave , 1995 .

[30]  Maurits Graafland,et al.  A Serious Game Can Be a Valid Method to Train Clinical Decision-Making in Surgery , 2014, World Journal of Surgery.

[31]  G. Duque,et al.  Evaluation of a blended learning model in geriatric medicine: A successful learning experience for medical students , 2013, Australasian journal on ageing.

[32]  John Kirriemuir,et al.  Literature Review in Games and Learning , 2004 .

[33]  Sarah Garside,et al.  Method and reporting quality in health professions education research: a systematic review , 2011, Medical education.

[34]  N. Cook,et al.  Impact of a web based interactive simulation game (PULSE) on nursing students' experience and performance in life support training--a pilot study. , 2012, Nurse education today.

[35]  T. Jirasevijinda,et al.  Jeopardy!: an innovative approach to teach psychosocial aspects of pediatrics. , 2010, Patient education and counseling.

[36]  B Price Kerfoot,et al.  An Online Spaced-Education Game for Global Continuing Medical Education: A Randomized Trial , 2012, Annals of surgery.

[37]  Maurits Graafland,et al.  Prospective cohort study on surgeons’ response to equipment failure in the laparoscopic environment , 2014, Surgical Endoscopy.

[38]  Bryan P. Bergeron,et al.  Developing serious games , 2006 .

[39]  David R. Michael,et al.  Serious Games: Games That Educate, Train, and Inform , 2005 .

[40]  Elisabeth F. M. Schlegel,et al.  Fun, collaboration and formative assessment: Skinquizition, a class wide gaming competition in a medical school with a large class , 2014, Medical teacher.

[41]  S. Hamstra,et al.  What counts as validity evidence? Examples and prevalence in a systematic review of simulation-based assessment , 2014, Advances in health sciences education : theory and practice.

[42]  Cees P M van der Vleuten,et al.  Strengths and Weaknesses of Simulated and Real Patients in the Teaching of Skills to Medical Students: A Review , 2008, Simulation in healthcare : journal of the Society for Simulation in Healthcare.

[43]  Christa R. Nevin,et al.  Gamification as a tool for enhancing graduate medical education , 2014, Postgraduate Medical Journal.

[44]  Marcel G M Olde Rikkert,et al.  A randomized controlled trial on teaching geriatric medical decision making and cost consciousness with the serious game GeriatriX. , 2014, Journal of the American Medical Directors Association.

[45]  Katherine A Sward,et al.  Use of a Web-based game to teach pediatric content to medical students. , 2008, Ambulatory pediatrics : the official journal of the Ambulatory Pediatric Association.

[46]  Martin Boeker,et al.  Game-Based E-Learning Is More Effective than a Conventional Instructional Method: A Randomized Controlled Trial with Third-Year Medical Students , 2013, PloS one.

[47]  RadhaKanta Mahapatra,et al.  EVALUATING TRAINING PROGRAMS , 2005 .

[48]  R. Kanthan,et al.  The impact of specially designed digital games-based learning in undergraduate pathology and medical education. , 2011, Archives of pathology & laboratory medicine.

[49]  Sergei N. Kurenov,et al.  Game-Based Mass Casualty Burn Training , 2009, MMVR.

[50]  D. Matlock.  Destination Unknown: The Ventricular Assist Device and the Advance of Technology , 2012, Journal of the American Geriatrics Society.

[51]  C. Whittlesea,et al.  The impact of automation on workload and dispensing errors in a hospital pharmacy , 2013, The International journal of pharmacy practice.

[52]  Sam Leinster,et al.  Some techniques for computer-based assessment in medical education , 1998 .

[53]  G. A. Mooney J. G. Bligh.  CyberIST :a virtual game for medical education , 1998 .

[54]  D. Moher,et al.  Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. , 2010, International journal of surgery.

[55]  Sarkis Meterissian,et al.  Games as teaching tools in a surgical residency , 2007, Medical teacher.

[56]  Maurits Graafland,et al.  A serious game to improve situation awareness in laparoscopic surgery , 2013, GFHEU.

[57]  D. Gaba.  The future vision of simulation in health care , 2004, Quality and Safety in Health Care.

[58]  Yasuharu Okuda,et al.  The utility of simulation in medical education: what is the evidence? , 2009, The Mount Sinai journal of medicine, New York.

[59]  Ruth M Ford,et al.  Effectiveness of interactive, online games in learning neuroscience and students' perception of the games as learning tools. A pre-experimental study. , 2011, Journal of allied health.

[60]  D. Moher,et al.  Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. , 2010, International journal of surgery.

[61]  Pheng-Ann Heng,et al.  A Serious Game for Learning Ultrasound-Guided Needle Placement Skills , 2012, IEEE Transactions on Information Technology in Biomedicine.

[62]  L. Diehl,et al.  InsuOnline, a Serious Game to Teach Insulin Therapy to Primary Care Physicians: Design of the Game and a Randomized Controlled Trial for Educational Validation , 2013, JMIR research protocols.

[63]  J. Hahn,et al.  Teaching gaming with technology in the classroom: so you want to be an educator? , 2014, Nursing education perspectives.

[64]  M. Strehlow,et al.  Evaluating the efficacy of simulators and multimedia for refreshing ACLS skills in India. , 2010, Resuscitation.

[65]  David A Cook,et al.  Association between funding and quality of published medical education research. , 2007, JAMA.

[66]  Kup-Sze Choi,et al.  Learning Blood Management in Orthopedic Surgery through Gameplay , 2010, IEEE Computer Graphics and Applications.

[67]  J Torrente,et al.  Application of game-like simulations in the Spanish Transplant National Organization. , 2013, Transplantation proceedings.

[68]  S. Oei,et al.  Serious gaming in women’s health care , 2011, BJOG : an international journal of obstetrics and gynaecology.

[69]  Christopher Spencer,et al.  Learning a new area with and without the use of tactile maps: a comparative study , 1985 .

[70]  B. Kerfoot,et al.  An online spaced-education game to teach and assess residents: a multi-institutional prospective trial. , 2012, Journal of the American College of Surgeons.

[71]  Fernanda Chiarion Sassi,et al.  Computer game-based and traditional learning method: a comparison regarding students’ knowledge retention , 2013, BMC Medical Education.

[72]  Marshall L. Smith,et al.  Design and Development of a Virtual Reality Simulator for Advanced Cardiac Life Support Training , 2014, IEEE Journal of Biomedical and Health Informatics.

[73]  K. Squire,et al.  HARNESSING THE POWER OF GAMES IN EDUCATION , 2003 .

[74]  K Suwa.  [Simulation in anesthesia]. , 1992, Masui. The Japanese journal of anesthesiology.

[75]  J. Barsuk,et al.  Does Simulation-Based Medical Education With Deliberate Practice Yield Better Results Than Traditional Clinical Education? A Meta-Analytic Comparative Review of the Evidence , 2011, Academic medicine : journal of the Association of American Medical Colleges.