LapBot-Safe Chole: validation of an artificial intelligence-powered mobile game app to teach safe cholecystectomy.

BACKGROUND: Gaming can serve as an educational tool to allow trainees to practice surgical decision-making in a low-stakes environment. LapBot is a novel free interactive mobile game application that uses artificial intelligence (AI) to provide players with feedback on safe dissection during laparoscopic cholecystectomy (LC). This study aims to provide validity evidence for this mobile game. METHODS: Trainees and surgeons participated by downloading and playing LapBot on their smartphone. Players were presented with intraoperative LC scenes and required to locate their preferred location of dissection of the hepatocystic triangle. They received immediate accuracy scores and personalized feedback using an AI algorithm ("GoNoGoNet") that identifies safe/dangerous zones of dissection. Player scores were assessed globally and across training experience using non-parametric ANOVA. Three-month questionnaires were administered to assess the educational value of LapBot. RESULTS: A total of 903 participants from 64 countries played LapBot. As game difficulty increased, average scores (p < 0.0001) and confidence levels (p < 0.0001) decreased significantly. Scores were significantly positively correlated with players' case volume (p = 0.0002) and training level (p = 0.0003). Most agreed that LapBot should be incorporated as an adjunct into training programs (64.1%), as it improved their ability to reflect critically on feedback they receive during LC (47.5%) or while watching others perform LC (57.5%). CONCLUSIONS: Serious games, such as LapBot, can be effective educational tools for deliberate practice and surgical coaching by promoting learner engagement and experiential learning. Our study demonstrates that players' scores were correlated to their level of expertise, and that after playing the game, most players perceived a significant educational value.

Evaluation of the "15 Minute Challenge": A Workplace Health and Wellbeing Program.

The 15 Minute Challenge is an mHealth workplace wellness initiative, employing gamification to promote physical activity, aiming to enhance health outcomes and overall well-being. This retrospective cohort study evaluated the effectiveness of the program among employees at various Australian, New Zealand, and UK workplaces. Real-world data from 11,575 participants across 73 companies were analyzed. The program encouraged daily 15 min physical activity sessions over six weeks. Participants self-reported their physical activity and fitness, energy, overall health, sleep quality, and mood at baseline and 6 weeks. Program satisfaction, engagement rates, and adherence to the program were also assessed. Effectiveness was evaluated using multi-level mixed-effects linear regression analyses. The intervention showed significant increases in physical activity, with 95% of participants meeting or exceeding international physical activity guidelines, up from 57% at baseline (p < 0.05). Self-reported fitness, energy, overall health, sleep quality, and mood significantly improved (between 7.1 and 14.0% improvement; all p < 0.05). High satisfaction was reported, with 92% of participants recommending the program. The 15 Minute Challenge effectively increased physical activity levels and improved self-reported health outcomes among participating employees. The high satisfaction rates and significant health improvements highlight the potential of workplace wellness programs to combat sedentary behavior and promote a healthier, more active lifestyle.

Effect of gamification with a support partner to increase physical activity in older adults at risk for Alzheimer's disease: The STEP 4Life randomized clinical trial.

INTRODUCTION: Physical activity is associated with reduced risk of cognitive and functional decline but scalable, sustainable interventions for populations at risk for Alzheimer's disease (AD) and AD and related dementias (ADRD) are lacking. METHODS: A 12-week randomized-controlled trial was conducted with a 3-week follow-up using a national AD prevention registry (GeneMatch). The control group (n = 50) set step goals and received daily feedback. The intervention group (n = 44) also received a behaviorally designed game based on achieving step goals and reinforced by a support partner. RESULTS: Intervention participants (94 participants, mean age 70, 78% female) had greater change in mean daily step count than control of 1699 steps/day (95% confidence interval [CI], 1149-2249), P < 0.0001, which was sustained in the follow-up period at 1219 steps/day (95% CI, 455-1983), P = 0.0018. Carriers of the apolipoprotein E ε4 gene (high risk) did not perform differently than non-carriers; however, high self-reported risk perception was associated with higher activity. DISCUSSION: A gamified intervention was effective in promoting and sustaining higher physical activity in older adults at genetic risk for AD/ADRD. HIGHLIGHTS: A simple game played with a support partner increased walking in older adults at risk for Alzheimer's disease (AD). The game also increased minutes of moderate-to-vigorous physical activity per day. Perception of lifelong AD risk was associated with increased activity but genetic risk (apolipoprotein E ε4+) was not. TRIAL REGISTRATION: ClinicalTrials.gov: NCT05069155.

