RESUMEN
Emotions play an important role in human-computer interaction, but there is limited research on affective and emotional virtual agent design in the area of teaching simulations for healthcare provision. The purpose of this work is twofold: firstly, to describe the process for designing affective intelligent agents that are engaged in automated communications such as person to computer conversations, and secondly to test a bespoke prototype digital intervention which implements such agents. The presented study tests two distinct virtual learning environments, one of which was enhanced with affective virtual patients, with nine 3rd year nursing students specialising in mental health, during their professional practice stage. All (100%) of the participants reported that, when using the enhanced scenario, they experienced a more realistic representation of carer/patient interaction; better recognition of the patients' feelings; recognition and assessment of emotions; a better realisation of how feelings can affect patients' emotional state and how they could better empathise with the patients.
RESUMEN
Nondigital board games are being used to engage players and impact outcomes in health and medicine across diverse populations and contexts. This systematic review and meta-analysis describes and summarizes their impact based on randomized and nonrandomized controlled trials. An electronic search resulted in a review of n = 21 eligible studies. Sample sizes ranged from n = 17 to n = 3110 (n = 6554 total participants). A majority of the board game interventions focused on education to increase health-related knowledge and behaviors (76%, n = 16). Outcomes evaluated included self-efficacy, attitudes/beliefs, biological health indicators, social functioning, anxiety, and executive functioning, in addition to knowledge and behaviors. Using the Cochrane Collaboration tool for assessing bias, most studies (52%, n = 11) had an unclear risk of bias (33% [n = 7] had a high risk and 14% [n = 3] had a low risk). Statistical tests of publication bias were not significant. A random-effects meta-analysis showed a large average effect of board games on health-related knowledge (d* = 0.82, 95% confidence interval; CI [0.15-1.48]), a small-to-moderate effect on behaviors (d* = 0.33, 95% CI [0.16-0.51]), and a small-to-moderate effect on biological health indicators (d* = 0.37, 95% CI [0.21-0.52]). The findings contribute to the literature on games and gamified approaches in healthcare. Future research efforts should aim for more consistent high scientific standards in their evaluation protocols and reporting methodologies to provide a stronger evidence base.