Abstract
BackgroundContinuing medical education is important but time-consuming for general practitioners (GPs). Current learning approaches are limited and lack the ability to engage some practitioners. Serious games are new learning approaches that use video games as engaging teaching material. They have significant advantages in terms of efficiency and dissemination.ObjectiveThe aim of this study was to create a serious game and to evaluate it in terms of effectiveness and satisfaction, comparing it with a traditional method of continuing education—article reading.MethodsWe produced a prototype video game called Hygie on the 5 most common reasons of consultation in general practice using 9 articles from independent evidence-based medicine journals (reviews from Prescrire and Minerva). We created 51 clinical cases. We then conducted a double-blinded randomized trial comparing the learning provided by a week of access to the game versus source articles. Participants were GPs involved as resident supervisors in 14 French university departments of family practice, recruited by email. Primary outcomes were (1) mean final knowledge score completed 3 to 5 weeks after the end of the intervention and (2) mean difference between knowledge pretest (before intervention) and posttest (3 to 5 weeks after intervention) scores, both scaled on 10 points. Secondary outcomes were transfer of knowledge learned to practice, satisfaction, and time spent playing.ResultsA total of 269 GPs agreed to participate in the study. Characteristics of participants were similar between learning groups. There was no difference between groups on the mean score of the final knowledge test, with scores of 4.9 (95% CI 4.6-5.2) in the Hygie group and 4.6 (95% CI 4.2-4.9) in the reading group (P=.21). There was a mean difference score between knowledge pre- and posttests, with significantly superior performance for Hygie (mean gain of 1.6 in the Hygie group and 0.9 in the reading group; P=.02), demonstrating a more efficient and persistent learning with Hygie. The rate of participants that reported to have used the knowledge they learned through the teaching material was significantly superior in the Hygie group: 77% (47/61) in the Hygie group and 53% (25/47) in the reading group; odds ratio 2.9, 95% CI 1.2-7.4. Moreover, 87% of the opinions were favorable, indicating that Hygie is of interest for updating medical knowledge. Qualitative data showed that learners enjoyed Hygie especially for its playful, interactive, and stimulating aspects.ConclusionsWe conclude that Hygie can diversify the offering for continuing education for GPs in an effective, pleasant, and evidence-based way.Trial RegistrationClinicalTrials.gov NCT03486275; https://clinicaltrials.gov/ct2/show/NCT03486275
Highlights
A total of 269 general practitioner PHP (GP) agreed to participate in the study
We conclude that Hygie can diversify the offering for continuing education for GPs in an effective, pleasant, and evidence-based way
A very favorable reception was given by most GPs who used the Hygie game, for its playful, interactive, and stimulating aspects, which supported the engaging learning experience
Summary
Serious games are new learning approaches that use video games as engaging teaching material. They have significant advantages in terms of efficiency and dissemination. New teaching materials called serious games are efficient [6,7] and disseminated methods for education [8]. They offer the possibility of combining learning activities such as testing [9], feedback [10], spaced repetition [11], and problem-based learning [12,13] with a positive experience. Serious games give active participation and autonomy to the learner, both of which are crucial qualities in adult education [17]
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