Educause, March. Homo Ludens: A study of the play element in culture (1st ed.). Gamification of health professions education: a systematic review,,,, Consider the value proposition of using gamification to engage consumers and employees in a way that permanently changes their behavior. digital or analogue and type of study or profession); Intervention (type of game element(s) and game attributes used); Study outcomes (including satisfaction, attitudes, perceptions, opinions, knowledge, behaviour and patient outcomes); Theoretical frameworks used to design or evaluate gamified educational programs. In a literal sense, to be motivated means ‘to want to … B., & Robins, L. (2016). For instance, Van Nuland et al. Simulation and Gaming, 43, 729–760. The increased autonomy in the pursuit of knowledge is assumed to result in higher motivation (Knowles 1980). The authors would like to thank Information Specialist Sjoukje van der Werf for her assistance in developing the search strategy. They include fast mini-games, as simple as lining up dots in a row, through to augmented reality (AR), and intricate shared worlds. Finally, this chapter provides an overview of gamification applications and how it can be used for health promotion. Uncertainty about inclusion or exclusion of 20 other articles (Bigdeli and Kaufman 2017; Boysen et al. Healthcare Gamification Market, By Game Type (Exercise Games, Serious Games, Casual Games), By Application (Education, Therapeutic, Prevention, Others), By End-Use (Consumer Based, Enterprise Based) Regional Outlook (North America, Europe, Asia-Pacific, LAMEA), Global Opportunity Analysis and Industry Forecast, 2019–2026 Games work on the human mind by creating an increase in motivation and learner engagement. Interactive spaced education to assess and improve knowledge of clinical practice guidelines: A randomized controlled trial. Quality computer games have been shown to enhance concentration (3), impro… (2015) aimed to trigger social comparison in an intervention group by using leader boards with peer-to-peer competition in a tournament environment. Gamification in health education The use of technology in the classroom has become an increasingly normal concept. residency) (n = 15), followed by nursing (n = 7), dental (n = 1), pharmacy (n = 1), osteopathic (n = 1), allied health (n = 1), speech language and hearing pathology students (n = 1) or a mix of students of different professional courses (n = 3) (Table 1). Hudon, A., Perreault, K., Laliberté, M., Desrochers, P., Williams-Jones, B., Ehrmann Feldman, D., et al. Relationships between game attributes and learning outcomes: Review and research proposals. 2014; Mekler et al. 2015; Worm and Buch 2014), often in combination with improved learning outcomes (El-Beheiry et al. Innovative learning activity: Toy Closet: A growth and development game for nursing students. Five domains have a minimum score of one, resulting in a range of 5–18 points. But you might be surprised … For example, reinforcement learning theory was applied to increase repetition by reinforcing right answers (Chen et al. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. By explicitly adding the designers’ intentions to the chosen definitions for these three types of game-based learning, we established criteria for distinguishing between them and guiding study inclusion and analysis in this systematic review. (2018). Medical Education, 51(11), 1169–1170. In fact, some of the most significant innovations involve the use of technology in a more behind-the-scenes capacity, including in the training and development of clinical professionals. BMC Med Educ., 15(1). 2018; Zuk 2012), a commonly applied definition is that of Deterding et al. 52 gamification mechanics and elements. Gamification refers to using game attributes in a non-gaming context. 1977; Møllerand and Jennions 2001) and that negative results remain un- or underreported. In Lecture Notes in Computer Science (Including Subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics). 2012; Chen et al. Here, the use of social comparison theory helped clarify this effect through the comparative element underlying the competitive features of gamified learning that may have increased participants’ motivation to excel. Application of game-like simulations in the Spanish Transplant National Organization. Here are a few common examples. The global healthcare gamification market is … (De-Marcos et al. We systematically searched multiple databases, and included all empirical studies evaluating the use of game attributes in health professions education. Hamari, J., Koivisto, J., & Sarsa, H. (2014). Gamification techniques can be employed not just in professional training settings, but also in everyday life. However, little is known about the concept of gamification and its possible working mechanisms. Ten years’ experience conducting the aging game workshop: Was it worth it? Courtier, J., Webb, E. M., Phelps, A. S., & Naeger, D. M. (2016). Acad Med., 87(10), 1443–9. El-Beheiry, M., McCreery, G., & Schlachta, C. M. (2017). “Most nurses are facing a lot of different pieces when they are onboarding or training,” Sorrentino says. Benefits of gamification in education … Singapore Nurs J [Internet]., 40(3), 21–6. To this end, we first clearly and carefully distinguished gamification studies from studies investigating other types of game-based learning. (2015) used social comparison theory to develop a digital, competition-based learning environment and explain research outcomes. Wills, T. A. Gamification and multimedia for medical education: A landscape review. For instance, further research could illuminate whether increased repetition results in less positive learning outcomes when students’ attention is distracted from their learning task by one or more game attributes. Ethics teaching in rehabilitation: results of a pan-Canadian workshop with occupational and physical therapy educators. (2014). 