Game-based Learning in medical education

GAME-BASED LEARNING IN MEDICAL EDUCATION

Sanchidrián Pardo, Rosa4

1,2,3: Facultad de Ciencias Sociales Universidad Europea de Valencia

Avda. Aragón nº 30 CP 46021 Valencia

e-mail: ablasco@hospitalmanises.es e-mail:juliavendrell@hotmail.com

e-mail:olsanber@hotmail.com

2: Universidad Europea de Valencia Cl/ General Elio, 8 Entresuelo

CP 46010 Valencia

e-mail: rosa.sanchidrián@uem.es, web: http://www.valencia.universidadeuropea.es

Abstract. This article main objective is to develop a proposal for an activity that permits medicine teachers and students -as well as doctors- in the branch of infectious diseases to study and/or review the main contents that the subject includes in an entertaining and enjoyable way through a game-based learning process.

1. INTRODUCTION.

The term gamification has been defined as the use of the elements of the games in contexts that are not games (Deterding et al., 2011). It is applicable to any context. Serious games use the dynamics of the games in contexts that are not games. The concept of videogame is important to be distinguished, it is a system based on rules and measurable response variable in which different values are assigned to different effects, in which the player makes an effort to influence these effects system has an emotional attachment to the effects and consequences of such activity are optional and negotiable. (Juul, 2003).

In the area of education the most correct it would be to talk about game-based learning as the use of games (already developed or developed expressly) for teaching-learning processes.

With the game-based learning training goes far beyond learning theoretical contents. The game-based learning allows students to develop their skills through practice.

Several authors suggest that games can be a way to engage students in a “flow”. (Vallejo, 2013) (Garcerá, 2015)

Flow statement has been defined as a state of deep absorption in an activity that is inherently joyful and has been detected for example when artists or athletes are focused on your game or performance (Csikszentmihalyi, 1990).

2. MOTIVATION.

Today’s students have grown up with digital technologies and various digital tools such as games, social media, and virtual worlds have profoundly impacted the way they study, play, and socialize. Digital games in particular as a form of entertainment are gaining popularity especially since the introduction of mobile devices and are becoming a ubiquitous means of how people spend their leisure time. It has been reported that “in a typical day, 8- to 18-year-olds spend an average of 1:13 playing video games on any of several platforms...” and “On any given day, 60% of young people play video games” (Rideout, Foehr, & Roberts, 2010, p. 25). Educators are therefore increasingly interested in exploring using digital games as a tool to facilitate learning, because if we do not take advantage of these new digital technologies, we run the risk of missing the opportunities to maximize student potentials and addressing digital literacy of today’s youth (Judson, 2010).

It is intended to break with the traditional model of higher education, which implies the classical model of lectures to passive learners, which is known to be inefficient (Larsen, 2006). Therefore, we suggest a different learning activity with the objective of reinforcing the active participation as well as the critical thinking of the student in the classroom.

In the last decade, a lot of bibliography related to game-based learning (Lacasa, 2011) has been collected highlighting that the use of game elements in non-gaming contexts like education has a positive impact in the retention of knowledge together with the understanding of the subject being taught (Tsui, 2014).

Game-based learning applications can draw us into virtual environments that look familiar and we can see the connection between the learning experience and our real-life work.

In an effective game-based learning environment, we work toward a goal, choosing actions and experiencing the consequences of those actions. We make mistakes without risk, and through experimentation, we actively learn and practice the right way to do things. This keeps us highly engaged in practicing behaviors and thought processes that we can easily transfer from the simulated environment to real life.

3. METHODOLOGY

This activity named What`s up Doc?, presents all the elements that can be appealing to a Medicine student. It permits to acquire the theoretical knowledge of infectious diseases in a practical way and the necessary competences to carry out their work correctly. It consists of a videogame in which the student has to face real clinic cases and situations where they have to treat the different diseases of patients with the objective of healing them.

The suggested game presents four levels and the student takes on different roles according to the level s/he is playing. To go from one level to the next, the player has to solve properly the six cases that appear in each level. When the patient is healed, s/he disappears and the player obtains points.

3.1. Gameplay Mechanics

Points. A tool used to partly motivate students and necessary to level up.

The board. The doctor’s office of the infectious diseases unit of a hospital. On the screen the records of 6 patients appear each time the user is playing a specific rule-play, the patient appears and has all the symptoms. The student/user can order lab tests, physical examination, interdepartmental assessment, etc.

Rules. The player has a limited time to each of the phases that must pass to cure the patient. To access the medical records has to select the photo of the patients. As an interactive puzzle type game, the user can solve every case and move on to other levels of major complications through different routes of action. In all, learning is assured. The steps are usually: having knowledge of patient’s symptoms, asking for lab tests and some extra patient’s anamnesis, making a diagnosis of the infectious disease and finally giving the patient an adequate treatment. All this against the clock, there is a time for each phase, the patient after a while without the correct answer gets worse, and decide to change doctor. Due to much of the first diagnoses in real life are not the most appropriate, this game allows the player to return to resolve cases more than once, whether is right to review concepts as it has successful to heal patient.

Badgets. Extra assessment of the activity provides the player with extra points with the ultimate goal of healing the sick. Some of the items assessed are mentioned in table 3. Levels. Referred to the different roles that a user can reach playing the game, solving the 6 clinical cases per level to level up. The lowest level is the role of Student, followed by the Intern and the Specialist. The best known roles is the Head of Service.

3.2. Game dynamics

Because in real life, a doctor can treat all types of patients, from different nationalities, religions, etc., the following items will be considered in the game- based learning presented in this article, altruism, empathy, rewards and use of English.

