Lee Allison, Goodman Stephanie, Chen Chen Miao, Landau Ruth, Chatterji Madhabi
Department of Anesthesiology and Critical Care, University of Pennsylvania, 3400 Spruce St, 680 Dulles, Philadelphia, PA, 19104, United States, 1 3055826077.
Department of Anesthesiology, Columbia University, New York, NY, United States.
JMIR Serious Games. 2024 Nov 19;12:e59047. doi: 10.2196/59047.
EmergenCSim is a novel researcher-developed serious game (SG) with an embedded scoring and feedback tool that reproduces an obstetric operating room environment. The learner must perform general anesthesia for emergent cesarean delivery for umbilical cord prolapse. The game was developed as an alternative teaching tool because of diminishing real-world exposure of anesthesiology trainees to this clinical scenario. Traditional debriefing (facilitator-guided reflection) is considered to be integral to experiential learning but requires the participation of an instructor. The optimal debriefing methods for SGs have not been well studied. Electronic feedback is commonly provided at the conclusion of SGs, so we aimed to compare the effectiveness of learning when an in-person debrief is added to electronic feedback compared with using electronic feedback alone.
We hypothesized that an in-person debriefing in addition to the SG-embedded electronic feedback will provide superior learning than electronic feedback alone.
Novice first-year anesthesiology residents (CA-1; n=51) (1) watched a recorded lecture on general anesthesia for emergent cesarean delivery, (2) took a 26-item multiple-choice question pretest, and (3) played EmergenCSim (maximum score of 196.5). They were randomized to either the control group that experienced the electronic feedback alone (group EF, n=26) or the intervention group that experienced the SG-embedded electronic feedback and an in-person debriefing (group IPD+EF, n=25). All participants played the SG a second time, with instructions to try to increase their score, and then they took a 26-item multiple-choice question posttest. Pre- and posttests (maximum score of 26 points each) were validated parallel forms.
For groups EF and IPD+EF, respectively, mean pretest scores were 18.6 (SD 2.5) and 19.4 (SD 2.3), and mean posttest scores were 22.6 (SD 2.2) and 22.1 (SD 1.6; F1,49=1.8, P=.19). SG scores for groups EF and IPD+EF, respectively, were-mean first play SG scores of 135 (SE 4.4) and 141 (SE 4.5), and mean second play SG scores of 163.1 (SE 2.9) and 173.3 (SE 2.9; F1,49=137.7, P<.001).
Adding an in-person debriefing experience led to greater improvement in SG scores, emphasizing the learning benefits of this practice. Improved SG performance in both groups suggests that SGs have a role as independent, less resource-intensive educational tools.
EmergenCSim是一款由研究人员开发的新型严肃游戏（SG），带有嵌入式评分和反馈工具，可再现产科手术室环境。学习者必须为脐带脱垂的紧急剖宫产实施全身麻醉。由于麻醉学实习生在现实世界中接触这种临床场景的机会越来越少，该游戏被开发为一种替代教学工具。传统的汇报（由主持人引导反思）被认为是体验式学习不可或缺的一部分，但需要教师的参与。对于严肃游戏的最佳汇报方法尚未得到充分研究。电子反馈通常在严肃游戏结束时提供，因此我们旨在比较在电子反馈的基础上增加面对面汇报与仅使用电子反馈时的学习效果。
我们假设，除了严肃游戏嵌入式电子反馈外，进行面对面汇报将比仅使用电子反馈提供更好的学习效果。
新手一年级麻醉科住院医师（CA-1；n=51）（1）观看关于紧急剖宫产全身麻醉的录制讲座，（2）进行一次包含26道题的多项选择题预测试，（3）玩EmergenCSim（最高分196.5分）。他们被随机分为仅接受电子反馈的对照组（EF组，n=26）或接受严肃游戏嵌入式电子反馈和面对面汇报的干预组（IPD+EF组，n=25）。所有参与者再次玩该严肃游戏，并被要求尽量提高分数，然后进行一次包含26道题的多项选择题后测试。预测试和后测试（每题最高分26分）是经过验证的平行版本。
EF组和IPD+EF组的预测试平均分分别为18.6（标准差2.5）和19.4（标准差2.3），后测试平均分分别为22.6（标准差2.2）和22.1（标准差1.6；F1,49=1.8，P=0.19）。EF组和IPD+EF组的严肃游戏分数分别为——第一次玩严肃游戏的平均分数为135（标准误4.4）和141（标准误4.5），第二次玩严肃游戏的平均分数为163.1（标准误2.9）和173.3（标准误2.9；F1,49=137.7，P<0.001）。
增加面对面汇报体验可使严肃游戏分数有更大提高，强调了这种做法的学习益处。两组严肃游戏表现的改善表明，严肃游戏可作为独立的、资源消耗较少的教育工具发挥作用。
