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Creating GridlockED: A Serious Game for Teaching About Multipatient Environments

Tsoy, Daniel, MD; Sneath, Paula, MD; Rempel, Josh, MD; Huang, Simon; Bodnariuc, Nicole; Mercuri, Mathew, PhD; Pardhan, Alim, MD, FRCPC, MBA; Chan, Teresa M., MD, FRCPC, MHPE

doi: 10.1097/ACM.0000000000002340
Innovation Report: PDF Only

Problem: As patient volumes increase, it is becoming increasingly important to find novel ways to teach junior medical learners about the intricacies of managing multiple patients simultaneously, as well as about working in a resource-limited environment.

Approach: Serious games (i.e., games not intended purely for fun) are a teaching modality that have been gaining momentum as teaching tools in medical education. From May 2016 to August 2017, the authors designed and tested a serious game, called “GridlockED,” to provide a focused educational experience for medical trainees to learn about multipatient care and patient flow. The game is collaborative, allowing as many as six people may play it at once. Gameplay relies on the players working collaboratively (as simulated members of a medical team) to triage, treat, and disposition “patients” in a manner that simulates true emergency department operations. After researching serious games, the authors developed the game through an iterative design process. Next, the game underwent preliminary peer review by experienced gamers and practicing clinicians, whose feedback the authors used to adjust the game. Attending physicians, nurses, and residents have tested GridlockED for usability, fidelity, acceptability, and applicability.

Outcomes: Based on initial testing, clinicians suggest that this game will be useful and has fidelity for teaching patient-flow concepts.

Next Steps: Further playtesting will be needed to fully examine learning opportunities for various populations of trainees and for various media. GridlockED may also serve as a model for developing other games to teach about processes in other environments or specialties.

D. Tsoy is a resident physician, Family Medicine, Western University, London, Ontario, and at the time of this project, he was a medical student, the Niagara Campus of the Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.

P. Sneath is a resident physician, Royal College of Physicians and Surgeons of Canada Emergency Medicine Program, McMaster University, Hamilton, and at the time of this project, she was a medical student, the Niagara Campus of the Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.

J. Rempel is a resident physician, Family Medicine, the University of Ottawa, Ottawa, Ontario, and at the time of this project, he was a medical student, the Niagara Campus of the Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.

S. Huang is a medical student, the College of Medicine, University of Saskatchewan, Regina, Saskatchewan, Canada.

N. Bodnariuc is a Baccalaureate student, the Bachelors of Health Sciences program, McMaster University, Hamilton, Ontario, Canada.

M. Mercuri is assistant professor, the Division of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, Ontario, Canada; ORCID ID: https://orcid.org/0000-0001-8070-9615.

A. Pardhan is program director, the Royal College of Physicians and Surgeons of Canada Emergency Medicine Program, and associate professor, the Division of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.

T. Chan is assistant professor, the Division of Emergency Medicine, the Department of Medicine; teacher, the Michael G. DeGroote School of Medicine; adjunct scientist, McMaster Education Research, Innovation, and Theory (MERIT) Center; and program director, the Clinician Educator Area of Focused Competency Program, McMaster University, Hamilton, Ontario, Canada; ORCID ID: https://orcid.org/0000-0001-6104-462X.

Supplemental digital content for this article is available at http://links.lww.com/ACADMED/A572 and http://links.lww.com/ACADMED/A573.

Acknowledgements: The authors would like to thank all of the McMaster Emergency Medicine (EM) residents, their Hamilton nursing colleagues, and their McMaster EM faculty colleagues who helped with pilot testing. Additionally, they would like to thank the Shad Valley Interns (Alain Lou, Annie Zou), the game testing summer associates (Eric Y.S. Jeong, Rebecca Ngoc Dang), external gameplay reviewers (Dr. Wayne Choi and Dr. David Savage), as well as the residents and medical students who have continued to help the game development team (Chris Heyd, Saif Shamsoon, Chad Singh, Tanishq Suryavanshi, Sam Lambert, Varun Srivatsav).

Funding/Support: None reported.

Other disclosures: None reported.

Ethical approval: The Hamilton Integrated Research Ethics Board granted approval (#2017-3130)for the evaluation reported in this Innovation Report.

Previous presentations: The initial description of this work was presented as the Top Innovation Abstract at the June 2017 Canadian Association of Emergency Physicians conference in Whistler, British Columbia. The program evaluation data were subsequently reported in the Top 5 What Works Track at the October 2017 International Conference on Residency Education.

Correspondence should be addressed to Teresa M. Chan, 237 Barton St. E, Hamilton General Hospital, McMaster Clinic, Room 255, Hamilton, ON, L8L 2X2, Canada; e-mail: teresa.chan@medportal.ca; Twitter: @TChanMD; @MacEmerg.

© 2018 by the Association of American Medical Colleges