3.3. Software

Software used for creating resources:

Wix. Is a platform that allows to create and publish a website for free and so easy, without having to know programming code (Wix, 2010)

ExeLearning

It is a program with GNU license for the creation and publication of educational content computer media. You can insert interactive content and is exportable as Web page. (eXeLearning, 2006)

4. CLINICAL CASES

One of the aims of this game-based Learning approach is to cure the patient, go through the game different levels to achieve a significant degree of knowledge comparable to a Head of Infectious Disease Service.

To reach the highest level, it is necessary to solve the following 24 clinical cases or to obtain at least 6301 points, through badges for example.

Level Clinical Cases Infectious diseases

Student

1 Genitourinary Tract Infection

2 Gastrointestinal Infection

3 Respiratory tract Infection

4 Central Nervous System Infection

5 Bood Infection

6 Skin and Soft Tissues Infection

Intern

7 Intraamniotic Infection and Sepsis Neonatal 8 Diarrhea by Parasites

9 Pulmonary Invasive Infection in Immunocompromised Patient

10 Meningitis

11 Pericarditis

12 Cutaneous anthrax

Specialist

13 Encrusted Cystitis

14 Chronic Atrophic Gastritis

15 Polyarticular Tuberculosis

16 Hepatitis

17 VIH

18 SARS

Head of Service

19 Nosocomial Infection

20 Managing an Epidemic of Microorganisms Risk Group 3

21 Ebola

22 Multidrug Resistant Microorganisms

23 Osteomyelitis

24 Optimization Programs in the Use of Antimicrobials

Table 1. Presention of all Game content

5. IMAGES OF THE GAME.

Most of our game takes place in the doctor's office; here an Image 1 displays the game's main page.

6. TABLES.

The following tables have been used to assess, measure how well students enrich the knowledge of Infectious Diseases, the Use of English and Empaphy. Therefore the correct answers and the response speed are evaluated.

Table2. Point distribution and Response speed

Level Clinical _Cases Points Maximun of 15 minutes Maximun of 15 minutes Maximun of 15 minutes Response speed 1 Response speed 2 Response speed 3

Student (0- 2100)

1 100

2 200

3 300

4 400

5 500

6 600

Intern

(2101-4200)

7 100

8 200

9 300

10 400

11 500

12 600

Specialist

(4201-6300)

13 100

14 200

15 300

16 400

17 500

18 600

Head of Service (6301-

8400)

19 100

20 200

21 300

22 400

23 500

Level Items + BADGETS From 50 to 100 points - BADGETS From 0 to 50 points

Adequate Non Adequate

Student

Speeding Empaphy Diagnosis Treatment Use of English

Intern

Speeding Empaphy Diagnosis Treatment Use of English

Specialist Speeding Empaphy Lab tests Diagnosis Treatment Use of English

Head of Service

7. CONCLUSIONS

Game-based learning is not a new phenomenon but the exponential growing of the use of game and videogames in the recent years has awakened the interest of experts to figure out the keys that turn this type of learning into a successful teaching methodology.

The application of game dynamics allows to obtain a number of experiences that enrich the activity providing students higher levels of motivation (Glover, 2013), engagement. We think this could be a very rewarding and stimulating exercise that will help students to improve their skills in learning by doing environment.

The game-based learning offers positive reinforcement, instant feedback, acceptance of error and possibility of modifying the behavior to achieve the objectives. Its application can be the key to reduce dropout rate.

8. LIMITATIONS AND FUTURE LINES OF RESEARCH

This methodology is flexible enough so it could be easily applied in other areas of knowledge such as architecture, psychology etc.

Despite numerous studies that support the efficacy of dynamic classes using multimedia tools (William C. et.al), it would be necessary to implement the proposed game-based learning activity in this article and evaluate the impact of its implementation.

9. REFERENCES

Csikszentmihalyi, M. (1990). Flow: The Psychology of Optimal Experience. New York: Harper-Perennial.

Deterding, S., Dixon, D., Khaled, R., & Nacke, L. (2011). From game design elements to gamefulness: defining gamification. In Proceedings of the 15th International Academic MindTrek Conference: Envisioning Future Media Environments (pp. 9-15). ExeLearning. (2006). eXeLearning. Recuperado 12 mayo 2015, de http://exelearning.net/

Garcerá Rius, E. (2015). Gamificando el aula. (Trabajo fin de Máster inédito). Universidad Católica de Valencia, Valencia.

Glover, I. (2013).Play as you learn: gamification as a technique for motivating learners. In:Proceedings of World Conference on Educational Multimedia, Hypermedia and Telecommunications 2013. AACE , Chesapeake, VA, 1999-2008.

Juul, J. (2003). The game, the player, the world: Looking for a heart of gamness.

Lacasa, P. (2011). Los videojuegos. Aprender en mundos reales y virtuales. Madrid: Ed. Morata.

Larsen, M.D. (2006). Advice for New and Students Lecturers on Probability and Statistics. Journal of Statistics Education, 14.

Rideout, V. J., Foehr, U. G. & Roberts, D. F. (2010). Generation M2 – Media in the Lives of 8- to 18-Year Olds. Menlo Park, CA: Kaiser Family Foundation.Lives of 8- to 18-Year Olds. Menlo Park, CA: Kaiser Family Foundation.

Tsui, J., Lau, J., & Shieh, L. (2014). Brief. Septris and SICKO: Implementing and Using Learning Analytics and Gamification in Medical Education. Standford University. Vallejo, S. (2013). Zombiología. Recuperado 5 de mayo de 2015 de http://zombiologia.com