Gamified Crowdsourcing as a Novel Approach to Lung Ultrasound Data Set Labeling: Prospective Analysis.

BACKGROUND: Machine learning (ML) models can yield faster and more accurate medical diagnoses; however, developing ML models is limited by a lack of high-quality labeled training data. Crowdsourced labeling is a potential solution but can be constrained by concerns about label quality. OBJECTIVE: This study aims to examine whether a gamified crowdsourcing platform with continuous performance assessment, user feedback, and performance-based incentives could produce expert-quality labels on medical imaging data. METHODS: In this diagnostic comparison study, 2384 lung ultrasound clips were retrospectively collected from 203 emergency department patients. A total of 6 lung ultrasound experts classified 393 of these clips as having no B-lines, one or more discrete B-lines, or confluent B-lines to create 2 sets of reference standard data sets (195 training clips and 198 test clips). Sets were respectively used to (1) train users on a gamified crowdsourcing platform and (2) compare the concordance of the resulting crowd labels to the concordance of individual experts to reference standards. Crowd opinions were sourced from DiagnosUs (Centaur Labs) iOS app users over 8 days, filtered based on past performance, aggregated using majority rule, and analyzed for label concordance compared with a hold-out test set of expert-labeled clips. The primary outcome was comparing the labeling concordance of collated crowd opinions to trained experts in classifying B-lines on lung ultrasound clips. RESULTS: Our clinical data set included patients with a mean age of 60.0 (SD 19.0) years; 105 (51.7%) patients were female and 114 (56.1%) patients were White. Over the 195 training clips, the expert-consensus label distribution was 114 (58%) no B-lines, 56 (29%) discrete B-lines, and 25 (13%) confluent B-lines. Over the 198 test clips, expert-consensus label distribution was 138 (70%) no B-lines, 36 (18%) discrete B-lines, and 24 (12%) confluent B-lines. In total, 99,238 opinions were collected from 426 unique users. On a test set of 198 clips, the mean labeling concordance of individual experts relative to the reference standard was 85.0% (SE 2.0), compared with 87.9% crowdsourced label concordance (P=.15). When individual experts' opinions were compared with reference standard labels created by majority vote excluding their own opinion, crowd concordance was higher than the mean concordance of individual experts to reference standards (87.4% vs 80.8%, SE 1.6 for expert concordance; P<.001). Clips with discrete B-lines had the most disagreement from both the crowd consensus and individual experts with the expert consensus. Using randomly sampled subsets of crowd opinions, 7 quality-filtered opinions were sufficient to achieve near the maximum crowd concordance. CONCLUSIONS: Crowdsourced labels for B-line classification on lung ultrasound clips via a gamified approach achieved expert-level accuracy. This suggests a strategic role for gamified crowdsourcing in efficiently generating labeled image data sets for training ML systems.

A gamified virtual environment intervention for gait rehabilitation in Parkinson's Disease: co-creation and feasibility study.

