Chang, T., P., Pusic, M.V., Bauman, E.B., Dong, C., Stapleton, G., Kachur, E. (2019, August). Theoretical & practical considerations for serious games development & implementation in medical education. Meeting of the Association of Medical Educators in Europe, Vienna, AT.

1. Theoretical &
practical
considerations for
serious games
development &
implementation in
medical education
AMEE 2019.08.26 Wien, AT

2. WORKSHOP FACILITATORS
•Todd P Chang, MD MAcM
•Martin V Pusic, MD PhD
•Eric B Bauman, PhD FSSH
•Chaoyan Dong, PhD
•Gerald R Stapleton, MS
•Elizabeth K Kachur, PhD

3. NO CONFLICTS & DISCLOSURES
•Elizabeth K Kachur, PhD
•Martin V Pusic, MD, PhD
•Chaoyan Dong, PhD
•Eric B Bauman, PhD, FSSH
•Gerald R Stapleton, MS
•Todd P Chang, MD, MAcM

4. OBJECTIVES
1. List types of games and game elements
used in medical education, with examples
2. Select types of games to fit curricular
needs
3. Discuss an implementation plan for
applying games to their own setting

5. BRIEF TERMINOLOGY
And definitions

6. WHAT IS A ‘GAME’?

7. 4 DEFINING TRAITS OF
A GAME
1. Goal
2. Rules
3. Feedback System
4. Voluntary
Participation

8. “WINNING” IS NOT A
NECESSARY GAME TRAIT

9. TYPES OF GAMES
1.Role playing
2.Frame games
3.Puzzles
4.Cross words
5.Game Show / Trivia
6.Strategy Game
7.Physical/Movement
Game
8.Dance Game
9.Escape Game
10.Survival Game
11.Memory Games
12.Scavenger Hunt
13.Treasure Hunt
14.Story Games
15.Tabletop / Board
Games
16.Slide Presentation
17.Multi Media
• Role Playing Game
• Puzzle
• Real-time Strategy
Game / Resource
Management
• 1st Person Shooter (FPS)
• Platform Game
• Adventure Game
• Sports Game
• Online / Massive Multi-
Player Online (MMO)
Bigdeli & Kaufman Med J Islamic Rep Iran 2017.

10. WHAT GAMES DO YOU PLAY?

11. WHAT IS A GAME’?
A game is a system in which players, participants engage in an artificial
conflict, contrived activity based on a well designed experience that is
defined by rules, that results in a quantifiable outcome
Salen, K., Tekinbaş, K. S., & Zimmerman, E. (2004). Rules of play: Game design fundamentals. MIT press.
Squire, K. (2006). From content to context: Videogames as designed experience. Educational researcher, 35(8), 19-29

12. WHAT IS A ‘SERIOUS GAME’?
…but designed to achieve an intentional purpose for learning, behavioral
change including but not limited to social justice, health, etc… Serous
Games attend to or map back to learning or training objectives
De Freitas, S. (2006). Learning in immersive worlds: A review of game-based learning.

13. WHAT IS ‘GAME-BASED LEARNING’?
Learning that takes place with and/or as a game… provides instructional content
where the intent is to promote knowledge and skill transfer
Van Eck, R. (2006). Digital game-based learning: It's not just the digital natives who are restless. EDUCAUSE review, 41(2), 16.

14. SERIOUS GAME vs
ENTERTAINMENT
GAME
Entertainment Games: strive to keep
immersed within the game environment as
long as possible.
Serious Games: Aim transfer knowledge or
develop skills to be applied in the real-world
with efficiency.
• A good Serious Game may be
intentionally and inherently short

17. SUMMARY TERMINOLOGY
•Game
•Serious Game
•Entertainment Game
•Game-based Learning

18. ANY QUESTIONS SO FAR?

19. WORKSHOP AGENDA

20. WORKSHOP AGENDA
20 35 20 15

21. Why Games?
Retention Rates
Students who learned by doing: 75%
Students who learned from lecture: 5%
(Magennis and Farrell - 2005)

22. Why Games?
Retention Rates
Students who learned by simultaneously
seeing, hearing, and doing: 90%
Students who learned by doing: 80%
Students who learned by seeing: 40%
Students who learned by hearing: 20%
Joyce - 2005

24. Foundations of Game-based Learning
David Kolb’s
Experiential Learning
Cycle

25. Foundations of Game-based Learning
Donald Schön
Patricia Benner
Reflection
- on action
- in action
Actions
Outcomes
Problem
Planning
Solving
Benner P. From novice to expert: Excellence and power in clinical nursing practice. Menlo Park, CA: Addison-Wesley; 1984
Schön DA. The reflective practitioner: How professionals think in action. New York: Basic Books; 1983

26. Contemporary Theory
Kurt Squire
Designed Experience
• Participant
experience or
learning as
Performance
James Paul Gee
Socially Situated Cognition
• Learning is situated
within a material, social
and cultural experience
Gee, J.P. (2003). What videogames have to teach us about learning and literacy. New York, NY: Palgrave-McMillan.
Squire, K.D. (2006). From Content to Context: Videogames as Designed Experience. Educational Researcher, 35(8), 19-29.

