Virtual Telemedicine: A serious game to develop problem solving skills in medical education

Abstract

Serious games have the potential to be an important teaching tool for both formal and informal education because of their affordances of interactivity and motivation, engaging users, providing a platform for active learning, being customized to learners, providing immediate feedback and including immersive activities. Serious games for medical education is a growing domain. Across the healthcare sector, there is growing interest in improving and sustaining interaction and engagement using game technologies. Game environments provide a safe and controlled setting within which players can learn in an engaging way. Health games for practitioners, such as doctors and nurses, tend to be simulation-based and used for training. This paper is a report on the design and development of the serious game called “Virtual Telemedicine”. The game responds to the need to train doctors for problem-solving in real-life situations of medical care. In the prototype scenario, the user, a practicing doctor, responds to a medical emergency situation to treat the symptoms of a virtual patient by taking specific actions and examining their results based on immediate feedback provided by both the system and the virtual patient. Virtual Telemedicine was created as part of the meducator Best Practice Network. mEducator enables specialized state-of-the-art medical educational content to be discovered, retrieved, shared and re-used across European higher academic institutions. The game makes use of data from an electrocardiogram (ECG), a transthoracic (across the thorax or chest) interpretation of the electrical activity of the heart over a period of time, as detected by electrodes attached to the outer surface of the skin and recorded by a device external to the body. The beta version of the game utilizes variables such as the patient’s heart rate, respiration and temperature, but there is inherent potential to use additional sources of data to increase the complexity of the game. With regard to technical information, the game was created using the programming language C with XNA for the game, C with Flex/Bison for the compiler and C# for the Runner, that runs the scripts. The three pieces are separate and the user runs the first piece. For testing and evaluation purposes, several scripts that used the features of the scripting language were implemented to examine whether they worked properly and a detailed command-by-command debugging was conducted to examine that the flow of the code worked as intended. The educational game “Virtual Telemedicine” is currently working as a standalone application on PCs with the Windows operating system. The game can be shared and repurposed (through changing its scenarios) through mEducator3.0/Melina+, an extended version of Drupal 7, which is offered as an installation profile and enables web site administrators to install a learning management system, which is focused in medical education. As part of future research and development work focusing on the educational evaluation of this serious game, usability testing sessions with practicing doctors will be scheduled to solicit the learners’ feedback and input on the design of the game. Suggested changes will be incorporated in an updated version of the game. A direction for further research is to examine whether learning will be transferred beyond the game context and how, and what is the retention rate of the game when this is used by medical students.