2016; Creutzfel dt et al. Repetition and memory. 2008). Two different studies in which the same gamified elements were used also found that the use of simulators had increased (El-Beheiry et al. (2014). 2008). The study selection process is shown in Fig. 2007). The Top 15 Examples of Gamification in Healthcare Technology can be your coach supporting lasting change. Personality and Social Psychology Bulletin, 22, 24–33. Alternatively, some professors use virtual reality simulations to gauge their students’ ability to treat patients, allowing them to practice certain skills in a realistic and high-pressure environment, but without the need to involve actual patients. Subsequently, they have to determine which game attribute or combination of game attributes and matching game elements may help prevent consolidation of undesirable behaviours and/or attitudes. 2018). American Journal of Pharmaceutical Education, 80(8), 139. Instead of only focusing on specific game elements, we chose to use this framework to identify whether there is a class of game elements that hold the highest promise of improving health professions education. 046 15 Minute Reinforcement Test Restores Murmur Recognition Skills in Medical Students. If a desired behaviour or action is followed by a reward, individuals’ tendency to perform that action will increase. (1955). Some researchers assumed that by gamifying their courses, students’ experiences and, consequently, their understanding (through reflection and conceptualization) might be enhanced. In doing so, we responded to the call for more theory-driven medical education research (Bligh and Parsell 1999; Bligh and Prideaux 2002; Cook et al. Patton, K. K., Branzetti, J. J Am Geriatr Soc., 54(1), 144–9. Advances in Health Sciences Education For example, any consumer fitness apps and step-counters are heavily gamified, enabling users to track their progress, try to beat their personal records or connect with other users in friendly competition. A serious game for learning ultrasound-guided needle placement skills. Terminological ambiguity: Game and simulation. Advances in Health Sciences Education, 21(3), 505–521. Medical Education, 42(11), 1117. Mind. Multigenerational challenges and the future of graduate medical education. 2008). Journal of Economic Theory, 77, 1–14. lectures and practicals) as well as digital contexts (e.g. Kerfoot, B. P., Kearney, M. C., Connelly, D., & Ritchey, M. L. (2009). Med Teach., 26(6), 525–8. 2013; Huotari and Hamari 2012, 2017; Kumar 2013; Muntean 2011; Perrotta et al. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Immersive content formats like augmented reality and virtual reality allow us to “be” in that world to explore, manipulate content and assimilate it like never before. 2017; Montrezor 2016; Patton et al. Gamification to affect healthy outcomes already exists, but healthcare organizations have just begun to scratch the surface. International Journal of Caring Sciences, 10(1), 464–470. In the modern world with short attention spans, this is one of the most important tools to use in the education sector. Wells, L. (2018). 2018; Koivisto et al. An Epistemological Approach. An excellent way to develop these skills is to pursue a degree from a leading-edge organization in a field that is related to healthcare but also inclusive of foundational technology skills. Journal of Graduate Medical Education, 8(3), 442–443. Virtual reality training for endoscopic surgery: Voluntary or obligatory? Gamification: Toward a definition. However, game-design techniques and solutions can be employed to create the simulated reality and the experience of something real (Alessi 1988; Jacobs and Dempsey 1993). Combinations of game attributes were most common in our review (n = 36). Kerfoot, B. P., & Kissane, N. (2014). (2012). They found that the intervention group outperformed their noncompeting peers on the second term test. A meta-analytic review of experiments examining the effects of extrinsic rewards on intrinsic motivation. 