27. Fit and Integration
Didactic
Preparation
Games, XR,
Interactive
Applications
Task Trainer
or Simulator
Real World
Experience
Bauman’s Layered Learning Framework
©Bauman 2019 all Rights Reserved
Felszeghy S., Pasonen-Seppanen S., Koskela A., Nieminen P, Harkonen K, Paldanius K.M.A., Gabbouj S., Ketola K., Hiltunen M., Lundin M., Haapaniemi T., Sointu E., Bauman
E.B., Gilbert G.E, Morto D., & Mahonen A. (In Press). Use of gamification in a histology course: An innovative strategy. BMC Medical Education.

28. Fit and Integration
Effective
AppealingEfficient
Proper Fit
Learning
Objectives
Complexity
Cost Time
Aleckson, J., & Ralston-Berg, P. (2011). MindMeld: Micro-Collaboration between eLearning designers and instructor experts. Madison, WI: Atwood Publishing
Bauman, E. B. and Ralston-Berg, P. (2014). Virtual simulation. In J. Palaganas, J. Maxworthy, C. Epps, and M.E. Mancini (Eds). Defining excellence in simulation.
Wolters Kluwer – Lippincott Williams & Wilkins

29. SMALL GROUP ACTIVITY
Application of Game Types to potential Educational Objectives
GAMES - SQUARED

30. Let’s Play!

31. Problem Card: Description of a learning challenge

32. Solution Cards
• Game Type
• Pros (Advantages)
• Cons (Limitations)

33. Best fit?
Reward

37. GAME ABOUT
GAMES
Learn
about
different
types of
games
and
discuss
the
pros/cons
of each
1. Distribute Solution
Cards/player, Problem Cards
face-down in center
2. Pick 1 Problem Card
3. Each player selects 1 Solution
Card and advocates for it to
be the BEST FIT for the
problem
4. Group ranks solutions by best
chance to solve problem
5. Distribute rewards among
group as appropriate
5 min/
round

38. !
!
Post-Game Reflections:
• How did it feel?
• What did you learn?
• Did the game achieve its goal?
• How could format/rules be
modified?

39. Next up…
What are some of the key characteristics,
elements and features of effective games
and game strategies?

40. Learning Principles
for Good Games
James Paul Gee
What Video Games Have to
Teach Us About Learning
and Literacy - 2003

42. Problem Solving Problem Solving
Empowerment
Risk
Feedback
Edge
Context
Transfer

43. Empowerment Problem Solving
Empowerment
Risk
Feedback
Edge
Context
Transfer

44. Risk Problem Solving
Empowerment
Risk
Feedback
Edge
Context
Transfer

45. Feedback Problem Solving
Empowerment
Risk
Feedback
Edge
Context
Transfer

46. Edge Problem Solving
Empowerment
Risk
Feedback
Edge
Context
Transfer
http://mashable.com/2010/07/13/game-mechanics-business/

47. Context Problem Solving
Empowerment
Risk
Feedback
Edge
Context
Transfer

48. Transfer Problem Solving
Empowerment
Risk
Feedback
Edge
Context
Transfer

49. Seven Keys
to PERFECT Games
Problem Solving
Empowerment
Risk
Feedback
Edge
Context
Transfer

50. IMPLEMENTATION
Now how will you make it fit?

51. Fit and Integration
Didactic
Preparation
Games, XR,
Interactive
Applications
Task Trainer
or Simulator
Real World
Experience
Bauman’s Layered Learning Framework
©Bauman 2019 all Rights Reserved
Felszeghy S., Pasonen-Seppanen S., Koskela A., Nieminen P, Harkonen K, Paldanius K.M.A., Gabbouj S., Ketola K., Hiltunen M., Lundin M., Haapaniemi T., Sointu E., Bauman
E.B., Gilbert G.E, Morto D., & Mahonen A. (In Press). Use of gamification in a histology course: An innovative strategy. BMC Medical Education.

52. Fit and Integration
Effective
AppealingEfficient
Proper Fit
Learning
Objectives
Complexity
Cost Time
Aleckson, J., & Ralston-Berg, P. (2011). MindMeld: Micro-Collaboration between eLearning designers and instructor experts. Madison, WI: Atwood Publishing
Bauman, E. B. and Ralston-Berg, P. (2014). Virtual simulation. In J. Palaganas, J. Maxworthy, C. Epps, and M.E. Mancini (Eds). Defining excellence in simulation.
Wolters Kluwer – Lippincott Williams & Wilkins

53. IMPLEMENTATION CONSIDERATIONS
•What is your context?
•Who are your
learners?
• How will you
implement the game
fir the first time?
• How will you continue
the game in the
future?

55. THANK YOU
dr.toddchang@gmail.com
• Todd P Chang, MD MAcM
• Martin V Pusic, MD PhD
• Eric B Bauman, PhD FSSH
• Chaoyan Dong, PhD
• Gerald R Stapleton, MS
• Elizabeth K Kachur, PhD

56. GAMIFICATION vs SERIOUS GAMES

57. GAMIFICATION
• Application of
game design
elements to
traditionally
nongame
contexts.
Deterding, S. (2014). The lens of intrinsic skill atoms: A method for gameful design. Human-Computer Interaction, Special
Issue" HCI and Digital Games," Forthcoming.
Deterding, S., Dixon, D., Khalid, R., Lennart, N. (2011). MindTrek’11, September 28-30, 2011, Tampere, Finland.
Rutledge et al. Academic Medicine 2018