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Westenhaver ZK, Africa RE, Zimmerer RE, McKinnon BJ. Gamification in otolaryngology: A narrative review. Laryngoscope Investig Otolaryngol 2022; 7:291-298. [PMID: 35155810 PMCID: PMC8823161 DOI: 10.1002/lio2.707] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 10/09/2021] [Accepted: 11/10/2021] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION The medical field has incorporated gamification elements into education platforms over the past decade. The standard definition for gamification that has been adopted by most research studies is the addition of game elements and game mechanics within a platform to enhance user engagement. In this review, seven established, consolidated components, as well as an additional new or novel component, will be evaluated: a point system/leaderboards, question banks or gradable content, social interaction with other participants, leaderboards, progress or levels, immediate feedback, badges/icons or a reward system, and the novel component, a story line. METHODS Two reviewers searched MEDLINE, Cochrane, PsycINFO, Web of Knowledge, and the Nursing Registry. This review compares the one identified otolaryngology study with current residency education gamification practices within the medical field.The authors searched "residency AND gamification", "residency AND video games", and "residency AND games". After applying exclusion criteria, the 13 remaining studies included a procedure, questions/scenarios, and at least three gamification elements. RESULTS Across the 13 studies, the average number of included gamification elements was higher than the minimum threshold of three (3.84). Ten of the studies incorporated leaderboards, feedback, and social interaction; eight incorporated a question bank; and four incorporated progress bars, rewards, and story lines. The otolaryngology study incorporated four of the gamification components: a point system, instant feedback/solution after a question was answered, player-to-player communication, and a leaderboard. CONCLUSION Review of the current literature found that the medical field has limited research regarding the use of gamification in educational platforms. Despite many simulation studies and attempts at gamification, the medical community has not fully embraced gamification within residency education. In closing, the medical education community should establish a definition of "gamification" and survey residency programs to identify desired gamification elements.
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Affiliation(s)
- Zack K. Westenhaver
- School of Medicine, UTMB HealthGalvestonTexasUSA
- Department of Otolaryngology‐Head and Neck SurgeryUniversity of Texas, Medical BranchGalvestonTexasUSA
| | | | | | - Brian J. McKinnon
- Department of Otolaryngology‐Head and Neck SurgeryUniversity of Texas, Medical BranchGalvestonTexasUSA
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Ordell Sundelin M, Paltved C, Kingo PS, Blichert-Refsgaard L, Lindgren MS, Kjölhede H, Jensen JB. The transferability of the minimal invasive surgeon’s skills to open surgery. Scand J Urol 2022; 56:131-136. [DOI: 10.1080/21681805.2022.2030401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Maria Ordell Sundelin
- Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark
- Corporate MidtSim, Central Denmark Region, Aarhus, Denmark
| | | | - Pernille Skjold Kingo
- Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark
- Department of Urology, Aarhus University Hospital, Aarhus, Denmark
| | - Linea Blichert-Refsgaard
- Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark
- Department of Urology, Aarhus University Hospital, Aarhus, Denmark
| | - Maria S. Lindgren
- Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark
- Department of Urology, Aarhus University Hospital, Aarhus, Denmark
| | - Henrik Kjölhede
- Department of Urology, Sahlgrenska University Hospital, Göteborg, Sweden
- Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Jørgen Bjerggaard Jensen
- Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark
- Department of Urology, Aarhus University Hospital, Aarhus, Denmark
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Are gamers better laparoscopic surgeons? Impact of gaming skills on laparoscopic performance in "Generation Y" students. PLoS One 2020; 15:e0232341. [PMID: 32845892 PMCID: PMC7449406 DOI: 10.1371/journal.pone.0232341] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 07/02/2020] [Indexed: 01/22/2023] Open
Abstract
Background Both laparoscopic surgery and computer games make similar demands on eye-hand coordination and visuospatial cognitive ability. A possible connection between both areas could be used for the recruitment and training of future surgery residents. Aim The goal of this study was to investigate whether gaming skills are associated with better laparoscopic performance in medical students. Methods 135 medical students (55 males, 80 females) participated in an experimental study. Students completed three laparoscopic tasks (rope pass, paper cut, and peg transfer) and played two custom-designed video games (2D and 3D game) that had been previously validated in a group of casual and professional gamers. Results There was a small significant correlation between performance on the rope pass task and the 3D game, Kendall’s τ(111) = -.151, P = .019. There was also a small significant correlation between the paper cut task and points in the 2D game, Kendall’s τ(102) = -.180, P = .008. Overall laparoscopic performance was also significantly correlated with both the 3D game, Kendall’s τ(112) = -.134, P = .036, and points in the 2D game, Kendall’s τ(113) = -.163, P = .011. However, there was no significant correlation between the peg transfer task and both games (2D and 3D game), P = n.s.. Conclusion This study provides further evidence that gaming skills may be an advantage when learning laparoscopic surgery.
