Gaming as a Tool
To Teach Patient Safety
Simulation Game Team, A.T. Still University
Fred Schwartz, DO, Tom Bennett, DO, Rupal Vora, MD, Noel Carrasco, MD,
Inder Makin, MD, Robin Pettit, PhD, Stan Brysacz DO, Lise McCoy, MTESL.
A project funded by HRSA.
Osteopathic Medical Education Leadership Conference
Scottsdale Arizona January 5, 2013
Audience Response
Game Shows for
Patient Safety
Robin Pettit, Ph.D.
Rupal Vora, M.D. FACP
Inder Makin M.D., Ph.D.
William Wightkin, PharmD
Learning Objectives
• Illustrate the application of Bravo games
in medical education, specifically
addressing patient safety
• Provide practice with the WHO Patient
Safety Competencies (Systems, Adverse
events, Infection control, Medication
safety, Communication) using an
interactive electronic game
Games in Medical Education
• How do games differ
from other educational
strategies?
– competitive nature
– rules and procedures
– rewards
Benefits of Games in Medical Education
• integration of fun, excitement in learning
process can reduce stress, anxiety
• motivation through competition
• social interaction, enhancement of
communication, teamwork
• complement, reinforce existing knowledge
• provide feedback
“enjoyable”
“stimulating”
“engaging”
“increased my content knowledge”
“helped me retain information”
Mobile App Games
for Patient Safety
Frederic Schwartz, D.O. Stanley Brysacz, DO
Lise McCoy, MTESL
3-5-Minute Cases
for Mobile Learning
• iPhone
• iPad
• Android
• Tablet
The Prognosis Game App
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Decision making
Investigation
Management
Instant feedback
Case Discussion
Skills Tracking
Game Results Provide Feedback
Branching Case Scenarios
Use patient
stories to
highlight errors
and dilemmas
Practice
decision
making for
diagnosis
“ Make game vignettes
available for optional
individual practice, or
prescribe specific games as
assignments for core
rotations.”
Virtual Patient Simulations
for Medical Education
In Fall
2012 beta
trials,
students
surveyed
found these
to be
engaging
and
valuable.
Tom Bennett, DO, Noel Carrasco, MD
Deliberate Practice
with Clinical Reasoning
Medical students need to rehearse
clinical encounters before
diagnosing real patients. This is
urgent for the reason of patient
safety.
Ziv et al., 2006
Key Takeaways
• Learning about patient safety can
be fun, exciting, and interactive.
• Games provide deliberate
practice to reinforce concepts
students need to know.
• Games can be used to teach or
test competencies.
Game Platforms
• C-3 Softworks (Bravo)
www.c3softworks.com
• Decision Simulation
http://decisionsimulation.com/
• Medical Joyworks
• medicaljoyworks.com
Citations
• WHO Patient Safety Curriculum Guide, 2011
• Teaching Physicians to Provide Safe Patient Care,
Lucian Leape Institute Roundtable on Reforming
Medical Education, National Patient Safety
Foundation, 2010
• http://www.cdc.gov
• http://www.uptodate.com
• Medical Education, 2009, 43:303–311
• Medical Teacher, 2011, 33:156-160
• BMC Medical Education, 2010, 10:26
• Archives of internal medicine, 2010, 171:1385–
90
• Simulation in healthcare, 2006, 1:252–6
Pedagogy and Educational Games
Lise McCoy, MTESL
School of Osteopathic Medicine in Arizona
A New Generation of Learners
“…a visually rich, multichannel form of
expression can be powerfully compelling,
engaging, and communicative” – Larry
Johnson
Serious Games & VPS Support the
Modern Learning Paradigm
1.
2.
3.
4.
5.
6.
7.
Learning to Think
Performance-based
Inductive-emergent
Multiple Modalities
Customizable
Ecological
Collaborative
New Paradigm; Gee: Pullias Lecture, USC 2011 http://www.youtube.com/watch?v=FmcgMK46nfg
Physiological/Social Impact of Games
• Interactivity increases brain
activity and neural nets.
• Engagement may be
operationalized and measured
as “flow”
• Game environments promote
unconscious learning, a
psycho social moratorium.
• Students must cooperate to
solve real world tasks
Games Support 21st Century Adult
Learning Strategies
Schema
Scaffolds
Feedback
Theoretical
connections
• Discovery
• Self-Direction
• Reflection
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Which Pedagogical Theories
Support Simulation/Game
Learning ?
