Cultural applicability and desirability of 'Broodles': The first serious game intervention for siblings of children with disabilities

Objective

Serious games can serve as easily accessible interventions to support siblings of children with disabilities, who are at risk of developing mental health problems. The Dutch serious game 'Broodles' was developed for siblings aged 6-9 years. The current study aims to assess the cultural applicability, desirability, feasibility, and acceptability of 'Broodles' in Norway.

Methods

Norwegian siblings (N = 16) aged 6-13 years and parents (N = 12) of children with intellectual disabilities assessed the game. Their feedback data from interviews and questionnaires were sorted using a model of engagement factors in serious games.

Results

At pre-use, participants showed interest in the game, and after initial use the participants were overall positive about the format, content and objectives, including validation of emotions and recognition. The participants had suggestions for improved engagement and feasibility.

Conclusion

The game was found to be culturally applicable, desirable and acceptable, although Norwegian translation is necessary for further evaluation. Recommendations to enhance engagement were provided, including suggestions to play the game with parents or in a group.

Innovation

This initial assessment of the serious game Broodles in a non-Dutch setting shows promise for an innovative way of supporting siblings of children with disabilities.

A Serious Game for Cognitive Stimulation of Older People With Mild Cognitive Impairment: Design and Pilot Usability Study

Background

Cognitive stimulation of older people helps prevent, and even treat, age-related diseases, such as mild cognitive impairment. Playing games reduces the probability of experiencing this pathology, which is related to the loss of the ability to carry out some instrumental activities of daily living.

Objective

This work describes the design and development of a serious game for the cognitive stimulation of older people, with exercises related to the daily life task of shopping. A pilot study for its preliminary usability validation is also presented.

Methods

The designed serious game includes 4 exercises consisting of shopping in a hypermarket, ordering products, making payments, and organizing the purchase, thus dealing with the most frequent cognitive problems of older people associated with episodic declarative memory, naming, calculation, and organization, respectively.

Results

A total of 19 older people participated in the pilot study for the usability validation of the serious game. They indicated that they like the aesthetic and interesting topic of the game. They reported that it provides a high level of entertainment and could be useful in daily life for mental stimulation. The participants found the serious game to be intuitive, but the ease of use and readability of the instructions could be improved.

Conclusions

This study suggests that the innovative serious game developed could be accepted by older people for their cognitive stimulation to prevent or treat mild cognitive impairment, although a long-term intervention study should be performed as future work. Its ecological validity design, with everyday tasks, adaptable levels of difficulty, and motivational mechanisms, is a differentiating factor compared to similar serious games.

Promoting teachers' wellbeing through a serious game intervention: a qualitative exploration of teachers' experiences

Introduction

Teachers' wellbeing plays a critical role in their overall job satisfaction, motivation, and effectiveness in building supporting learning environments. In today's dynamic educational settings, where teachers often face numerous challenges and stressors, their wellbeing becomes increasingly vital. Consequently, there is an urgent need to innovate and develop targeted training interventions that can support specifically the wellbeing of educators.

Methods

This study sought to provide an overview of the "Online Wellbeing Course - OWC," a serious game developed to enhance teachers' wellbeing, and to investigate the participants' feedback after being engaged in the OWC, utilizing a qualitative approach through focus group discussions. A total of 189 in-service teachers took part in the study. To qualitatively explore their experiences with the OWC, participants were involved in focus groups and asked to provide feedback about how and to what extent the course was beneficial for their wellbeing.

Results

Teachers reported enhancements in areas such as emotional competence, self-care strategies, social awareness, relationship skills, decision-making, and school climate.

Discussion

These outcomes suggested the potential of serious games as an innovative training approach for supporting teachers' wellbeing, offering valuable insights for researchers, policymakers, and educators.

A Serious Game ("Fight With Virus") for Preventing COVID-19 Health Rumors: Development and Experimental Study

BACKGROUND

Health rumors arbitrarily spread in mainstream social media on the internet. Health rumors emerged in China during the outbreak of COVID-19 in early 2020. Many midelders/elders (age over 40 years) who lived in Wuhan believed these rumors.

OBJECTIVE

This study focused on designing a serious game as an experimental program to prevent and control health rumors. The focus of the study was explicitly on the context of the social networking service for midelders/elders.

METHODS

This research involved 2 major parts: adopting the Transmission Control Protocol model for games and then, based on the model, designing a game named "Fight With Virus" as an experimental platform and developing a cognitive questionnaire with a 5-point Likert scale. The relevant variables for this experimental study were defined, and 10 hypotheses were proposed and tested with an empirical study. In total, 200 participants were selected for the experiments. By collecting relevant data in the experiments, we conducted statistical observations and comparative analysis to test whether the experimental hypotheses could be proved.

RESULTS

We noted that compared to traditional media, serious games are more capable of inspiring interest in research participants toward their understanding of the knowledge and learning of health commonsense. In judging and recognizing the COVID-19 health rumor, the test group that used game education had a stronger ability regarding identification of the rumor and a higher accuracy rate of identification. Results showed that the more educated midelders/elders are, the more effective they are at using serious games.

CONCLUSIONS

Compared to traditional media, serious games can effectively improve midelders'/elders' cognitive abilities while they face a health rumor. The gameplay effect is related to the individual's age and educational background, while income and gender have no impact.

Co-design and evaluation of a digital serious game to promote public awareness about pancreatic cancer

BACKGROUND

Pancreatic cancer, ranking seventh in global cancer-related deaths, poses a significant public health challenge with increasing incidence and mortality. Most cases are diagnosed at an advanced stage, resulting in low survival rates. Early diagnosis significantly impacts prognosis, making symptom awareness crucial. Symptoms are often subtle, leading to delayed help-seeking behaviour. Patients and their carers prioritise increased public awareness, indicating a need for innovative approaches to promote awareness of the disease.

METHODS

This study employed a quasi-experimental pre-test/post-test design to assess the relationship between a serious game and pancreatic cancer awareness. Members of the public (N = 727) were recruited internationally, via social media and with signposting by relevant organisations. Participants completed measures of symptom awareness and help-seeking intentions before and after playing the game. The serious game, co-designed with experts by lived experience, patient advocates and healthcare professionals, presented participants with a human anatomy diagram, with each section linked to a question about pancreatic cancer.