BACKGROUND: Treadmill gait training has been shown to improve gait performance in People with Parkinson's Disease (PwPD), and in combination with Virtual Reality, it can be an effective tool for gait rehabilitation. The addition of gamification elements can create a more stimulating and adherent intervention. However, implementation of new technologies in healthcare can be challenging. This study aimed to develop and evaluate the feasibility of a treadmill rehabilitation program in a Gamified Virtual Reality Environment (GVRE) for PwPD. METHODS: The GVRE was developed following a user-centered design approach, involving both PwPD and physiotherapists in the development and evaluation of the intervention. The intervention consisted of a walking simulation in three different environments (countryside, city, and park), which had a progressive increase in difficulty. To test its feasibility, three sessions were carried out with four PwPD and four physiotherapists. To assess the usability, the System Usability Scale (SUS), Assistive Technology Usability Questionnaire for people with Neurological diseases (NATU Quest) and Simulator Sickness Questionnaire (SSQ) were used. To assess the intervention's acceptability, feedback and in-game performance was collected from participants. RESULTS: Results showed the feasibility of the intervention, with a SUS score of 74.82 ± 12.62, and a NATU Quest score of 4.49 ± 0.62, and positive acceptability feedback. Participants showed clear preferences for naturalistic environments, and gamification elements were seen as positive. Difficulty settings worked as intended, but lowered enjoyment of the experience in some cases. CONCLUSIONS: This intervention was successfully shown as a feasible option for the training of gait under Dual Task conditions for PwPD. It offers a safe and replicable environment in which complex situations can be trained. However, further iterations of the intervention need to be improved in order to guarantee accurate tracking and a more realistic training progression. TRIAL REGISTRATION NUMBER: NCT05243394-01/20/2022.

Gamification in marketing: Insights on current and future research directions based on a bibliometric and theories, contexts, characteristics and methodologies analysis.

Gamification involves using game design elements in non-game contexts. It is an emerging strategy that, being able to motivate consumer engagement with brands, has been increasingly used by companies in marketing activities. Recently, the application of gamification to marketing has become increasingly popular, with an increasing amount of research outputs. However, a clear overview of the field, a theoretical orientation or an agenda for research are still missing, which justifies the analysis of the existing literature joining these two fields of research. The motivation for conducting this review was twofold: Firstly, it is helpful to attain a broad overview of this developing field, synthesizing the existing knowledge in a structured way, understanding how gamification research in marketing has progressed and what type of knowledge has been acquired; secondly, it allows us to provide valuable information that will guide future research. Thus, this study provides a hybrid review, which integrates a bibliometric and TCCM analysis, of gamification in marketing by analyzing 114 articles. The data was retrieved from the Scopus scientific database. The bibliometric analysis showed the existence of 8 clusters, mostly representing current areas of research. It was found that the focus of the literature, so far, has been on studying which game elements should be implemented in a gamification system, as well as examining the impact of gamification experiences on engagement and consumer's behaviors. The TCCM analysis revealed the major theories and methodological approaches explored in published articles. The use of self-determination theory and quantitative methodology, based on primary data using online surveys, stands out. These complementary analyzes allowed to provide future research directions to scholars and practitioners working in this domain, promoting the advancement of scientific knowledge, contextual relevance and methodological rigor. Moreover, this review also helps marketers make more informed strategic decisions and supports successful gamification design.

Effects of gamification in advanced life support training for clinical nurses: A cluster randomized controlled trial.

BACKGROUND: Cardiopulmonary resuscitation training is a mandatory competency, especially for healthcare professionals. However, the spread of COVID-19 caused a sharp decline in the number of participants on advanced life support training, thereby accelerating the diversification of educational methods. Gamification is an increasingly popular method of diversifying instruction, but its effectiveness remains controversial. AIM: To evaluate the effectiveness of gamification learning in advanced life support training. DESIGN: A cluster randomized controlled trial. SETTING: A single advanced life support training center. PARTICIPANTS: Clinical nurses who are currently practicing in a hospital. METHODS: A part of the existing advanced life support course was gamified using Kahoot! platform. Conventional learning and gamified learning were each conducted 11 times, and the level of knowledge after training was assessed. The assessment questions were categorized into advanced life support algorithms, teamwork, and cardiac arrest rhythms. RESULTS: A total of 267 were enrolled in the study, and 148 and 139 learners were assigned to CL and GL, respectively. There was no difference in post-training knowledge related to teamwork, and cardiac arrest rhythms between the conventional learning and gamified learning groups, but knowledge related to the advanced life support algorithm was low in the gamified learning group. CONCLUSIONS: Even if the learners are the same, advanced life support gamification training can lead to negative outcomes depending on the simplicity or goal of the training content. To improve the effectiveness of the training, various methods of gamification training should be applied depending on the goal and content of the training.

