Serious gaming for orthotopic liver transplant anesthesiology: A randomized control trial

Abstract

Anesthetic management of orthotopic liver transplantation (OLT) is complex. Given the unequal distributions of liver transplant surgeries performed at different centers, anesthesiology providers receive relatively uneven OLT training and exposure. One well-suited modality for OLT training is the "serious game," an interactive application created for the purpose of imparting knowledge or skills, while leveraging the self-motivating elements of video games. We therefore developed a serious game designed to teach best practices for the anesthetic management of a standard OLT and determined if the game would improve resident performance in a simulated OLT. Forty-four residents on the liver transplant rotation were randomized to either the gaming group (GG) or the control group (CG) prior to their introductory simulation. Both groups were given access to the same educational materials and literature during their rotation, but the GG also had access to the OLT Trainer. Performance on the simulations were recorded on a standardized grading rubric. Both groups experienced an increase in score relative to baseline that was statistically significant at every stage. The improvements in scores were greater for the GG participants than the CG participants. Overall score improvement between the GG and CG (mean [standard deviation]) was statistically significant (GG, 7.95 [3.65]; CG, 4.8 [4.48]; P = 0.02), as were scores for preoperative assessment (GG, 2.67 [2.09]; CG, 1.17 [1.43]; P = 0.01) and anhepatic phase (GG, 1.62 [1.01]; CG, 0.75 [1.28]; P = 0.02). Of the residents with game access, 81% were "very satisfied" or "satisfied" with the game overall. In conclusion, adding a serious game to an existing educational curriculum for liver transplant anesthesia resulted in significant learning gains for rotating anesthesia residents. The intervention was straightforward to implement and cost-effective. Liver Transplantation 23 430-439 2017 AASLD.

Serious Gaming and Gamification Education in Health Professions: Systematic Review

“…Five studies included only nursing students [22,27,29,37,41] and four included only surgical residents [18,30,31,38]. The remaining studies included primary care doctors (n=2) [36,43]; dental students (n=2) [21,32]; anesthesiology residents (n=1) [35]; urologists (n=1) [15]; speech and language science students (n=1) [44]; participants of the Major Incident Medical Management and Support course, which typically includes doctors, nurses, and paramedics with an interest in prehospital care (n=1) [23]; nursing and medical students (n=1) [28]; and medical students, residents, and specialists in Obstetrics and Gynecology (n=1, reported in one article and one conference abstract) [33,34].…”

“…A total of 22 interventions had original design purposes other than entertainment, of which 11 interventions were classified as “Message Broadcasting - Educative” [15,17,20,28,36,37, 39-41,43,44]; four were classified as “Training - Mental” [19,22,23,29], three were classified as “Training - Physical” [18,21,32], and four were classified as both “Training - Mental” and “Training - Physical” [16,27,35,45]. All of the interventions with design purposes other than entertainment were classified under “Education” for “Scope.”…”

“…Serious gaming/gamification was compared with traditional learning in 19 studies [18-23,27-31,35,37,38,41-45], with digital education in 7 studies [14,16,17,32,36,39,40], and with other serious gaming/gamification interventions in 6 studies [15,24-26,31,33,42].…”

Toward interprofessional team training for surgeons and anesthesiologists using virtual reality

“…Grottke et al [17] developed a VR-based simulator for regional anesthesia training using multi-model representations in a large immersive virtual environment. Katz et al [18] presented a serious game designed to teach anesthetic management of a standard orthotopic liver transplantation procedure. Furthermore, Shewaga et al [19] developed a serious game for anesthesia-based crisis management training.…”

Serious games, a game changer in teaching neonatal resuscitation? A review

“…Furthermore, serious games have the potential to reduce error rates and are available at low costs 19 20. Indeed, healthcare areas including surgery,20 21 emergency medicine22 23 and anaesthesiology24 have introduced serious games as SBE and reported improved decision-making skills in their learners. However, evidence about the use of serious games in neonatology is lacking.…”