RESULTS

The serious game demonstrated a statistically significant improvement on pancreatic cancer awareness based on matched paired t-tests. Due to missing data, paired comparisons were only possible for 489 cases. Symptom awareness scores exhibited a statistically significant increase from pre-test to post-test, with a large effect size (p < 0.001, d = 1.43). Help-seeking intentions also markedly improved, showing a significant increase from pre-test to post-test, with a large effect size (p < 0.001, d = 1.10). Independent-samples t-tests were also conducted to determine if there were any group differences on pre- to post-test changes based on age, gender, and previous knowledge and/or experience of pancreatic cancer. Participants overwhelmingly endorsed the game's usability and educational value, suggesting its potential as an effective tool for enhancing public awareness and proactive health-seeking behaviour.

DISCUSSION

This study is the first to explore a serious game's utility in pancreatic cancer awareness. Results suggest that such interventions can effectively increase public awareness and influence help-seeking intentions. The co-design process ensured content relevance, and participant satisfaction was high. Findings highlight the game's potential as an accessible and convenient tool for diverse populations.

A Serious Game to Train Rhythmic Abilities in Children With Dyslexia: Feasibility and Usability Study

BACKGROUND

Rhythm perception and production are related to phonological awareness and reading performance, and rhythmic deficits have been reported in dyslexia. In addition, rhythm-based interventions can improve cognitive function, and there is consistent evidence suggesting that they are an efficient tool for training reading skills in dyslexia.

OBJECTIVE

This paper describes a rhythmic training protocol for children with dyslexia provided through a serious game (SG) called Mila-Learn and the methodology used to test its usability.

METHODS

We computed Mila-Learn, an SG that makes training remotely accessible and consistently reproducible and follows an educative agenda using Unity (Unity Technologies). The SG's development was informed by 2 studies conducted during the French COVID-19 lockdowns. Study 1 was a feasibility study evaluating the autonomous use of Mila-Learn with 2500 children with reading deficits. Data were analyzed from a subsample of 525 children who spontaneously played at least 15 (median 42) games. Study 2, following the same real-life setting as study 1, evaluated the usability of an enhanced version of Mila-Learn over 6 months in a sample of 3337 children. The analysis was carried out in 98 children with available diagnoses.

RESULTS

Benefiting from study 1 feedback, we improved Mila-Learn to enhance motivation and learning by adding specific features, including customization, storylines, humor, and increasing difficulty. Linear mixed models showed that performance improved over time. The scores were better for older children (P<.001), children with attention-deficit/hyperactivity disorder (P<.001), and children with dyslexia (P<.001). Performance improved significantly faster in children with attention-deficit/hyperactivity disorder (β=.06; t3754=3.91; P<.001) and slower in children with dyslexia (β=-.06; t3816=-5.08; P<.001).

CONCLUSIONS

Given these encouraging results, future work will focus on the clinical evaluation of Mila-Learn through a large double-blind randomized controlled trial comparing Mila-Learn and a placebo game.

An umbrella review of the benefits and risks associated with youths' interactions with electronic screens

The influence of electronic screens on the health of children and adolescents and their education is not well understood. In this prospectively registered umbrella review (PROSPERO identifier CRD42017076051 ), we harmonized effects from 102 meta-analyses (2,451 primary studies; 1,937,501 participants) of screen time and outcomes. In total, 43 effects from 32 meta-analyses met our criteria for statistical certainty. Meta-analyses of associations between screen use and outcomes showed small-to-moderate effects (range: r = -0.14 to 0.33). In education, results were mixed; for example, screen use was negatively associated with literacy (r = -0.14, 95% confidence interval (CI) = -0.20 to -0.09, P ≤ 0.001, k = 38, N = 18,318), but this effect was positive when parents watched with their children (r = 0.15, 95% CI = 0.02 to 0.28, P = 0.028, k = 12, N = 6,083). In health, we found evidence for several small negative associations; for example, social media was associated with depression (r = 0.12, 95% CI = 0.05 to 0.19, P ≤ 0.001, k = 12, N = 93,740). Limitations of our review include the limited number of studies for each outcome, medium-to-high risk of bias in 95 out of 102 included meta-analyses and high heterogeneity (17 out of 22 in education and 20 out of 21 in health with I2 > 50%). We recommend that caregivers and policymakers carefully weigh the evidence for potential harms and benefits of specific types of screen use.

"What It Means to be a Digital Citizen": Using concept mapping and an educational game to explore children's conceptualization of digital citizenship

Digital citizenship (DC) education is key to a bright future for children in the digital age. Despite its attention in K-12 settings, little is known about how children conceptualize DC, which diminishes the effectiveness of associated lessons. This study introduced the conceptual content cognitive mapping (3CM) approach to investigate children's conceptualization of DC and its changes after digital game-based learning with MinecraftEDU. Results showed that children tended to conceptualize DC superficially as personal responsibility and generally ignored the role of active online engagement. The game's mechanism had weak influence on how children conceptualized this idea, mainly reflected in the change of importance they perceived during the game. These changes were related to their perceptions of emotion, game design, and value commitments. Children jointly showed their interest in the game and exhibited diverse behaviors and learning reflections during the game. Implications for teaching DC and using educational games are discussed to promote DC localization in China.

Learning Italian as a Second Language in a Sample of Ukrainian Children: A Game-Based Learning Approach

Game-based learning is an educational approach aimed at acquiring knowledge through the use of play. There are various studies that note the effectiveness of playing as an educational tool and the use of digital platforms as a tool that can increase its effectiveness. We wanted to investigate whether a game-based learning approach may determine an improvement in Italian as a foreign language in terms of vocabulary expansion. The sample consists of 48 Ukrainian children between 6 and 7 years old. There were 24 female children and 24 male children in the sample, divided into two groups: the control group (Gr1) learnt Italian through frontal lessons (traditional approach), the experimental group (Gr2) learnt Italian through games and activities (game-based learning). The results have shown that the experimental group had a major increase in Italian vocabulary. However, both groups had an increase in this sense. Game-based learning remains an effective and promising educational approach, but other variables must be taken into account. Furthermore, the scarcity of literature on foreign language learning through game-based learning creates the need for more studies.

Open pilot trial of an interactive digital application for campus sexual violence prevention

Digital applications, or "serious games" for health address learning goals in a cognitively active, interactive manner, with the potential for widespread dissemination. This study used a mixed methods approach to develop and conduct a formative evaluation of a digital application for sexual assault prevention. Make a change is a digital application that uses the principles of games for health to foster learning, engagement, and skill-building around risk and protective factors for sexual victimization, sexual aggression, and bystander intervention. The digital application includes four narrative chapters, six embedded activities, as well as a user-derived change plan in which individuals establish goals for behavior change following program completion. This multisite study at a 2- and a 4-year college utilized student interviews (n = 14), stakeholder interviews (n = 10), and focus groups with students (n = 40) to inform intervention development. A total of 41 college students then participated in an open trial and completed self-report surveys (pre, post, and 1-month follow-up) to evaluate the feasibility, acceptability, utility, and preliminary outcomes. Most of the sample reported enjoyment, usefulness, and perceived competence after completing the application. Data evidenced a trend to reduce the frequency of heavy drinking, and perceptions of social norms evidenced change over time. Findings support the feasibility and effectiveness of this novel format for the delivery of sexual assault prevention programming.