Gamification preferences in nutrition apps: Toward healthier diets and food choices.

Background: Unhealthy eating habits are costly and can lead to serious diseases such as obesity. Nutrition apps offer a promising approach to improving dietary behavior. Gamification elements (GEs) can motivate users to continue using nutrition apps by making them more enjoyable, which can lead to more positive behavioral changes regarding dietary choices. However, the effects of users' preferences and individual characteristics on gamified systems are not yet understood. Current calls for research suggest that personalized gamified systems might lead to user satisfaction, continuous app use, and-ultimately-long-term improvements in diet. Objective: The aim was to determine the most preferred GEs in nutrition apps and to define clusters of GEs preferences in terms of personality and socio-demographic characteristics. Methods: We surveyed 308 people to measure their preferences regarding GEs in nutrition apps and applied best-worst scaling to determine the most preferred GEs. Furthermore, we used cluster analysis to identify different user clusters and described them in terms of personality and socio-demographic characteristics. Results: We determine that GEs most favored are goals, progress bars, and coupons. We revealed three distinct user clusters in terms of personality and socio-demographic characteristics. Based on the individual factors of openness and self-perception, we find that significant differences exist between the preferences for leaderboards and coupons. Conclusion: We contribute by shedding light on differences and similarities in GE preferences relating to specific contexts and individual factors, revealing the potential for individualized nutrition apps. Our findings will benefit individuals, app designers, and public health institutions.

Gamification of dermatoscopy education using a smartphone mobile platform: A pilot study.

Background: Dermatoscopy is a noninvasive method of examining skin lesions under high magnification, gradually replacing the need for invasive biopsies. Training is required to gain clinical competency. Gamification employs game-like elements to enhance education engagement and is an engaging means of delivering medical education. We sought to use gamification and a mobile-based platform to deliver dermatoscopy education to physicians. Methods: We developed SKIN@GoPRIME, an interactive smartphone platform. Thirty physician participants were randomly assigned to watch an online dermatoscopy lecture or to use SKIN@GoPRIME. Twenty-eight participants completed prelearning and postlearning quizzes and provided feedback on SKIN@GoPRIME. Results: Users of SKIN@GoPRIME demonstrated a significant 1.71-point mean score improvement (P = .0018). The group that watched the online dermatoscopy lecture had a higher 2.36-point mean score improvement (P = .00021). Both family medicine and internal medicine physicians demonstrated a significant mean score increase of 1.29 (P = .049) and 2.14 (P = .023), respectively, after using SKIN@GoPRIME. Based on feedback, 83% believed that SKIN@GoPRIME can be used to acquire the applied competencies required for their job scope. Discussion and Conclusion: SKIN@GoPRIME, a novel learning tool via gamification effectively delivers dermatoscopy education, although it is not shown to be more effective than lectures. Larger studies are required to further validate the effectiveness of gamified learning techniques in dermatoscopy education. Future studies should involve the optimization of SKIN@GoPRIME to more effectively deliver dermatoscopy education.

N-of-1 health optimization: Digital monitoring of biomarker dynamics to gamify adherence to metabolic switching.