2013; Dankbaar et al. We acknowledge, however, that the qualitative components of the mixed-methods studies may be very valuable. The idea is to apply applying game design techniques to non-game applications (i.e. Simulations provide instant feedback on performance, which is delivered as accurate and realistic as possible in a safe environment (Alessi 1988; Vallverdú 2014). Deliberate Practice Theory was applied to develop an educational tool using game-elements (such as points and time constrains) and virtual reality to practice urinary catheterization in nursing education (Butt et al. Caponetto, I., Earp, J., & Ott, M. (2014). Oxford English Dictionary. Forbes, in 2013 estimated that over 70% of their 'Global 2000 Companies' list were recorded saying on a survey that they planned to use gamification … The purpose of theory is to generate hypotheses, predict (learning) outcomes and explain underlying mechanisms. While it has some drawbacks, gamification offers advantages in encouraging behaviors and generating measureable feedback. To view a copy of this licence, visit Further studies are needed to quantify objective data on the effects of gamification on clinical knowledge retention among adult learners in health care professions. The remaining eight studied included in our study were well-controlled studies using assessment and conflict/challenge attributes, so these study results could be interpreted with more confidence. Gamification of health professions education: a systematic review. Jacobs, J. W., & Dempsey, J. V. (1993). Similarly, shifts of motivation may occur with different game attributes. (2017) used Reinforcement Learning Theory to explain the effect of direct feedback in digital learning. Rondon, S., Sassi, F. C., & Furquim De Andrade, C. R. (2013). Journal of Personality and Social Psychology, 28(1), 129–137. 2011). Huizinga, J. use of game design and mechanics to enhance non-game contexts by increasing participation 2011; Szyma 2014), we did not set a timeframe for our search since individual game elements were used in a non-game context long before the term “gamification” was coined and appeared in scientific literature. In Handbook of theories of social psychology: Volume One. Designing attractive gamification features for collaborative storytelling websites. 2016; McCoy et al. Satisfaction rates are generally high and positive changes in behaviour and learning have been reported. Second, this intention is different from the intention in serious games, which are defined as games (in their various forms) in which education is the primary goal, rather than entertainment (Susi et al. 2018; Ericsson et al. Experiential learning theory: Previous research and new directions. Computers and Education, 63, 380–392. rewards, leader boards and social elements (Petrucci et al. An active-learning methodology for teaching oxidative phosphorylation. In doing so, we added a new perspective to existing reviews on gamification in higher (Caponetto et al. Healthcare Gamification Market Size By Game Type (Casual Games, Serious Games, Exercise Games), By Application (Prevention, Therapeutic, Education, Others), By End-Use (Enterprise Based, Consumer Based), Industry Analysis Report, Regional Outlook, Application Potential, Price Trends, Competitive Market Share & Forecast, 2017 – 2024 Archives of Disease in Childhood: Education and Practice Edition, 101(6), 311–315. Kaylor, S. K. (2016). In sum, despite the apparent encouraging early results, it remains unclear whether the reported effects on academic performance can be solely attributed to the gamified interventions due to the absence of (non-confounded) control-groups. Anatomical Sciences Education, 8(5), 404–412. Hardly important education is for Healthcare, Science, Public Sector, Marketing, Logistics, Finance. Gamification in education. How healthcare providers use gamification. The Education Gamification market study further highlights the segmentation of the Education Gamification industry on a global distribution. Alas, getting rewards for passing certain courses or learning new things has been proven to encourage students to be more productive as that can impact their real life and improve their learning process even more. Lin, D. T., Park, J., Liebert, C. A., & Lau, J. N. (2015). Nevin, C. R., Westfall, A. O., Rodriguez, J. M., Dempsey, D. M., Cherrington, A., Roy, B., et al. Aided by the rise of technology, gamification offers both patients and providers novel ways … Academy of Management Journal, 20, 132–141. The use of game design elements to enhance academic performance (e.g., learning attitudes, learning behaviours and learning outcomes) is known as gamification or ‘gamified learning’ (Deterding et al. We used the following search terms: (gamif* OR gameplay* OR game OR games OR gamelike OR gamebased OR gaming OR videogam* OR edugam* OR flow-theor* OR “social network*” OR scoreboard* OR leveling OR levelling OR contest OR contests OR badgification) AND (medical educat* OR medical train* OR medical field training OR medical school* OR medical Intern* OR medical residen* OR medical student* OR dental student* OR nursing student* OR pharmacy student* OR veterinary student* OR clinical education* OR clinical train* OR clinical Intern* OR clinical residen* OR clinical clerk* OR teaching round* OR dental education* OR pharmacy education* OR pharmacy residen* OR nursing education* OR paramedics education* OR paramedic education* OR paramedical education* OR physiotherapy education* OR physiotherapist education* OR emergency medical services educat* OR curricul* OR veterinary education OR allied health personnel). If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. Hsu, S. H., Chang, J.