Engaging learners with games-Insights from functional near-infrared spectroscopy

The use of game elements in learning tasks is thought to facilitate emotional and behavioral responses as well as learner engagement. So far, however, little is known about the underlying neural mechanisms of game-based learning. In the current study, we added game elements to a number line estimation task assessing fraction understanding and compared brain activation patterns to a non-game-based task version. Forty-one participants performed both task versions in counterbalanced order while frontal brain activation patterns were assessed using near-infrared spectroscopy (within-subject, cross-sectional study design). Additionally, heart rate, subjective user experience, and task performance were recorded. Task performance, mood, flow experience, as well as heart rate did not differ between task versions. However, the game-based task-version was rated as more attractive, stimulating and novel compared to the non-game-based task version. Additionally, completing the game-based task version was associated with stronger activation in frontal brain areas generally involved in emotional and reward processing as well as attentional processes. These results provide new neurofunctional evidence substantiating that game elements in learning tasks seem to facilitate learning through emotional and cognitive engagement.

Playing at the school table: Systematic literature review of board, tabletop, and other analog game-based learning approaches

The unique characteristics of games have led scientific research to increasingly focus on their potential role in learning processes. Currently, their effectiveness in fostering experiential learning and skill acquisition in several areas is already supported by the existing evidence, mainly about the potential of digital games. Paradoxically, the current post-digital era seems to have led to a growing popularity of analog games. The present Systematic Literature Review aimed to map the existing literature on the potential of board, tabletop, or other analog games in learning processes. It intended to systematize the contemporary state of the art (2012-2022) around the pedagogical role of these games, their effectiveness, the promoted learning outcomes, the methodological aspects of the interventions, the used games-including mechanics and other characteristics-and the current discussions around inclusion and accessibility in analog game-based learning. Adopting the PRISMA methodology, we searched ACM Digital Library, EBSCO, ERIC, Scopus-Elsevier, and Web of Science databases, as well as other peer-reviewed "grey literature" sources. The search resulted in an initial sample of 2,741 articles that was then screened by inclusion and exclusion criteria previously defined according to the research objectives. We obtained a final sample of 45 articles. To formulate the mapping of existing research, these studies were analyzed using a combination of statistical, content, and critical analysis procedures. The obtained results support the role of board, tabletop, and other analog games in educational contexts-based on their educational potential-with a broad range of knowledge, cognitive, and psychological outcomes. The study also emphasized the relevance of these games in the promotion of soft skills and other aspects typically associated with meaningful learning, such as engagement, satisfaction, flexibility, and freedom of experimentation. However, important limitations were found in a fair amount of the pedagogical approaches studied, which can be mostly attributed to the low prevalence of modern board games that relate what is intended to be learned to aspects of game design and have little to no consideration of accessibility and inclusion aspects in these studies.

Latent factors on the design and adoption of gamified apps in primary education

The main objective of this research is to determine the perception of teachers about the elements that increases the educational effectiveness of gamified apps in primary education. A methodology based on an importance-performance analysis was daeveloped, using a structural equations model to calcuate the degree of importance of each variable. The sample was formed of 212 Spanish teachers with experience using educational apps in the teaching-learning process. Six categories were identified as precursors of educational effectiveness: (1) curriculum connection, (2) feedback and operational experience, (3) assessment and learning analytics, (4) sustainability (Protection Personal data), (5) equal access and (6) flow. These six categories enhance the three traditional areas of gamification intervention: cognitive, emotional and social. In this sense, the design and adoption of an educational gamified app should: (1) establish a clear link between the game and curricular content and competence development; (2) promote self-regulated learning through individual and collaborative activities; (3) offer adapted learning by integrating differentiated personalized learning pathways; (4) integrate learning analytics that can be consulted by teacher, student and family; (5) comply with data protection regulation and promote a safe, sustainable and ethical use of the information generated; (6) take into account different levels of functional diversity. When the gamified app design incorporates these attributes, primary education teachers perceive that such resources can be integrated effectively into the teaching-learning processes.

Puzzle game-based learning: a new approach to promote learning of principles of coronary artery bypass graft surgery

INTRODUCTION

Since learning with high educational quality requires an advanced intervention. This study seeks to answer how many puzzles game-based training can improve knowledge and cognitive function of surgical technology students in CABG surgery and its sequence, as well as the tools and equipment used in each stage of surgery and the sequence of their preparation.

MATERIALS AND METHODS

This study was carried out as a quasi-experimental single-group pre-test-post-test, during which, after designing a puzzle game including various stages of surgery (from the preparation of the patient for surgical sutures and the necessary equipment to perform each stage), 18 people from third-year surgical technology students who met the inclusion criteria were entered in the study by convenience sampling method and based on the sample size determined using a similar study and they participated in the test of knowledge and cognitive function, that the validity and reliability were measured, before the intervention and 14 days after the intervention (using a puzzle game). Data were analyzed using descriptive and Wilcoxon statistical tests.

RESULTS

After the withdrawal of 2 people, 15 person (93.80 per cent) of the students were female, the average age of students was 21.87 ± 0.71 years, and 50% (8 people) of them were 22 years old. Also, the average score of the end-of-semester exam of the heart surgery technology course was 15.19 ± 2.30 (the lowest score was 11.25, and the highest score was 18.63), and the score of 43.80% (7 people) of them were in the range of 15.01-17.70, and their average of grade point average was 17.31 ± 1.10 (the lowest grade point average is 15 and the highest grade point average is 19.36) and grade point average 75% (11 people) of students were 16-18. The average scores of knowledge(5.75 ± 1.65 vs. 2.68 ± 0.79) and cognitive performance(6.31 ± 2.57 vs. 2.00 ± 1.09) of students in the post-intervention phase were significantly higher than the pre-intervention phase (P < 0.0001).

CONCLUSION

The results of the present study showed that the use of puzzle games in CABG surgery training led to a significant improvement in the knowledge and cognitive performance of surgical technology students regarding the stages of CABG surgery and its sequence, as well as the tools and equipment used in each stage of surgery and the sequence of their preparation.