The digital health field is experiencing substantial growth due to its potential for sustained and longitudinal deployment. In turn, this may drive improved monitoring and intervention as catalysts for behavioral change compared to traditional point-of-care practices. In particular, the increase in incidence of population health challenges such as diabetes, heart disease, fatty liver disease, and other disorders coupled with rising healthcare costs have emphasized the importance of exploring technical, economics, and implementation considerations, among others in the decentralization of health and healthcare innovations. Both healthy individuals and patients stand to benefit from continued technical advances and studies in these domains. To address these points, this study reports a N-of-1 study comprised of sustained regimens of intermittent fasting, fitness (strength and cardiovascular training), and high protein, low carbohydrate diet and parallel monitoring. These regimens were paired with serial blood ketone, blood glucose (wearable and finger stick) and blood pressure readings, as well as body weight measurements using a collection of devices. Collectively this suite of platforms and approaches were used to monitor metabolic switching from glucose to ketones as energy sources-a process associated with potential cardio- and neuroprotective functions. In addition to longitudinal biomarker dynamics, this work discusses user perspectives on the potential role of harnessing digital devices to these dynamics as potential gamification factors, as well as considerations for the role of biomarker monitoring in health regimen development, user stratification, and potentially informing downstream population-scale studies to address metabolic disease, healthy aging and longevity, among other indications.

A gamified cognitive behavioral therapy for Arabs to reduce symptoms of depression and anxiety: A case study research.

Background: Depression and anxiety are prevalent mental health issues addressed by online cognitive behavioral therapy (CBT) via mobile applications. This study introduces Sokoon, a gamified CBT app tailored for Arabic individuals, focusing on alleviating depression and anxiety symptoms (DASDs). Objectives: The objectives of this study were to: Evaluate the effectiveness of Sokoon in reducing symptoms of depression and anxiety. Assess the usability of the intervention through user engagement and adherence to CBT skills. Methods: A single-group pre-post design evaluated Sokoon's impact on adults with DASDs. In consultation with psychiatrists, Sokoon integrates evidence-based skills such as relaxation, gratitude, behavioral activation, and cognitive restructuring, represented by planets. Its design incorporates Hexad theory and gamification, supported by a dynamic difficulty adjustment algorithm. The study involves 30 participants aged 18-35 (86.7% female), specifically those with mild to moderate depression and anxiety. Results: Based on a sample of 30 participants, Sokoon, a smartphone-based intervention, significantly reduced symptoms of depression and anxiety (d = 2.7, d = 3.6, p < 0.001). Over a two-week trial, participants experienced a notable decrease in anxiety and depressive symptoms, indicating the effectiveness of the model. Sokoon shows potential as a valuable tool for addressing DASDs. Conclusion: Sokoon, the gamified CBT application, offers an innovative approach to increasing CBT skills adherence and engagement. By leveraging Hexad theory and gamification, Sokoon provides an enjoyable and engaging user experience while maintaining the effectiveness of traditional CBT techniques. The study findings suggest that Sokoon has a positive impact on reducing symptoms of depression and anxiety.

Max Well-Being: a modular platform for the gamification of rehabilitation.

This study proposes a modular platform to improve the adoption of gamification in conventional physical rehabilitation programs. The effectiveness of rehabilitation is correlated to a patient's adherence to the program. This adherence can be diminished due to factors such as motivation, feedback, and isolation. Gamification is a means of adding game-like elements to a traditionally non-game activity. This has been shown to be effective in providing a more engaging experience and improving adherence. The platform is made of three main parts; a central hardware hub, various wired and wireless sensors, and a software program with a stream-lined user interface. The software interface and hardware peripherals were all designed to be simple to use by either a medical specialist or an end-user patient without the need for technical training. A usability study was performed using a group of university students and a group of medical specialists. Using the System Usability Scale, the system received an average score of 69.25 ± 20.14 and 72.5 ± 17.16 by the students and medical specialists, respectively. We also present a framework that attempts to assist in selecting commercial games that are viable for physical rehabilitation.

Gamified Closed-Loop Intervention Enhances Tic Suppression in Children: A Randomized Trial.

