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Preparing Residents Effectively in Emergency Skills Training With a Serious Game

Dankbaar, Mary E.W. PhD; Roozeboom, Maartje Bakhuys MSC; Oprins, Esther A.P. B. PhD; Rutten, Frans MD; van Merrienboer, Jeroen J.G. PhD; van Saase, Jan L.C.M. PhD, MD; Schuit, Stephanie C.E. PhD, MD

Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare: February 2017 - Volume 12 - Issue 1 - p 9–16
doi: 10.1097/SIH.0000000000000194
Empirical Investigations

Introduction: Training emergency care skills is critical for patient safety but cost intensive. Serious games have been proposed as an engaging self-directed learning tool for complex skills. The objective of this study was to compare the cognitive skills and motivation of medical residents who only used a course manual as preparation for classroom training on emergency care with residents who used an additional serious game.

Methods: This was a quasi-experimental study with residents preparing for a rotation in the emergency department. The “reading” group received a course manual before classroom training; the “reading and game” group received this manual plus the game as preparation for the same training. Emergency skills were assessed before training (with residents who agreed to participate in an extra pretraining assessment), using validated competency scales and a global performance scale. We also measured motivation.

Results: All groups had comparable important characteristics (eg, experience with acute care). Before training, the reading and game group felt motivated to play the game and spent more self-study time (+2.5 hours) than the reading group. Game-playing residents showed higher scores on objectively measured and self-assessed clinical competencies but equal scores on the global performance scale and were equally motivated for training, compared with the reading group. After the 2-week training, no differences between groups existed.

Conclusions: After preparing training with an additional serious game, residents showed improved clinical competencies, compared with residents who only studied course material. After a 2-week training, this advantage disappeared. Future research should study the retention of game effects in blended designs.

From the Departments of Work, Health and Care (M.B.R.) and Training and Performance Innovations (E.A.P.B.O.), TNO; Training Institution for the Professional Education of General Practitioners SBOH (F.R.); Health, Medicine and Life Sciences, Educational Development and Research, Maastricht University (J.J.G.V.M); and Departments of Internal Medicine (J.L.C.M.V.S.) and Emergency Care and Internal Medicine (S.C.E.S.), Erasmus University Medical Center, Rotterdam, The Netherlands.

Reprints: Mary E. W. Dankbaar, PhD, Institute for Medical Education Research, Erasmus University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, Room Ae 234, The Netherlands (e-mail:

The authors declare no conflict of interest.

AbcdeSIM B.V. is a spin-off company founded by Erasmus University Medical Center Rotterdam (Erasmus MC) and Stichting SBOH (a Dutch foundation for the professional education of general practitioners) as a joint venture to aid in the further development of and selling licenses for the abcdeSIM serious game to other hospitals and institutions. By virtue of standard policies at Erasmus MC, S.C.E.S.(author) and Erasmus MC have a financial interest in abcdeSIM B.V.: Erasmus MC Holding B.V. and Stichting SBOH as founders of abcdeSIM B.V. own most shares, and S.C.E.S. as an inventor of the abcdeSIM serious game received certified shares (without voting rights) from Erasmus MC. To mitigate this financial interest in the research, the authors asked TNO, an independent research institute with expertise in research on game effectiveness, to conduct the data collection and data analysis. S.C.E.S. and Erasmus MC were in no way directly involved in this data collection and data analysis.

Supported by the Dutch Ministry of Economic Affairs and Stichting SBOH. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the article.

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© 2017 Society for Simulation in Healthcare