A scoping review of neurodegenerative manifestations in explainable digital phenotyping

Neurologists nowadays no longer view neurodegenerative diseases, like Parkinson's and Alzheimer's disease, as single entities, but rather as a spectrum of multifaceted symptoms with heterogeneous progression courses and treatment responses. The definition of the naturalistic behavioral repertoire of early neurodegenerative manifestations is still elusive, impeding early diagnosis and intervention. Central to this view is the role of artificial intelligence (AI) in reinforcing the depth of phenotypic information, thereby supporting the paradigm shift to precision medicine and personalized healthcare. This suggestion advocates the definition of disease subtypes in a new biomarker-supported nosology framework, yet without empirical consensus on standardization, reliability and interpretability. Although the well-defined neurodegenerative processes, linked to a triad of motor and non-motor preclinical symptoms, are detected by clinical intuition, we undertake an unbiased data-driven approach to identify different patterns of neuropathology distribution based on the naturalistic behavior data inherent to populations in-the-wild. We appraise the role of remote technologies in the definition of digital phenotyping specific to brain-, body- and social-level neurodegenerative subtle symptoms, emphasizing inter- and intra-patient variability powered by deep learning. As such, the present review endeavors to exploit digital technologies and AI to create disease-specific phenotypic explanations, facilitating the understanding of neurodegenerative diseases as "bio-psycho-social" conditions. Not only does this translational effort within explainable digital phenotyping foster the understanding of disease-induced traits, but it also enhances diagnostic and, eventually, treatment personalization.

Associations between emotions and psychophysiological states and confirmation bias in question formulation in ongoing simulated investigative interviews of child sexual abuse

Introduction

In forensic settings interviewers are advised to ask as many open-ended questions as possible. However, even experts may have difficulty following this advice potentially negatively impacting an investigation. Here, we sought to investigate how emotions and psychophysiological parameters are associated with question formulation in real time in an ongoing (simulated) child sexual abuse (CSA) interview.

Method

In a experimental study, psychology students (N = 60, Mage = 22.75) conducted two interviews with child avatars, while their emotions (anger, sadness, disgust, surprise and relief), GSR and heart rate (HR) were registered.

Results

First, we found that general emotionality related to CSA and perceived realness of the avatars was associated with stronger overall emotional reactions. Second, we found that closed (vs. open) questions were preceded by more facially observable anger, but not disgust, sadness, surprise or relief. Third, closed (vs. open) questions were preceded by higher GSR resistance and lower heart rate.

Discussion

Results suggest for the first time that emotions and psychophysiological states can drive confirmation bias in question formulation in real time in CSA.

The Good Talk! A Serious Game to Boost People's Competence to Have Open Conversations About COVID-19: Protocol for a Randomized Controlled Trial

BACKGROUND

Vaccine hesitancy is one of the many factors impeding efforts to control the COVID-19 pandemic. Exacerbated by the COVID-19 infodemic, misinformation has undermined public trust in vaccination, led to greater polarization, and resulted in a high social cost where close social relationships have experienced conflict or disagreements about the public health response.

OBJECTIVE

The purpose of this paper is to describe the theory behind the development of a digital behavioral science intervention-The Good Talk!-designed to target vaccine-hesitant individuals through their close contacts (eg, family, friends, and colleagues) and to describe the methodology of a research study to evaluate its efficacy.

METHODS

The Good Talk! uses an educational serious game approach to boost the skills and competences of vaccine advocates to have open conversations about COVID-19 with their close contacts who are vaccine hesitant. The game teaches vaccine advocates evidence-based open conversation skills to help them speak with individuals who have opposing points of view or who may ascribe to nonscientifically supported beliefs while retaining trust, identifying common ground, and fostering acceptance and respect of divergent views. The game is currently under development and will be available on the web, free to access for participants worldwide, and accompanied by a promotional campaign to recruit participants through social media channels. This protocol describes the methodology for a randomized controlled trial that will compare participants who play The Good Talk! game with a control group that plays the widely known noneducational game Tetris. The study will evaluate a participant's open conversation skills, self-efficacy, and behavioral intentions to have an open conversation with a vaccine-hesitant individual both before and after game play.

RESULTS

Recruitment will commence in early 2023 and will cease once 450 participants complete the study (225 per group). The primary outcome is improvement in open conversation skills. Secondary outcomes are self-efficacy and behavioral intentions to have an open conversation with a vaccine-hesitant individual. Exploratory analyses will examine the effect of the game on implementation intentions as well as potential covariates or subgroup differences based on sociodemographic information or previous experiences with COVID-19 vaccination conversations.

CONCLUSIONS

The outcome of the project is to promote more open conversations regarding COVID-19 vaccination. We hope that our approach will encourage more governments and public health experts to engage in their mission to reach their citizens directly with digital health solutions and to consider such interventions as an important tool in infodemic management.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/40753.

A Software Engineering Framework for Reusable Design of Personalized Serious Games for Health: Development Study

BACKGROUND

The use of serious games in health care is on the rise, as these games motivate treatment adherence, reduce treatment costs, and educate patients and families. However, current serious games fail to offer personalized interventions, ignoring the need to abandon the one-size-fits-all approach. Moreover, these games, with a primary objective other than pure entertainment, are costly and complex to develop and require the constant involvement of a multidisciplinary team. No standardized approach exists on how serious games can be personalized, as existing literature focuses on specific use cases and scenarios. The serious game development domain fails to consider any transfer of domain knowledge, which means this labor-intensive process must be repeated for each serious game.

OBJECTIVE

We proposed a software engineering framework that aims to streamline the multidisciplinary design process of personalized serious games in health care and facilitates the reuse of domain knowledge and personalization algorithms. By focusing on the transfer of knowledge to new serious games by reusing components and personalization algorithms, the comparison and evaluation of different personalization strategies can be simplified and expedited. In doing so, the first steps are taken in advancing the state of the art of knowledge regarding personalized serious games in health care.

METHODS

The proposed framework aimed to answer 3 questions that need to be asked when designing personalized serious games: Why is the game personalized? What parameters can be used for personalization? and How is the personalization achieved? The 3 involved stakeholders, namely, the domain expert, the (game) developer, and the software engineer, were each assigned a question and then assigned responsibilities regarding the design of the personalized serious game. The (game) developer was responsible for all the game-related components; the domain expert was in charge of the modeling of the domain knowledge using simple or complex concepts (eg, ontologies); and the software engineer managed the personalization algorithms or models integrated into the system. The framework acted as an intermediate step between game conceptualization and implementation; it was illustrated by developing and evaluating a proof of concept.