BACKGROUND: Gamification of behavioral intervention for tic disorders (TDs) potentially enhances compliance and offers key clinical advantages. By delivering immediate positive feedback upon tic-suppression, games may counteract negative reinforcement, which presumably contribute to tic consolidation by relieving uncomfortable premonitory urges. OBJECTIVES: We developed a gamified protocol (XTics), which leverages this potential by combining gamified tic-triggering with immediate feedback, and evaluated its clinical value in enhancing tic suppression. METHODS: XTics encompasses two conditions: Immediate and Contingent Reward (ICR), where game progression is contingent upon successful tic suppression, and Delayed Reward (DR), where game events' outcomes are random. Employing a randomized crossover design, 35 participants (aged 7-15 years) underwent daily gaming sessions over a week per condition. Improvements in our primary measures, including the inter-tic interval (ITI) and tic severity assessment by blinded evaluators (Yale Global Tic Severity-Total Tic Score [YGTSS-TTS], Rush), and parents (Parent Tic Questionnaire [PTQ]), were compared between ICR and DR, and assessed across conditions for the 4-week protocol. RESULTS: No participant voluntarily left the study before completing its two-phase protocol. As expected, ITI showed significantly larger improvement (Z = 4.19, P = 2.85 × 10-5) after ICR (1442 ± 2250%) versus DR (242 ± 493%) training, increasing at a higher pace (t(67) = 3.15, P = 0.0025). Similarly, Rush tic severity scores reduced more post-ICR versus DR (t(47) = 3.47, P = 0.002). We observed a clinically significant reduction of 25.69 ± 23.39% in YGTSS-TTS following a f4-week protocol including both conditions. Parent-reported tic severity decreased by 42.99 ± 31.69% from baseline to 3 months post-treatment. CONCLUSIONS: The combination of gamified tic-triggering with immediate and contingent rewards demonstrates a promising approach for enhancing treatment efficacy in TDs, boosting traditional therapeutic methods. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Investigating the influence of gamification on motivation and learning outcomes in online language learning.

Introduction: This study investigates the influence of gamification integration on language learning achievement among Chinese students while probing the mediating role of learners' motivation. Furthermore, it extends the boundaries of this investigation by exploring the moderating effect of digital literacy as a psychological predisposition. Methods: Data is collected through surveys from Chinese students enrolled in linguistic programs, employing a stratified random sampling technique and analyzed via SmartPLS SEM. Results: The findings affirm the significant and positive impact of gamification integration on language learning achievement. The study introduces a moderated mediation model where learners' motivation serves as the mediator, and digital literacy acts as a moderator, further accentuating the significant impact of this integrated approach. Discussion: This research advances our theoretical understanding of language learning, validating gamification's effectiveness as a motivational tool, and introduces digital literacy as a critical factor, providing deeper insights into personalized language learning experiences.

Procedure-Focused Escape Room: A Pilot Study on Teaching High-Stakes Technical Skills in Anesthesia Residents.

Background: High-stakes yet clinically infrequent procedures are challenging to teach. Escape rooms may offer an innovative solution through game-based learning. There is limited guidance on how to design an escape room focused on physical puzzles. We designed and implemented a procedure-focused escape room to teach high-stakes procedures to anesthesiology residents. Methods: We selected 5 procedural skills relevant to anesthesiology residents through a modified Delphi technique: fiberoptic intubation, rapid infuser setup, intraosseous line placement, flexible bronchoscopy, and supraglottic airway exchange. We designed associated skills stations and linked them in sequence using an elaborate series of puzzles, locks, keys, and codes. The total cost of puzzle equipment was $169.53. After pilot testing, we implemented the escape room from July to November 2022. We assessed residents using a single group pretest-posttest study design. Results: Forty-three of 55 (78%) eligible anesthesiology residents participated in the escape room. Thirty-one residents completed the surveys. Resident self-efficacy significantly improved for each of the 5 procedures. Twenty-six of 27 (96%) residents preferred the escape room over a typical procedural skills workshop. Conclusions: This pilot study demonstrated the feasibility of a procedure-focused escape room for teaching high-stakes technical skills. We identified 3 lessons in procedure-focused escape room design: set participant caps intentionally, optimize resource usage, and maximize reproducibility. Participating in a single escape room session significantly increased resident self-efficacy. Residents strongly preferred the escape room format over a traditional procedural skills workshop.