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Kowalewski KF, Schmidt MW, Proctor T, Pohl M, Wennberg E, Karadza E, Romero P, Kenngott HG, Müller-Stich BP, Nickel F. Skills in minimally invasive and open surgery show limited transferability to robotic surgery: results from a prospective study. Surg Endosc 2018; 32:1656-1667. [PMID: 29435749 DOI: 10.1007/s00464-018-6109-0] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 02/07/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND There is limited evidence on the transferability of conventional laparoscopic and open surgical skills to robotic-assisted surgery. The primary aim of this study was to evaluate the transferability of expertise in conventional laparoscopy and open surgery to robotic-assisted surgery using the da Vinci Skills Simulator (dVSS). Secondary aims included evaluating the influence of individual participants' characteristics. METHODS Participants performed four tasks on the dVSS: Peg Board 1 (PB), Pick and Place (PP), Thread the Rings (TR), and Suture Sponge 1 (SS). Participants were classified into three groups (Novice, Intermediate, Experts) according to experience in laparoscopic and open surgery. All tasks were performed twice except for SS. Performance was assessed using the built-in scoring system. RESULTS 37 medical students and 25 surgeons participated. Experts did not perform significantly better than less experienced participants on the dVSS. Specifically, with regard to laparoscopic experience, total simulator scores were: Novices 68.2 ± 28.8; Intermediates 65.1 ± 31.2; Experts 65.1 ± 30.0; p = 0.611. Regarding open surgical experience, scores were: Novices 68.6 ± 28.7; Intermediates 68.2 ± 30.8; Experts 63.2 ± 30.3; p = 0.305. Although there were some significant differences among groups for single parameters in specific tasks, there was no constant superiority of one group. Laparoscopic and open surgical Novices improved significantly in overall score and time for all three tasks (p < 0.05). Laparoscopic intermediates improved only in PP time (4.64 ± 3.42; p = 0.006), open Intermediates in PB score (11.98 ± 13.01; p = 0.025), and open Experts in PP score (6.69 ± 11.48; p = 0.048). Laparoscopic experts showed no improvement. Participants with gaming experience had better overall scores than non-gamers when comparing all second attempts (Gamer 83.62 ± 7.57; Non-Gamer 76.31 ± 12.78; p = 0.008) as well as first and second attempts together (Gamer 72.08 ± 8.86; Non-Gamer 65.45 ± 11.68; p = 0.039). Musical and sports experience showed no correlation with robotic performance. CONCLUSIONS Robotic-assisted surgery requires skills distinct from conventional laparoscopy or open surgery. Basic robotic skills training prior to patient contact should be required.
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Affiliation(s)
- Karl-Friedrich Kowalewski
- Department of General, Visceral, and Transplantation Surgery, University Hospital of Heidelberg, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Mona W Schmidt
- Department of General, Visceral, and Transplantation Surgery, University Hospital of Heidelberg, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Tanja Proctor
- Institute of Medical Biometry and Informatics, University of Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Moritz Pohl
- Institute of Medical Biometry and Informatics, University of Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Erica Wennberg
- Department of General, Visceral, and Transplantation Surgery, University Hospital of Heidelberg, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Emir Karadza
- Department of General, Visceral, and Transplantation Surgery, University Hospital of Heidelberg, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Philipp Romero
- Division of Pediatric Surgery, Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Hannes G Kenngott
- Department of General, Visceral, and Transplantation Surgery, University Hospital of Heidelberg, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Beat P Müller-Stich
- Department of General, Visceral, and Transplantation Surgery, University Hospital of Heidelberg, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Felix Nickel
- Department of General, Visceral, and Transplantation Surgery, University Hospital of Heidelberg, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
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Hopkins L, Hampton BS, Abbott JF, Buery-Joyner SD, Craig LB, Dalrymple JL, Forstein DA, Graziano SC, McKenzie ML, Pradham A, Wolf A, Page-Ramsey SM. To the point: medical education, technology, and the millennial learner. Am J Obstet Gynecol 2018; 218:188-192. [PMID: 28599897 DOI: 10.1016/j.ajog.2017.06.001] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 05/25/2017] [Accepted: 06/01/2017] [Indexed: 11/26/2022]
Abstract
This article, from the "To The Point" series that was prepared by the Association of Professors of Gynecology and Obstetrics Undergraduate Medical Education Committee, provides an overview of the characteristics of millennials and describes how medical educators can customize and reframe their curricula and teaching methods to maximize millennial learning. A literature search was performed to identify articles on generational learning. We summarize the importance of understanding the attitudes, ideas, and priorities of millennials to tailor educational methods to stimulate and enhance learning. Where relevant, a special focus on the obstetrics and gynecology curriculum is highlighted.