Cognitive Science
- Schema Theory
- Cognitive Load Theory
- Skills Training
- Scaffolding
- Novice to Expert
-Thinking and Reasoning
-Knowledge Bundling
Constructivism
- Situated Learning
- Conceptual
Frameworks
- Social Learning
- Case Based Practice
Learning Rewards: Games / Simulations
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Rich environments
Legitimate peripheral participation
Alignments of perspectival framing
Shared virtual experiences
Learning affordances
Deliberate (anytime) practice
Non-linear learning
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Education References
21. Net Generation Learners: Johnson, L. (2006). The Sea Change Before Us. Educause, 72–73.
22a. New Paradigm: Gee, J. (2011). Pullias Lecture, USC.
22b. 21st Century Skills: Mishra, P. (2012). Rethinking technology & creativity in the 21st century:
Crayons are the future. TechTrends, (September/October), 13–16.
22c. Barab, S., Gresalfi, M., & Ingram-Goble, A. (2010). Transformational Play: Using Games to Position
Person, Content, and Context. Educational Researcher, 39(7), 525–536.
23a. Brain: Zull, J. E. (2004). The Art of Changing the Brain. Educational Leadership, September.
23b. Brain: Green, C. S., & Bavelier, D. (2003). Action video game modifies visual selective attention.
Nature, 423(6939), 534–7. 23c. Brain: CNN (2012) Gaming Reality.
23c. Brain: CNN. (2012) Gaming Reality. Retrieved from:
www.cnn.com/interactie/2012/08/gaming.series/teachers.html
23d. Flow: Schiefele, U., & Raab, A. (2011). Skills demands compatibility as a determinant of flow
experience in an inductive reasoning task. Psychological Reports, 109(2).
23e. Engagement: Gee, J. P. (2005). Pleasure, Learning, Video Games, and Life: the projective stance. ELearning, 2(3), 211.
23f. Psychosocial Moratorium: Deterding, S., & Dixon, D. (2011). Gamification : Using Game Design
Elements in Non-Gaming Contexts. Sociology The Journal Of The British Sociological Association, May,
5–8.
23g. Social Collaboration: Brown, J. S., Collins, A., & Duguid, P. (2007). Situated cognition and the
culture of learning. Educational Researcher, 18(1), 32–42.
24a. Schema: Anderson J. The Architecture of Cognition. Cambridge, MA: Harvard University Press;
1983.
24b. Scaffolding Connections: Bransford J, Brown A, Cocking R. (2000). Mind and Brain. In: How
People Learn: Brain, Mind, Experience, and School. Washington, D.C.: New Academy Press.
24c. Social Interaction: Aufschnaiter, C. (2003). Interactive processes between university students:
Structures of interactions and related cognitive development. Research in Science Education. 233:341–
374.
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Education References-Continued
24d. Inquiry Episodes: Duckworth E. The Having of Wonderful Ideas and Other Ideas on Teaching and
Learning. New York, NY: Teachers College, Columbia University; 2006.
24e. Time to Reflect: Mann K, Gordon J, MacLeod A. Reflection and reflective practice in health professions
education: a systematic review. Advances in Health Sciences Education. 2009;14(4):595–621.
25a. Constructivism: Bronack S, Riedl R, Tashner J. (2006). Learning in the zone: A social constructivist
framework for distance education in a 3-dimensional virtual world. Interactive Learning Environments.
14(3):219–232.
25b. Cognitive Learning: Patel VL, Arocha JF, Zhang J. (2004). Thinking and Reasoning in Medicine. In:
Cambridge Handbook of Thinking and Reasoning. Cambridge, UK: Cambridge University Press; 1–34.
25c. Game Learning: Kebritchi M, Hirumi A. (2008). Examining the pedagogical foundations of modern
educational computer games. Computers & Education. 51(4):1729–1743.
26a. Fun: Prensky M. (2001). Fun, Play and Games: What Makes Games Engaging. In: Digital Game Based
Learning. McGraw-Hill. 1–31.
26b. Deterding, S., & Dixon, D. (2011). Gamification : Using Game Design Elements in Non-Gaming Contexts.
Sociology The Journal Of The British Sociological Association.
26c. Affordances: Dalgarno, B., & Lee, M. (2010). What are the learning affordances of 3-D virtual
environments? British Journal of Educational Technology, 41(1), 10–32.
26d.Non-linear learning: Poulton, T., Conradi, E., Kavia, S., Round, J., & Hilton, S. (2009). The replacement of “
paper ” cases by interactive online virtual patients in problem-based learning. Academic Medicine, 31, 752–
758.
26e. Perspectival Framing: Van de Sande, C., & Greeno, J. G. (2012). Achieving Alignment of Perspectival
Framings in Problem-Solving Discourse. Journal of the Learning Sciences, (November 2012), 37–41.
26f. Legitimate Peripheral Participation: Lave, J., & Wenger, E. (1991). Situated learning: Legitimate peripheral
participation (p. 123). New York, NY: Cambridge University Press.