The effectiveness of the Escape Room as an educational methodology in the Infarction Code.

OBJECTIVE: To evaluate the efficacy of an educational intervention (escape room) in the acquisition and retention of knowledge in relation to the Infarction Code, and to compare the knowledge of other teaching methodologies related to the Infarction Code. METHODS: A pre-post study was designed without a control group. After one month of the master class on the Infarction Code given to master's degree (doctors and nurses), an educational intervention was carried out consisting of an Escape Room on the same content, with a questionnaire that collected various sociodemographic data, and a knowledge test on the Infarction Code, which was repeated immediately after the activity and at the end of 2 months after the activity, and a test of knowledge on the Infarction Code. immediately after the activity and 2 months after the master class. Likewise, after the activity, a gamified experience evaluation questionnaire (GAMEX) was completed. RESULTS: Thirty-two students received the educational intervention (12 physicians and 20 nurses), and differences were observed between medical and nursing professionals in terms of initial knowledge of simulation and gamification. After the activity, and based on the initial knowledge test, the score increased by 3.49 points, an increase that was also reflected in the test taken two months after the master class, where an increase of 2.08 points was maintained. The participants rated the experience positively, with no significant overall differences between the two professional groups. CONCLUSIONS: The nurses had greater knowledge and contact with clinical simulation, virtual reality and gamification. The escape room showed to be a valid method for the assimilation and retention of knowledge in master's degree students. Medical professionals experienced a greater degree of immersion in the activity.

Exergames as an Effective Alternative to Real Environmental Tennis Training for Adolescents.

(1) Background: The popularity of motion-sensing computer-based games, like virtual reality (VR) exergames, is increasing among adolescents. However, their efficacy compared to conventional physical training methods remains unclear. This study investigated whether VR exergames produce effects on reaction time (RT) comparable to traditional tennis training in school-aged adolescents. (2) Methods: In total, 130 adolescents (mean age: 15.6 ± 2.0 years; 67 boys: 15.5 ± 2.2 years; 63 girls: 15.7 ± 1.8 years) were recruited in schools and assigned to one of three groups: VR exergame (G1, n = 39), tennis training (G2, n = 25), or control (G3, n = 66). Participants' RTs were evaluated before and after the interventions. G1 engaged in VR exergames for 8 min, G2 underwent traditional tennis training for 30 min, and G3 did not participate in any physical activity. (3) Results: Our results indicated that in G3, girls exhibited slower RTs compared to boys (p < 0.0). No differences were observed in RTs when comparing G1 and G2. (4) Conclusions: Sex appeared to influence RT, with girls showing slower RTs than boys in G3. The findings suggest that VR exergames and traditional tennis training have similar impacts on RT. This indicates the potential of VR exergames as an alternative to conventional physical training for improving RT in adolescents.

Inquiry for the win: Fostering curiosity through a BINGO exercise in a longitudinally integrated clerkship.

EDUCATIONAL CHALLENGE: As technological advancements challenge the current roles healthcare workers fill, curiosity and lifelong learning are becoming increasingly important. However, descriptions of specific curricular interventions that successfully develop these attitudes and skills remain limited. PROPOSED SOLUTION: We aimed to promote curiosity and advance practical application of evidenced-based medicine through a longitudinal, gamified learning activity within a longitudinal integrated clerkship (LIC). Thirty-seven students across two inquiry-themed LICs based at a university hospital and a community-based integrated healthcare delivery system used BINGO cards containing various assignments designed to develop the skill of asking and answering clinical questions. Assignments included: engaging experts, using evidence-based medical resources, attending education events, utilizing medical library resources, and Phone-a-Scientist. Students shared their experiences in a group setting and wrote a reflection for each assignment that was qualitatively analyzed to determine the perceived educational outcomes according to the Kirkpatrick Evaluation Model. LESSONS LEARNED: Results suggest that Inquiry BINGO fosters curiosity and builds skill in applied evidenced-based medicine early in clinical training. Most assignments prompted students to engage in opportunities they might not have otherwise explored. All but three students reported a change in behavior as a result of the assignment and 57% reported positive clinical or research results. NEXT STEPS: Future iterations of this activity should be evaluated by obtaining patient and/or preceptor feedback as well as longitudinal evaluations of student behavior to ensure higher level educational outcomes are being met.