RESULTS

The proof of concept, a serious game for shoulder rehabilitation, was evaluated using simulations of heart rate and game scores to assess how personalization was achieved and whether the framework responded as expected. The simulations indicated the value of both real-time and offline personalization. The proof of concept illustrated how the interaction between different components worked and how the framework was used to simplify the design process.

CONCLUSIONS

The proposed framework for personalized serious games in health care identifies the responsibilities of the involved stakeholders in the design process, using 3 key questions for personalization. The framework focuses on the transferability of knowledge and reusability of personalization algorithms to simplify the design process of personalized serious games.

Reducing older people's risk of fraud victimization through an anti-scam board game

This study adopted an experimental design to evaluate the effectiveness of an anti-scam education program for older adults. Participants in the experimental group (n = 55) first participated in an anti-scam board game and then joined another board game featuring local tea restaurants two weeks later, whereas such order was reversed for the control group (n = 54). Compared with the control group, participants in the experimental group reported significant increases in their self-efficacy in fraud prevention and awareness of scam situations, and a significant decrease in perceived susceptibility to scams immediately and two weeks after the intervention, demonstrating the immediate and the short-term effects of the anti-scam education program in reducing fraud victimization risk of older adults.

Successful learning with whiteboard animations - A question of their procedural character or narrative embedding?

Although whiteboard animations are increasingly used for educational purposes, there is little empirical evidence as to why such animations can enhance learning. To specify essential elements, their dynamic visual presentation, as well as their narrative embedding, were found to be theortically important. In a first Experiment (N = 133) with a 2 (presentation mode: static pictures vs. progressive drawing) x 2 (narrative context: with vs. without a narrative) between-subject factorial design, motivational, cognitive, affective variables, as well as learning outcomes, of secondary school students were measured. Results revealed that progressive drawing, as well as a narrative context, are mostly associated with an increase in learning-relevant variables. In a second experiment with the same sample and the same experimental design but a different whiteboard animation, results from Experiment 1 generalize to another learning content. Again, a progressive drawing, as well as a narrative context within whiteboard animation, fostered learning relevant variables as well as learning outcomes. Results are discussed considering the cognitive theory of multimedia learning, the contiguity effect as well as the instructional design theory of anchored instruction.

Who Engages and Why It Matters?

While the use and benefits of serious games in health care are increasingly recognized, the impact of individuals' game engagement remains understudied, limiting the potential for impact. This pilot study aims to describe game engagement and its associations with learning outcomes, sociodemographics, and health factors in women with advanced cancer receiving a 12-week self-advocacy serious game intervention. Game engagement was collected from study tablets and weekly self-reported surveys. Participants' game engagement was overall high but with large amounts of variation and did not differ by their sociodemographics and health factors. Participants with lower baseline symptom severity were more likely to repeat game scenarios, and those who engaged in all scenarios had higher connected strength post-intervention. Knowing what prevents patients with advanced cancer from engaging in the serious game enlightens ways to refine the gamified interventions. Future research is suggested to evaluate patients' engagement to deepen understanding of its impacts on learning outcomes.

Technology in psychology: a bibliometric analysis of technology-based interventions in clinical and health psychology

This study aimed to identify, synthesize, and evaluate the current state of research on the use of technology-based interventions in clinical psychology through 2017 as a recent innovative area of study. It was intended to provide a critical overview of trends in different tools and populations and identify future areas of interest. This paper focuses on studies published in psychological interventions in childhood, adolescents, adults, and geriatric populations using new technologies, including web-based intervention, virtual reality, augmented reality, mobile applications, and robotics, with particular attention to methodology. To achieve this aim, a systematic search was made in the ISI Web of Science for intervention, psychology, and the technological tools previously mentioned. The results of the study show that the use of information and communication technologies in psychology has been an innovative and growing field of study for the last 10 years. In total, 743 were included in this study. A growing trend has been observed in publications related to psychology and the use of technologies since 2007. Resea0rch topics were focused mainly on interventions on specific problems or disorders such as depression. The largest number of publications were found for the web-based intervention, in randomized clinical trials and applied to adults.

Mechanisms of change in external implementation support: A conceptual model and case examples to guide research and practice

Background

External implementation support (EIS) is a well-recognized feature of implementation science and practice, often under related terms such as technical assistance and implementation facilitation. Existing models of EIS have gaps related to addressing practice outcomes at both individual and organizational levels, connecting practice activities to intended outcomes, or grounding in well-established theories of behavior and organization change. Moreover, there have been calls to clarify the mechanisms of change through which EIS influences related outcomes.

Method

In this article, we theorize about mechanisms of change within EIS. Our theorizing process aligns with the approach advocated by Kislov et al. We aim to consolidate prior EIS literature, combining related constructs from previous empirical and conceptual work while drawing on our extensive EIS experience to develop a higher-order, midrange theory of change.

Results

Our theory of change is empirically and practically informed, conceptually situated within an established grand theory of change, and guided by eight practice principles and social cognitive theory. The theory of change proposes 10 core practice components as mechanisms of change within EIS. When used according to underlying theory and principles, they are believed to contribute to favorable practice outcomes at individual, team, organizational, and system levels. The model offers flexibility by recognizing the need for sequential support processes and the demand to practice in dynamic and responsive ways. Case examples are presented to illustrate major themes and patterns of the model in action.

Conclusions

The proposed model is intended to support prospective EIS studies by conceptualizing discernable practice components with hypothesized relationships to proximal and distal practice outcomes. The model can be behaviorally operationalized to compliment and extend competency-based approaches to implementation support practitioner (ISP) training and coaching. Over time, the model should be refined based on new empirical findings and contributions from ISPs across the field.

Different aspects of fraction understanding are associated selectively with performance on a fraction learning game

Fraction understanding seems a double-edged sword. On the one hand, it is an important predictor of later mathematical achievement. On the other hand, it is also one of the topics students struggle most in secondary math education. To complement traditional instruction, digital learning games were developed and found to successfully foster fraction understanding. However, so far, it is not known to what degree different aspects of fraction understanding (e.g., part-whole relations, fraction magnitude, fraction arithmetic) may be conveyed by such games. The current study evaluated selective associations of in-game performance of the fraction learning game Semideus with specific aspects of fraction understanding assessed using a comprehensive paper-pencil test. In Semideus, seventh graders (M_age=12.3years) from academic track secondary schools in Germany estimated the location of fractions on a number line and compared fractions according to their magnitude. Results replicated previous findings showing that in-game performance was significantly associated with mathematics achievement (i.e., math grades) and basic, whole number arithmetic skills. Moreover, we observed significant associations for aspects of fraction understanding closely matching mechanics of the learning game such as fraction number line estimation, fraction magnitude comparison and fraction ordering. These associations were observed for accuracy on the game's fraction learning tasks (e.g., estimation accuracy on the number line) but also generalized to game-based metrics such as virtual incentives (i.e., stars awarded in the game). This implies that the actual game mechanic may help to convey aspects of fraction understanding, substantiating ideas of intrinsic integration in game design.

