The gamification of medical training

Video games evoke several connotations. They are regarded as childish, escapist, and time wasters that prompt isolation and bad habits. Video games are even blamed for violence and other ills of society. In actuality, many serious scientists have convincingly argued that video games not only have acquired an undeserved reputation, but they are actually potent and effective tools for science education.

Features of video games inherently support scientific learning

While it may not be obvious to most video game users, the core constructs of video games (and games in general) that make them appealing and even addictive can be used for science education. Morris and colleagues illustrate the remarkable overlap between the motivations of video games and science education. The authors separate the shared domains into three “scaffolds”: motivational, cognitive, and metacognitive scaffolds.

The motivational scaffold is the construct that prompts users to engage in the game. There is no monetary reward for shooting aliens or chopping fruit with a katana, yet people will spend countless hours in this endeavor. As Morris and peers explain, the motivational scaffold includes curiosity, feedback, praise, motivation orientations, fun failure, and flow states — all of which are constructs that could be used to motivate learning. The cognitive scaffold mirrors the attributes of what we regard as high-quality scientific thinking. One uses tools from the video game environment to solve complex problems. The player makes educated guesses about the best course of action, analyzes the results, reformulates the original hypothesis based on these outcomes, and continues until an acceptable conclusion is reached. The metacognitive scaffold is the ability to alter cognitive constructs based on new information. The player must realize that her theory is a representation of the truth, rather than “the way things are.”

Video games improve medical training

While they aren’t replacing lectures, video games have scored several successes in the medical classroom. For example, a quiz-based clinical neurophysiology game was shown to significantly improve scores residency in-service exams. PGY2 general surgical residents showed similar gains with the use of quiz-based learning games. In this case, long-term learning was demonstrably enhanced. Indeed, the tactile processes involved in some video games help surgeons not only master didactic content, but may also improve surgical skill. Rosser and coauthors found that video game skill correlates with laparoscopic surgical skills.  Heavy video game users made 37% fewer errors and were 27% faster than non-gamer residents were at actual laparoscopic procedures.

Medical games are preferred over lectures

When you ask students and educators which technique they prefer, game-based learning is the clear winner. In a survey of 434 residency program directors, more than 90% support the use of games in residency education. Roughly eight in ten support quiz-based exercises to supplement learning. Quiz-type games not only improved learning outcomes among medical students, they improved the students’ opinion of medical microbiology as a field. Medical students were “highly engaged” with a geriatric house call video game and, as a group, strongly supported the inclusion of the game in training. Impressively, these favorable sentiments toward video games are not restricted to video game users. Eighty percent of medical students surveyed — including 47% who don’t play video games for entertainment — believed that video games have educational value. More than three-quarters of respondents would use a video game on their own time if it would help them improve their medical knowledge or patient management skills.

The inherent properties of most video games, such as goal-directed challenges and real-time feedback, coincide with ideal approaches to science education. Users are highly motivated to perform tasks within a video game environment for digital, rather than tangible gains. There are numerous examples in which video games, especially quiz-based games, improve medical and science learning outcomes. Moreover, most students and educators involved in medical education endorse the premise of video game-based exercises. It is conceivable that video game learning may soon become a more mainstream component of medical education.

Vincent Stevenson is CEO, Precision Enterprises LLC, creator of the Scrub Wars medical gaming app.

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