-W., & Lee, C.-C. (2013). Gamification of education: A review of literature. (2017). Serious games for knee replacement surgery procedure education and training. Does competition work as a motivating factor in e-learning? In Library (Issue 15). They distinguished studies as focusing on description, justification and clarification. Plan differently. (2007). However, caution should be taken in drawing strong conclusions, because most studies were descriptive, (confounded) justification or (confounded) clarification studies, or clarification studies that did not include control groups (total n = 36). 2008). International Journal of Human Computer Studies, 74, 14–31. BMC Med Educ., 15(1). 2015). Of the 17 studies excluded in this step, one was excluded because no consensus could be reached (Mullen 2018), the others did not meet the inclusion criteria. BMC Med Educ., 16(1). This is at least suggested by the number of peer-reviewed scientific publications on gamification in this field, which has increased almost tenfold over the past 5 years. Learn more about the wide range of healthcare degree programs offered online at UCF. The modern practice of adult education: From pedagogy to andragogy. The gamification intervention was associated with a modest reduction in numbers of days to reach the target blood pressure in a subgroup of already hypertensive patients. Dankbaar, M. E. W., Richters, O., Kalkman, C. J., Prins, G., Ten Cate, O. T. J., van Merrienboer, J. J. G., et al. Hardly important education is for Healthcare, Science, Public Sector, Marketing, Logistics, Finance. We classified all included studies as descriptive, justification or clarification. However, in case of uncertainties, the entire team was involved in the decision-making process and we undertook double screening on a 10% random sample of the excluded articles as a form of triangulation. (2008). Part of Springer Nature. Our findings suggest that it is possible to improve learning outcomes in health professions education by using gamification, especially when employing game attributes that improve learning behaviours and attitudes towards learning. Using such an approach, we were better able to make a distinction between the three forms of game-based learning (gamification, serious games and simulations) and, therefore, to make an accurate selection of gamification studies. Gamification Examples Marketing Health Education Websites Influencers . Serious Gaming and Gamification interventions for health professional education. In NFER (National Foundation for Educational Research). Fidelity in the design of instructional simulations. Computers and Education, 75, 82–91. BMC Medical Education, 17(1), 30. Doctors have exploited the benefits of eLearning apps, which has been applied to everything from physical health to mental health to rehabilitation. Fleiszer, D., Fleiszer, T., & Russell, R. (1997). Inangil, D. (2017). However, giving rewards for a previously unrewarded activity can lead to a shift from intrinsic to extrinsic motivation and even loss of interest in the activity when the rewards are no longer given. 2017), it was assumed that incorporating gamification into courses could enhance students’ experience and, therefore, their reflection on and conceptualization of that experience (Kolb et al. The majority of the studies were conducted in the USA (n = 20) or Canada (n = 8). The goal of gamification is to motivate the user into forward momentum, and also provide a way of quantifying and rewarding progress. 2008). Game-based learning: Latest evidence and future directions. (2018). 2014; Hsu et al. 2014; Subhash and Cudney 2018) and health professions education (Gentry et al. Richey Smith, C. E., Ryder, P., Bilodeau, A., & Schultz, M. (2016). © In seven studies, theoretical assumptions were affirmed or refuted, based on the results of the study (Table 1). The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. Comparative effectiveness of a serious game and an e-module to support patient safety knowledge and awareness. Teaching EBP using game-based learning: Improving the student experience. Gamification … We found that certain game attributes were more often applied to a particular context. Landers, R. N., Bauer, K. N., Callan, R. C., & Armstrong, M. B. Conclusion. Using an online neurological localisation game. The examination game. Description studies make no comparison, focus on observation and describe what was done. Simulations are therefore best seen as learning activities that necessarily carry some game intention, but do not use game elements. That’s the game I’m in. There are many fields in which to apply gamification in healthcare, such as: specialized medical training rehabilitation active ageing prevention improving adherence to therapy Game mechanics include things like: Points & Levels; Progress Bars; Badges; Leaderboards; These mechanics are pretty much the only si m ilarity between games and gamification. Gamification: Design of IT-based enhancing services for motivational support and behavioral change. Innovative Patient Safety Curriculum Using iPAD Game (PASSED) Improved Patient Safety Concepts in Undergraduate Medical Students. 