Cognitive Training: A Field in Search of a Phenomenon

Considerable research has been carried out in the last two decades on the putative benefits of cognitive training on cognitive function and academic achievement. Recent meta-analyses summarizing the extent empirical evidence have resolved the apparent lack of consensus in the field and led to a crystal-clear conclusion: The overall effect of far transfer is null, and there is little to no true variability between the types of cognitive training. Despite these conclusions, the field has maintained an unrealistic optimism about the cognitive and academic benefits of cognitive training, as exemplified by a recent article (Green et al., 2019). We demonstrate that this optimism is due to the field neglecting the results of meta-analyses and largely ignoring the statistical explanation that apparent effects are due to a combination of sampling errors and other artifacts. We discuss recommendations for improving cognitive-training research, focusing on making results publicly available, using computer modeling, and understanding participants' knowledge and strategies. Given that the available empirical evidence on cognitive training and other fields of research suggests that the likelihood of finding reliable and robust far-transfer effects is low, research efforts should be redirected to near transfer or other methods for improving cognition.

Positive effects of online games on the growth of college students: A qualitative study from China

Objectives

This study aimed to explore the positive effects of online games on college students' psychological demands and individual growth.

Methods

A qualitative study design was carried out in September 2021. Semi-structured, in-depth, and individual interviews were conducted with a purposive sample of 20 undergraduates who played the online game "Glory of Kings" from six universities. Thematic analysis was employed to explore the positive features caused by "Glory of Kings".

Results

College students reported three positive effects of online games, namely, satisfying the need for personal growth, meeting the requirement of social life and promoting academic performance.

Conclusion

College educators and families should take advantage of the positive effect of online games to guide college students to use online games reasonably.

How does technology challenge teacher education?

The paper presents an overview of challenges and demands related to teachers' digital skills and technology integration into educational content and processes. The paper raises a debate how technologies have created new skills gaps in pre-service and in-service teacher training and how that affected traditional forms of teacher education. Accordingly, it is discussed what interventions might be applicable to different contexts to address these challenges. It is argued that technologies should be viewed both as the field where new competences should be developed and at the same time as the method used in developing learning environments for teacher students.

Business Simulation Games in Higher Education: A Systematic Review of Empirical Research

Over the last few years, business simulation games (BSGs) in higher education have attracted attention. BSGs tend to actively engage students with course material, promoting higher engagement and motivation and enabling learning outcomes. Increasingly, researchers are trying to explore the full potential of these games with an upsurge of research in the BSG field in recent years. There is a need to understand the current state of research and future research opportunities; however, there is a lack of recent systematic literature reviews in BSG literature. This study addresses this gap by systematically compiling online empirical research from January 2015 to April 2022. We followed PRISMA guidelines to identify fifty-seven (57) papers reporting empirical evidence of the effectiveness of BSGs in teaching and learning. Findings showed that BSGs improve learning outcomes such as knowledge acquisition, cognitive and interactive skills, and behaviour. The review also summarises different issues concerning the integration of BSGs into the curriculum, learning theories used in the selected studies, and assessment methods used to evaluate student achievement in learning outcomes. The findings of this review summarise the current research activities and indicate existing deficiencies and potential research directions that can be used as the basis for future research into the use of BSGs in higher education.

Improving Reading Skills Using a Computerized Phonological Training Program in Early Readers with Reading Difficulties

In the last years, there has been a big effort to identify risk factors for reading difficulties and to develop new methodologies to help struggling readers. It has been shown that early intervention is more successful than late intervention, and that intensive training programs can benefit children with reading difficulties. The aim of our study is to investigate the effectiveness of an intensive computerized phonological training program designed to improve reading performance in a sample of children with reading difficulties at the early stages of their reading learning process. Thirty-two children with reading difficulties were randomly assigned to one of the two intervention groups: RDIR (children with reading difficulties following a computerized intensive remediation strategy) (n = 20) (7.01 ± 0.69 years), focused on training phonemic awareness, decoding and reading fluency through the computational training; and RDOR (children with reading difficulties following an ordinary remediation strategy) (n = 12) (6.92 ± 0.82 years), which consisted of a reinforcement of reading with a traditional training approach at school. Normal readers (NR) were assigned to the control group (n = 24) (7.32 ± 0.66 years). Our results indicate that both the RDIR and RDOR groups showed an increased reading performance after the intervention. However, children in the RDIR group showed a stronger benefit than the children in the RDOR group, whose improvement was weaker. The control group did not show significant changes in reading performance during the same period. In conclusion, results suggest that intensive early intervention based on phonics training is an effective strategy to remediate reading difficulties, and that it can be used at school as the first approach to tackle such difficulties.

Contributions of the psychology of mathematical cognition in early childhood education using apps

Educational interventions are necessary to develop mathematical competence at early ages and prevent widespread mathematics learning failure in the education system as indicated by the results of European reports. Numerous studies agree that domain-specific predictors related to mathematics are symbolic and non-symbolic magnitude comparison, as well as, number line estimation. The goal of this study was to design 4 digital learning app games to train specific cognitive bases of mathematical learning in order to create resources and promote the use of these technologies in the educational community and to promote effective scientific transfer and increase the research visibility. This study involved 193 preschoolers aged 57–79 months. A quasi-experimental design was carried out with 3 groups created after scores were obtained in a standardised mathematical competence assessment test, i.e., low-performance group (N = 49), high-performance group (N = 21), and control group (N = 123). The results show that training with the 4 digital learning app games focusing on magnitude, subitizing, number facts, and estimation tasks improved the numerical skills of the experimental groups, compared to the control group. The implications of the study were, on the one hand, provided verified technological tools for teaching early mathematical competence. On the other hand, this study supports other studies on the importance of cognitive precursors in mathematics performance.

