Gamification for the Win in Internal Medicine Residency: A Longitudinal, Innovative, Team-Based, Gamified Approach to Internal Medicine Board-Review

The House Cup: Using Longitudinal Gamification to Improve Didactic Attendance

OBJECTIVE

Determine if a point-based attendance system combined with longitudinal gamification is feasible and improves didactic session attendance and learner perceptions at our internal medicine residency.

METHODS

A prospective before-after cohort study. Weekly attendance was tracked from June 2022 through April 2023 at our university-affiliated internal medicine residency program. We implemented a point-based longitudinal game incentivizing residents to attend didactics with positive reinforcement in July 2022 (C: carrot). We added tiered positive reinforcement and positive punishment to the game in January 2023 (CS: carrot and stick). Attendance during these periods was compared to pre (P) and postintervention (S). Perceptions were assessed during the P, C, and CS periods with Likert scale ratings.

RESULTS

CS was associated with higher attendance than other study periods (P = .002). Median attendance was P-51% (IQR 37.5-64.5), C-65% (IQR 50-74), CS-81% (IQR 78-94), and S-66% (IQR 63-71). Perceptions were similar during pre and intervention study periods, including perceptions of camaraderie (P-4.4, C-4.4, CS-4.5; P = .56), interest in attending didactic sessions (P-3.7, C-3.4, CS-3.2; P = .21), and mandate as the primary reason for attending didactics (P-3.1, C-3.1, CS-3.2; P = .96).

CONCLUSIONS

A point-based attendance system combined with a longitudinal game that included tiered positive reinforcement and positive punishment was feasible and associated with higher didactic attendance but not associated with changes in resident perceptions.

Gamified Educational Learning Path on HIV/AIDS Stigma and Discrimination (REDXIR): Design, Development and Pilot Study

Background

HIV/AIDS-related stigma and discrimination are among the main barriers to controlling the HIV epidemic. Discriminatory behavior in healthcare settings deprives people of accessing high-quality health services.

Methods

This study presents the design, development, and pilot study of a novel web-based application ("REDXIR"), which is designed based on behavioral and gamification principles and aims to eliminate HIV/AIDS-related discriminatory behavior among health professions students. REDXIR storyline is set in an imaginary world where the students' journey is like a 10-level game, in which each level consists of several missions with a certain amount of score. The participants have to accomplish the mission to reach the minimum amount of score to pass each level. Finally, each becomes an individual who has not only the knowledge but also the competency to educate and advocate appropriately in the field.

Results

The pilot was done in six medical sciences universities in Tehran, Iran. The feasibility of the instructional design, specifically gamification strategies in the field of HIV education, and the executive functions to run the program on a bigger scale were evaluated. In total, 241 students were included and performed 1952 missions. The program evaluation showed a mean satisfaction score of 4.16 (from 1, the lowest, to 5, the highest) and participants considered their learning practical and gamification method appropriate for HIV education.

Conclusion

A meaningful gamification design for an online medical education program could be a suitable, functional, and applicable learning model to reduce HIV/AIDS stigma and discrimination among health professions students.

Novel Academic Tabletop 2022 (NAT22): A Dynamic Dice-Based Emergency Medicine Education Tool

Gamification is an effective teaching tool that improves engagement and knowledge retention. Tabletop role-playing games are dynamic games that use random chance and foster player/leader partnership. To date, there are no teaching tools that mimic dynamic or unpredictable patient presentations. This style of game may work well as a tool for medical education in a simulation-based modality. In this report, we document the rules, materials, and training required to reproduce a hybrid game created to combine facets of simulation and tabletop role-playing games (TRPGs) to create a dynamic medical education tool. After testing the game for flaws and fluidity of gameplay, we plan to collect data evaluating emergency medicine residents' enjoyability and knowledge retention. In this article, we describe a novel TRPG simulation hybrid game that we hypothesize will improve learner enjoyability/engagement and have similar educational benefits to standard medical education.

Flipped learning as an educational model in a cardiology residency program

INTRODUCTION

Flipped learning (FL) is a model which allows students to adjust their study rhythm by taking advantage of class time to apply their knowledge. Although FL meets many of the needs of the traditional lecture-based model and the exclusively virtual model, its effectiveness in medical residency programs has not been thoroughly studied. Our study evaluates the efficacy of an FL model in a cardiology residency program based on the satisfaction and academic performance of the participants.

METHOD

A prospective, observational, and descriptive study was conducted at Ignacio Chávez National Institute of Cardiology in Mexico City to evaluate the satisfaction and effectiveness of an FL model for acquiring competencies in electrocardiographic diagnosis among thirty-one first-year cardiology residents. The Advanced Electrocardiography Workshop and a virtual classroom were designed for the intervention. Four teachers taught the workshop and video classes, and ten medical specialists from the participants' areas of work performed evaluations of practical skills before and after the intervention.

RESULTS

75% of the participants rated the intervention as very favorable compared to the traditional and virtual models. The main advantages offered by the FL model were identified. An improvement of high statistical significance was observed in participants' academic performance after the intervention (P value < 0.001).

CONCLUSION

The FL model has a high degree of acceptance among participants and teachers. Our study shows an improvement in academic performance after the intervention. Considering that the FL model is flexible and reproducible in other areas of medicine, it represents an excellent educational alternative that meets current needs.