Enhancing COVID-19 Knowledge among Nursing Students: A Quantitative Study of a Digital Serious Game Intervention.

BACKGROUND: This study aimed to evaluate the effectiveness of a digital serious game intervention about COVID-19 on pre-registration nursing student knowledge. METHOD: This study included 282 nursing students from a university in Northern Ireland, with 210 students providing comparable pre-test and post-test results. The 'serious game' aimed to debunk common COVID-19 myths and provide accurate information about the virus. Participants completed a 25-item questionnaire before and after engaging with the game, which included true/false items based on the World Health Organisation's list of top COVID-19 myths. The data were analysed using paired t-tests to assess knowledge changes, and scores were calculated as percentages of correct answers. RESULTS: A statistically significant improvement in COVID-19 knowledge was demonstrated among first-year nursing students who engaged with the serious game. The post-test scores (M = 92.68, SD = 13.59) were notably higher than the pre-test scores (M = 82.64, SD = 13.26), with a p-value less than 0.001. CONCLUSION: This research suggests that integrating serious games into undergraduate nursing education can effectively enhance COVID-19 knowledge. This approach is aligned with the evolving trend of employing technology and gamification in healthcare education.

Gamification Approach to Provide Support About the Deferral Experience in Blood Donation: Design and Feasibility Study.

BACKGROUND: Multiple studies have examined the impact of deferral on the motivation of prospective blood donors, proposing various policies and strategies to support individuals who undergo this experience. However, existing information and communications technology systems focused on blood donation have not yet integrated these ideas or provided options to assist with the deferral experience. OBJECTIVE: This study aims to propose an initial gamified design aimed at mitigating the impact of the deferral experience by addressing the drivers of awareness and knowledge, interaction and validation, and motivation. Additionally, the study explores the feasibility of implementing such a system for potential users. METHODS: We conducted a literature review focusing on the dynamics of motivation and intention related to blood donation, as well as the deferral situation and its impact on citizens. Through this review, we identified weak donor identity, lack of knowledge, and reduced motivation as key factors requiring support from appropriate interventions. These factors were then defined as our key drivers. Taking these into account, we proposed a gamification approach that incorporates concepts from the MDA framework. The aim is to stimulate the aforementioned drivers and expand the concept of contribution and identity in blood donation. For a preliminary evaluation, we designed a prototype to collect feedback on usability, usefulness, and interest regarding a potential implementation of our proposed gamification approach. RESULTS: Among the participants, a total of 11 citizens interacted with the app and provided feedback through our survey. They indicated that interacting with the app was relatively easy, with an average score of 4.13 out of 5 when considering the 11 tasks of interaction. The SUS results yielded a final average score of 70.91 from the participants' answers. Positive responses were received when participants were asked about liking the concept of the app (3.82), being likely to download it (3.55), and being likely to recommend it to others (3.64). Participants expressed positivity about the implementation of the design but also highlighted current shortcomings and suggested possible improvements in both functionality and usability. CONCLUSIONS: Although deferral is a common issue in blood donation, there is a missed opportunity in existing ICT services regarding how to effectively handle such experiences. Our proposed design and implementation seem to have captured the interest of prospective users due to its perceived positive usefulness and potential. However, further confirmation is needed. Improving the design of activities that currently rely heavily on extrinsic motivation elements and integrating more social components to create an enhanced activity loop for intrinsic motivation could further increase the value of the proposed project. Future research could involve conducting a more specialized and longitudinal design evaluation with a larger sample size.