Online Assessment and Game-Based Development of Inductive Reasoning

The aims of the study were (1) to develop a domain-general computer-based assessment tool for inductive reasoning and to empirically test the theoretical models of Klauer and Christou and Papageorgiou; and (2) to develop an online game to foster inductive reasoning through mathematical content and to investigate its effectiveness. The sample was drawn from fifth-grade students for the assessment (N = 267) along with the intervention study (N = 122). The online figurative test consisted of 54 items: nine items were developed for each of the six inductive reasoning processes. The digital game-based training program included 120 learning tasks embedded in mathematical content with differential feedback and instructional support. The test had good psychometric properties regarding reliabilities, means, and standard deviations. Confirmatory factor analyses revealed that the six processes of inductive reasoning and the three latent factors of Similarity, Dissimilarity, and Integration could be empirically confirmed. The training program was effective in general (corrected effect size = .38); however, the process of cross-classification was not developed significantly. Findings could contribute to a more detailed understanding of the structure and the modifiability of inductive reasoning processes and could reveal further insights into the nature of fluid intelligence.

Impact of compulsory participation of medical students in a multiuser online game to learn radiological anatomy and radiological signs within the virtual world Second Life

Competitive game-based learning within Second Life enables effective teaching of basic radiological anatomy and radiological signs to medical students, with good acceptance and results when students participate voluntarily, but unknown in a compulsory context. The objectives of this study were to reproduce a competitive online game based on self-guided presentations and multiple-choice tests in a mandatory format, to evaluate its development and student perceptions compared to a voluntary edition in 2015 (N = 90). In 2016 and 2017, respectively, 191 and 182 third-year medical students participated in the game as a mandatory course activity. The mean (±SD) score of the game was 74.7% (±19.5%) in 2015, 71.2% (±21.5%) in 2016, and 67.5% (±21.5%) in 2017 (P < 0.01). Participants valued positively the organization and educational contents but found the virtual world less attractive and the game less interesting than in the voluntary edition. The experience globally was rated with 8.2 (±1.5), 7.8 (±1.5), and 7.1 (±1.7) mean points (±SD) in a ten-point scale, in the 2015, 2016, and 2017 editions, respectively (P < 0.05). Competitive learning games within virtual worlds like Second Life have great learning potential in radiology, but the mean score in the game decreased, acceptance of virtual world technology was lower, and opinion about the game was worse with a compulsory participation, and even worse when dropouts were not allowed. Under the conditions in which this study was conducted, learning games in three-dimensional virtual environments should be voluntary to maintain adequate motivation and engagement of medical students.

Immersive Virtual Reality Serious Games With DL-Assisted Learning in High-Rise Fire Evacuation on Fire Safety Training and Research

In case of fires in high-rise buildings, appropriate safe behaviors for leaving the high floors are the key to reducing injuries and increasing the chance of survival. Traditional training methods are often used to provide knowledge about a fire escape but may become ineffective in terms of knowledge acquisition and internalization. Serious games are an innovative teaching method, aiming at training and educating people in game environments. In recent years, immersive virtual reality has become popular in many educational environments. Various educational training programs are combined with serious games and attract more and more attention because they can make users feel highly involved and promote learning cognition. Therefore, this study proposed the fire safety training of high-rise building fire escape based on virtual reality and invited 140 college students to make explorations through this virtual situation. In addition, deep learning was integrated into the recommended safety training system, so that students could be trained in areas where concepts were ill-defined. According to the results, through the high-rise building fire escape training based on virtual reality, students’ fire safety skills were significantly improved and most students could use their behavioral skills in real situations, which has positive effects on promoting the development of fire escape knowledge. Finally, according to the analysis on the results of the DL-assisted learning system, some suggestions were made in this study on behavioral skills training for professional firefighters and researchers.

Live-Action Role Playing for Safety Training: Effectiveness Evaluation in two Italian Companies

Researchers, corporate decision-makers, government agencies, and international bodies want to know how to improve safety and limit the serious social and economic consequences of occupational injuries. Understanding how to deliver effective training is important to achieving this aim. Gamification is considered a new frontier in effective safety training. This study tested the use of gamification in safety training, considering two Italian companies that used a live-action role-play methodology called "PratiCARE la Sicurezza." Workers who were required by Italian law to receive safety training or retraining participated in a pre-post study. Collection of measures relating to knowledge, attitudes, behaviors, and perception of the health and safety climate took place at baseline and immediately after the intervention. Participants' average safety knowledge at the end of the training was significantly better than the initial level, indicating that the training improved workers' knowledge level.

The Benefits of Video Games on Brain Cognitive Function: A Systematic Review of Functional Magnetic Resonance Imaging Studies

Benefits of video games on cognitive function have been proved by increasing evidence. However, reasons for game-induced changes in cognitive function are still elusive. Therefore, this study conducted a systematic review of brain function activation changes in association with video games. We retrieved publications from three electronic databases (PubMed, Web of Science, and PsycInfo), with publication dates before 8 February 2021. After screening the study with fMRI data, 13 studies were included in this work, including 9 cross-sectional studies and 4 types of research. In this review, we summarized the potential benefits of video games on cognitive function and discussed the effects of different types of video games on cognitive function. In particular, we highlighted the effect of video games on attention ability and visuospatial ability and addressed the functional brain activation changes in frontal and parietal lobes and other related brain regions induced by games. Finally, we pointed out that when discussing the effect of video games on brain function, types of video games should be carefully categorized.

Determining an Evidence Base for Particular Fields of Educational Practice: A Systematic Review of Meta-Analyses on Effective Mathematics and Science Teaching

The call for evidence-based practice in education emphasizes the need for research to provide evidence for particular fields of educational practice. With this systematic literature review we summarize and analyze aggregated effectiveness information from 41 meta-analyses published between 2004 and 2019 to inform evidence-based practice in a particular field. In line with target specifications in education that are provided for a certain school subject and educational level, we developed and adopted a selection heuristic for filtering aggregated effect sizes specific to both science and mathematics education and the secondary student population. The results include 78 context-specific aggregated effect sizes based on data from over one million students. The findings encompass a multitude of different teaching strategies, most of which offer a measurable advantage to alternatives. Findings demonstrate that context-specific effect size information may often differ from more general effect size information on teaching effectiveness and adherence to quality standards varies in sampled meta-analyses. Thus, although meta-analytic research has strongly developed over the last few years, providing context-specific and high-quality evidence still needs to be a focus in the field of secondary mathematics and science teaching and beyond.