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The experimental analysis of problematic video gaming and cognitive skills: A systematic review. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.jtcc.2017.05.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Bragg HR, Towle Millard HA, Millard RP, Constable PD, Freeman LJ. Association of gender and specialty interest with video-gaming, three-dimensional spatial analysis, and entry-level laparoscopic skills in third-year veterinary students. J Am Vet Med Assoc 2017; 248:1414-8. [PMID: 27270065 DOI: 10.2460/javma.248.12.1414] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine whether gender or interest in pursuing specialty certification in internal medicine or surgery was associated with video-gaming, 3-D spatial analysis, or entry-level laparoscopic skills in third-year veterinary students. DESIGN Cross-sectional study. SAMPLE A convenience sample of 68 (42 female and 26 male) third-year veterinary students. PROCEDURES Participants completed a survey asking about their interest in pursuing specialty certification in internal medicine or surgery. Subsequently, participants' entry-level laparoscopic skills were assessed with 3 procedures performed in box trainers, their video-gaming skills were tested with 3 video games, and their 3-D spatial analysis skills were evaluated with the Purdue University Visualization of Rotations Spatial Test. Scores were assigned for laparoscopic, video-gaming, and 3-D spatial analysis skills. RESULTS Significantly more female than male students were interested in pursuing specialty certification in internal medicine (23/42 vs 7/26), and significantly more male than female students were interested in pursuing specialty certification in surgery (19/26 vs 19/42). Males had significantly higher video-gaming skills scores than did females, but spatial analysis and laparoscopic skills scores did not differ between males and females. Students interested in pursuing specialty certification in surgery had higher video-gaming and spatial analysis skills scores than did students interested in pursuing specialty certification in internal medicine, but laparoscopic skills scores did not differ between these 2 groups. CONCLUSIONS AND CLINICAL RELEVANCE For this group of students, neither gender nor interest in specialty certification in internal medicine versus surgery was associated with entry-level laparoscopy skills.
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Nickel F, Hendrie JD, Kowalewski KF, Bruckner T, Garrow CR, Mantel M, Kenngott HG, Romero P, Fischer L, Müller-Stich BP. Sequential learning of psychomotor and visuospatial skills for laparoscopic suturing and knot tying—a randomized controlled trial “The Shoebox Study” DRKS00008668. Langenbecks Arch Surg 2016; 401:893-901. [DOI: 10.1007/s00423-016-1421-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 03/30/2016] [Indexed: 11/29/2022]
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The effects of video games on laparoscopic simulator skills. Am J Surg 2014; 208:151-6. [DOI: 10.1016/j.amjsurg.2013.11.006] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Revised: 10/23/2013] [Accepted: 11/22/2013] [Indexed: 11/20/2022]
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Millard HAT, Millard RP, Constable PD, Freeman LJ. Relationships among video gaming proficiency and spatial orientation, laparoscopic, and traditional surgical skills of third-year veterinary students. J Am Vet Med Assoc 2014; 244:357-62. [DOI: 10.2460/javma.244.3.357] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Assessing performance in brain tumor resection using a novel virtual reality simulator. Int J Comput Assist Radiol Surg 2013; 9:1-9. [PMID: 23784222 DOI: 10.1007/s11548-013-0905-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2013] [Accepted: 06/03/2013] [Indexed: 12/17/2022]
Abstract
PURPOSE NeuroTouch is a virtual reality (VR) simulator developed for neurosurgical skill training. Validation demonstrating that the system is useful and reliable is required for formal adoption into training curriculums. Face and content validity have been demonstrated for some neurosurgical simulators, but construct validity remains difficult to establish. A pilot validation study was conducted for a NeuroTouch training exercise. METHODS Participants completed the internal resection of a simulated convexity meningioma and filled out questionnaires to provide feedback on the experience. Performance metrics included volume of tissues removed, tool path lengths, duration of excessive forces applied and efficient use of the aspirator. Results were analyzed according to participants' level of training, gender, handedness, surgical experience in meningioma removal and hours/week playing musical instruments or video games. RESULTS Seventy-two participants (10 medical students, 18 junior residents and 44 senior residents) were enrolled. Analyses demonstrated statistically significant increase in tumor removed and efficiency of ultrasonic aspirator use between medical students and residents, but not between junior and senior residents. After covariate adjustment for the number of meningioma cases operated on, multivariate analysis of the level of training became nonsignificant. Participants judged the exercise appropriate and realistic, desiring use of the system in current training programs. CONCLUSION We have conducted a pilot validation study for the NeuroTouch tumor resection scenario and demonstrated for the first time, face, content and construct validity of a VR neurosurgical simulation exercise. Future full-scale studies will be conducted in noncompetitive settings and incorporate expert participants.
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