2007). New York: Schocken Books. Burke, B. An example of gamification in a digital environment was a web-based platform where gamification elements were inspired by the Tetris game (Lin et al. Whether this implies that opting for digital modalities is better suited to postgraduate courses or whether digital modalities are better suited for a combination of conflict and challenge attributes remains uncertain. Therefore, the characteristic difference between gamification and serious games lies in their design intention. For instance, traditionally, professors in medical schools use multiple choice quiz games to test students and measure their retention of key concepts. 2012; Klabbers 2009). The conceptual framework we used in this study originated from serious games. We included quantitative as well as mixed-method studies. 2013; De Sousa Borges et al. So even though repetition is vital for knowledge retention, increased repetition of the learning material in gamified interventions might not necessarily benefit learning, especially when students get distracted by game elements. Gamification at work: Designing engaging business software. Patient-centered apps may be used to help monitor the progress of an individual’s nutrition, daily physical activity, physical therapy and more. (2013). Gamification in healthcare has the potential to bring together people and technology to change health outcomes. Zichermann says that gamification will gain in popularity in politics and civic organizations. 2015; Frederick et al. Association between funding and quality of published medical education research. To take advantage of gamification, healthcare leaders must: Think differently. In addition, realist evaluation can help provide a deeper understanding by identifying what works for whom, in what circumstances, in what respects and how (Tilley and Pawson 2000). Academic Radiology, 24(11), 1428–1435. On the contrary, gamification has been commonplace in fields like education and military for years. Gamification for Education. improved performance would be achieved by letting students identify discrepancies in their knowledge through upward comparison or validate their assumptions on knowledge through downward comparison (Van Nuland et al. A combination of conflict and challenge attributes was also more often chosen by researchers from Europe (6 out of 8 European studies) and the USA (17 out of 21 USA studies) than by researchers from Canada (3 out of 8 Canadian studies). Börgers, T., & Sarin, R. (1997). Oxford English Dictionary. Cochrane Database of Systematic Reviews, 2016(6), 1–9. Gerard, J. M., Scalzo, A. J., Borgman, M. A., Watson, C. M., Byrnes, C. E., Chang, T. P., et al. 2016). Lobo, V., Stromberg, A. Q., & Rosston, P. (2017). Health professions educators increasingly turn to gamification to optimize students’ learning outcomes. All studies reported positive results compared to a control group not using gamification, or similar results for both groups (Table 1). Quality improvement project to reduce paediatric prescribing errors in a teaching hospital. Gamification in medtech is a very new area, especially if you’re talking specifically about health and medicines, whereby there is a lot of legislation and costs, such as clinical trials and … Archives of Disease in Childhood, 102, A24. Understanding the principles of gamification. Abstract Background: There is a worldwide shortage of health workers, and this issue requires innovative education solutions. Department of Biomedical Sciences of Cells and Systems, Section Anatomy & Medical Physiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands, Faculty Behavioural and Social Sciences, Department of Educational Sciences, University of Groningen, Groningen, The Netherlands, Center for Education Development and Research in Health Professions (CEDAR), LEARN, University Medical Center Groningen, University of Groningen, 713AV, Groningen, The Netherlands, J. Schönrock-Adema, T. Bouwkamp-Timmer & A. D. C. Jaarsma, You can also search for this author in Performance in physiology evaluation: Possible improvement by active learning strategies. In addition, we hand-searched the reference lists of included articles and citations for additional articles. PLoS ONE, 10, e0120644. B. Butler, A. C., Karpicke, J. D., & Roediger, H. L. (2007). to structure game elements in other, non-educational domains (Landers 2014). Gamification … Especially this combination of attributes was found to increase the use of learning materials, sometimes leading to improved learning outcomes. Simulation and Gaming, 45, 752–768. What is the quality of existing research on gamified learning in health professions education? In addition, we attempted to uncover the theory underpinning the gamified interventions reported in this systematic review. Fishing for pharmacology success: Gaming as an active learning strategy. (2012). Journal of Medical Internet Research, 15, e9. Crosswords and word games improve retention of cardiopulmonary resuscitation principles.
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