Decision-Makers’ Understanding of Cyber-Security’s Systemic and Dynamic Complexity: Insights from a Board Game for Bank Managers

Cyber-security incidents show how difficult it is to make optimal strategic decisions in such a complex environment. Given that it is hard for researchers to observe organisations’ decision-making processes driving cyber-security strategy, we developed a board game that mimics this real-life environment and shows the challenges of decision-making. We observed cyber-security experts participating in the game. The results showed that decision-makers who performed poorly tended to employ heuristics, leading to fallacious decision approaches (overreaction strategies in place of proactive ones), and were not always aware of their poor performances. We advocate the need for decision support tools that capture this complex dynamic nature.

Gamification in education: A scientometric, content and co-occurrence analysis of systematic review and meta-analysis articles

This study seeks scientometric, content and co-occurrence analysis of systematic review and Meta-analysis articles in the field of gamification in education. In terms of purpose, this is an applied study and regarding type, it is a scientometric and co-occurrence analysis. The researchers conducted a search in WoS, Scopus and PubMed databases. The abstract and full text of 25 out of 71 articles were selected to be included in the study. Then, the citation and altmetrics indicators were investigated. In addition, VOSviewer software was utilized to analyze and visualize keywords and map of articles. Finally, the full texts of all articles were analyzed to be provided more information about the types of analyses in these articles. The findings showed that 25 articles were published between 2016 and 2021. Co-occurrence map of articles showed that the three variables of motivation, learning, and engagement have been considered in gamified education studies and most studies have examined gamification in the e-learning environment. Finally, the content analysis of the articles showed that 344 articles were included and analyzed in these 25 systematic reviews and meta-analyses. The types of analyzes performed on these 344 articles categorized them in 7 categories including Country/Territory, Duration of intervention, Lessons/content and the level of gamified educational course, the number of learners, platforms, the game elements and the theories. The results of the study illustrate that different dimensions of the gamification in articles in the field of Education have been considered by the researchers.

Individual Differences in Digital Game-Based Supply Chains Management Learning: Evidence from Higher Vocational Education in Taiwan

This study aims to investigate the differences in the learning path and value between students of different genders and educational backgrounds in digital game-based learning in Taiwan’s higher vocational education. A game-based digital Supply Chains Learning System was used to explore the value network based on “system attributes—learning consequences—target value” from the perspective of the student. To investigate the research question, this study conducted a cross-analysis of differences in gender and education background. Findings from the study revealed that irrespective of gender and educational background in higher vocational education in Taiwan, students developed distinctively different learning paths, values, and emphasis from specific system attributes. These findings will not only enable trainers and educators to learn more about the differences in learning by individuals but will also serve as useful guidelines for the improvement of the teaching strategy used by digital games developers.

Development of intellectual and scientific abilities through game-programming in Minecraft

In recent years, the technological revolution has changed the way we see reality and interact with it. Inevitably, education and didactic planning have also had to deal with new technologies. Indeed, the presence of digital tools has radically changed people's lives since childhood. Many educational realities have exploited this digital transformation to speed up and specialize learning, customizing study plans and type of software according to age groups. The activity of the Digital Education Lab is part of this context. It is a digital education school which uses the game software Minecraft Education Edition to teach its students the fundamental principles of computer science, geometry and mathematics. This article discusses learning key science concepts through game learning. The analysis carried out allows to see that students are facilitated in learning complex scientific concepts when these are shown through the game and can therefore be "experienced". The learning of 186 students aged between 8 and 10, who are generally at the first approaches to the digital world, has been evaluated. To evaluate the acquisition of knowledge through these innovative methods, at the end of the didactic course we have administered anonymous tests through the Google classroom platform. The results show that learning through a game-software facilitates the learning of basic scientific information as well as fostering the capacity for interconnection and transversality.

Attention Detection in Virtual Environments Using EEG Signals: A Scoping Review

The competitive demand for attention is present in our daily lives, and the identification of neural processes in the EEG signals associated with the demand for specific attention can be useful to the individual’s interactions in virtual environments. Since EEG-based devices can be portable, non-invasive, and present high temporal resolution technology for recording neural signal, the interpretations of virtual systems user’s attention, fatigue and cognitive load based on parameters extracted from the EEG signal are relevant for several purposes, such as games, rehabilitation, and therapies. However, despite the large amount of studies on this subject, different methodological forms are highlighted and suggested in this work, relating virtual environments, demand of attention, workload and fatigue applications. In our summarization, we discuss controversies, current research gaps and future directions together with the background and final sections.

An investigation of traffic density changes inside Wuhan during the COVID-19 epidemic with GF-2 time-series images

In order to mitigate the spread of COVID-19, Wuhan was the first city to implement strict lockdown policy in 2020. Even though numerous researches have discussed the travel restriction between cities and provinces, few studies focus on the effect of transportation control inside the city due to the lack of the measurement and available data in Wuhan. Since the public transports have been shut down in the beginning of city lockdown, the change of traffic density is a good indicator to reflect the intracity population flow. Therefore, in this paper, we collected time-series high-resolution remote sensing images with the resolution of 1 m acquired before, during and after Wuhan lockdown by GF-2 satellite. Vehicles on the road were extracted and counted for the statistics of traffic density to reflect the changes of human transmissions in the whole period of Wuhan lockdown. Open Street Map was used to obtain observation road surfaces, and a vehicle detection method combing morphology filter and deep learning was utilized to extract vehicles with the accuracy of 62.56%. According to the experimental results, the traffic density of Wuhan dropped with the percentage higher than 80%, and even higher than 90% on main roads during city lockdown; after lockdown lift, the traffic density recovered to the normal rate. Traffic density distributions also show the obvious reduction and increase throughout the whole study area. The significant reduction and recovery of traffic density indicates that the lockdown policy in Wuhan show effectiveness in controlling human transmission inside the city, and the city returned to normal after lockdown lift.

Learning through Play: A Serious Game as a Tool to Support Circular Economy Education and Business Model Innovation

Despite the increasing attention on circular economy at the policy level, the implementation of circular business models in companies is still limited. Many companies are put off by the apparent complexity to translate the general concepts of a circular economy into their business practice. This paper presents the development and testing of a simulation board game that aimed to address this gap between theory and business practice. The board game, Risk&RACE, was developed with the purpose of enabling students and business executives to experiment with circular economy business models. The gameplay was tested with 120 users, and cognitive learning outcomes as well as learning dynamics were assessed using a survey. The results of the game workshops demonstrated that the game advanced the participants’ awareness of the need for a circular economy, their understanding of basic circular economy principles, and their insight in opportunities and challenges of circular business models at the company level. When reflecting on the game as a learning tool, players highlighted its engaging and realistic nature and praised how it stimulated strategic thinking. Complementing the gameplay with a debriefing discussion afterwards encouraged players to reflect upon their newly gained insights, deepening their learning experience.