HealthFebruary 25, 2016

‘Game-Based’ clinical learning

Computer-based learning has long been a mainstream educational tool across all curriculums, but what about the use of video games as learning modules?

Video games used for education are often referred to as “serious games” to differentiate them from those designed for entertainment. Game-based education allows students to learn in a simulated environment, but games have the advantage of providing much more complex scenarios than are possible in laboratory simulation exercises.

Experiential learning

The use of virtual-world simulation through gaming is experiential—students, in this case nurses, learn by doing something online rather than just watching someone do something or listening to how something ought to be done. By using games, learners can travel down an infinite number of paths that have been determined through the rules integrated into the game engine.

The experiences in games designed for nurses encourage them to learn by acting and reacting in ordered, problem-solving spaces. In a virtual game, students also learn by thinking and reflecting on their actions. Their experiential learning is enhanced by reflection. During games, learners can promptly be made aware of mistakes or omissions during the exercise and receive feedback on their performance.

For example, when a nursing student is working with a virtual patient, short-term consequences, such as hypoxia, are evident if the learner neglects to provide oxygen, just as they are in the real world.

A virtual patient room, for example, contains objects that would be found in a real patient environment, such as monitors, intravenous pumps, oxygen, and other supplies required for patient care. These objects are interactive, meaning that they can be used by the learner in the course of the simulation experience.

Virtual nursing programs

The virtual world is the environment in which interactive activity can take place. Many universities have used virtual-world platforms, such as Second Life and OpenSim to design learning experiences for students in virtual settings. Another is CliniSpace, which offers a next generation 3D virtual training environment for healthcare professionals that replicate the surroundings of daily work.

Logging into these environments, learners encounter realistic scenarios and problems, fostering enhanced critical-thinking skills. They practice alone and in teams, learning to make decisions, to communicate effectively, and to recover safely from errors. Areas in the CliniSpace virtual world include wards, individual patient rooms, intensive care units, emergency bays, examination rooms, conference rooms, and even a reception area. The patients found in CliniSpace (called DynaPatients™) incorporate dynamic simulations of physiology and pathophysiology—they can hemorrhage, go into shock, develop infections, express pain, and interact with caregivers.

Virtual worlds allow nursing students to actively engage in an activity, such as patient assessment or intervention, in response to changes in the patient's condition. In the virtual emergency department, for example, clinicians can assess a young man who is hemorrhaging after a motor vehicle accident and take appropriate action. The patient's monitor displays vital signs and other data to guide decisions and interventions (which might include intravenous fluids, blood transfusions, and further diagnostic tests) and provide immediate feedback about those interventions.

Virtual or real-world? 

Like other simulated environments, game-based learning is not intended to substitute for real-world clinical practice. Game-based learning is best viewed as an integrated step towards supervised clinical practice. It won't become a substitute for learning crucial hands-on skills with real patients. Games can, however, prepare nurses for clinical encounters so that the time spent with patients is a safer and more valuable experience.

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