Lessons Learned From an Evaluation of Serious Gaming as an Alternative to Mannequin-Based Simulation Technology: Randomized Controlled Trial

Abstract

Background: The use of new technology like virtual reality, e-learning, and serious gaming can offer novel, more accessible options that have been demonstrated to improve learning outcomes.

Objective: The aim of this study was to compare the educational effectiveness of serious game-based simulation training to traditional mannequin-based simulation training and to determine the perceptions of physicians and nurses. We used an obstetric use case, namely electronic fetal monitoring interpretation and decision making, for our assessment.

Methods: This study utilized a mixed methods approach to evaluate the effectiveness of the new, serious game-based training method and assess participants' perceptions of the training. Participants were randomized to traditional simulation training in a center with mannequins or serious game training. They then participated in an obstetrical in-situ simulation scenario to assess their learning. Participants also completed a posttraining perceptions questionnaire.

Results: The primary outcome measure for this study was the participants' performance in an in-situ mannequin-based simulation scenario, which occurred posttraining following a washout period. No significant statistical differences were detected between the mannequin-based and serious game-based groups in overall performance, although the study was not sufficiently powered to conclude noninferiority. The survey questions were tested for significant differences in participant perceptions of the educational method, but none were found. Qualitative participant feedback revealed important areas for improvement, with a focus on game realism.

Conclusions: The serious game training tool developed has potential utility in providing education to those without access to large simulation centers; however, further validation is needed to demonstrate if this tool is as effective as mannequin-based simulation.

Keywords: continuing medical education; obstetrics; simulation training.

Figure 1

NOELLE S550 Maternal and Neonatal Birthing Simulator depiction.

Figure 2

Study design flow diagram. EFM: electronic fetal monitoring.

Figure 3

Depiction of the avatar participants utilized to navigate the serious game.

Figure 4

Depiction of the screen participants utilized to input answers in the serious game.