Game-based Intervention Research Articles

Effectiveness of a nursing board games in psychiatric nursing course for undergraduate nursing students: An experimental design

AimTo examine the effectiveness of a psychiatric nursing board game in an undergraduate psychiatric nursing course. BackgroundDidactic teaching fails to assist students in deepening their understanding of abstract concepts in psychiatric nursing. The game-based learning of professional courses can address the demands of digital-age students, which may improve their learning outcomes. DesignA parallel two-arm experimental design was adopted in a nursing college in southern Taiwan. MethodsThe participants were fourth-year students enroled in a college nursing programme in southern Taiwan. Simple random sampling was used to divide the class into intervention and control groups. The former participated in an eight-week game-based intervention course, while the latter continued to receive traditional instruction. In addition to collecting the students’ demographic data, three structural questionnaires were developed to examine the variation in students’ nursing knowledge and attitudes toward psychiatric nursing, as well as their learning satisfaction before and after the intervention. ResultsThere were a total of 106 participants, with 53 in each group. After the intervention, the two groups were significantly different in terms of their psychiatric nursing knowledge, attitudes and self-reported learning satisfaction. The intervention group’s scores were significantly higher than those of the control group across all three dimensions. This suggests the positive effects of the board game intervention on students’ learning outcomes. ConclusionThe research outcome can be applied in formative and undergraduate nursing education in teaching psychiatric nursing globally. The game-based learning materials developed can be used to train psychiatric nursing teachers. Future studies should recruit a larger sample and increase the follow-up time for assessing students’ learning outcomes, as well as examine the similarities and differences in the learning outcomes of students from different educational systems.

Digital game-based interventions for cognitive training in healthy adults and adults with cognitive impairment: protocol for a two-part systematic review and meta-analysis

IntroductionDigital game-based training interventions are scalable solutions that may improve cognitive function for many populations. This protocol for a two-part review aims to synthesise the effectiveness and key features of...

How does therapist guided game-based intervention program effect motor skills in children with Attention Deficit Hyperactivity Disorder?: Single blind randomised study design

BackgroundVirtual reality and game-based approaches to the rehabilitation process also brought an opportunity to design more accessible intervention programs.It was seen that many studies utilized trademarked and commercially available games, which were not originally designed as rehabilitation tools but were administrated by a rehabilitation professional to achieve the maximum therapeutic value. AimsStudy aims to investigate the effects of a Self-oriented game based program(SGBP)and Therapist Guided Game-based Intervention Program(TGGIP) on the motor skills of children with Attention Deficit Hyperactivity Disorder(ADHD). Methods and ProceduresThis study was designed as a single-blind, randomized, controlled trial. A total of 176 children with ADHD participated in the study and were randomly divided into two groups (TGGIP and SGBP). Intervention in both groups was done with a telerehabilitation methodology. Outcomes and ResultsAccording to the within-group comparisons of pre- and post-intervention BOT2-BF scores, there were significant increases in all sub-scores and the total score(p < 0.05). The comparison of the BOT2-BF all sub-scores and the total score changes between the groups showed significantly higher in TGGIP. Conclusion and ImplicationsTGGIP was found to be more effective compared to SGBP in improving motor skills of children with ADHD.TGGIP that we designed acts as a facilitator for therapists in using trademarked and easily accessible games for structured and supervised virtual reality and game-based rehabilitation.

Game-Based Solutions and the Plastic Problem: A Systematic Review

Plastic pollution is an urgent worldwide environmental issue affecting marine, freshwater and terrestrial ecosystems. Half of the global plastic production is dedicated to items only used once: the so-defined single-use plastic (SUP) items. Different strategies have been implemented to reduce SUP consumption. Game-based solutions are an emerging strategy to favour behaviour change. The present systematic review aims at providing a synthesis of the current evidence about the use of game-based solutions to encourage sustainable behaviours concerning plastic (i.e., consumption, avoidance, waste management, pollution). Relevant studies were identified via three databases: Scopus, ProQuest and Web of Science for qualifying papers published between 2015 and 2021. Twenty-two studies that employed or designed game-based interventions to address the plastic problem were included. Results suggest that there is still little research exploring the use of game-based solutions to address the plastic issue. The studies included in this review mostly aim at changing behaviours and raising awareness towards plastic pollution among the general public. Although findings suggest that game-based intervention can be promising in terms of engagement and motivation and increasing knowledge of the issue, there is still little research focused on proving actual behaviour change, especially over time and in different settings.

Games in Times of a Pandemic: Structured Overview of COVID-19 Serious Games.

The COVID-19 pandemic introduced an urgent need for effective strategies to disseminate crucial knowledge and improve people's subjective well-being. Complementing more conventional approaches to knowledge dissemination, game-based interventions were developed to create awareness and educate people about the pandemic, hoping to change their attitudes and behavior. This study provided an overview and analysis of digital and analog game-based interventions in the context of the COVID-19 pandemic. As major pandemics and other large-scale disruptive events are expected to increase in frequency in the coming decades, this analysis aimed to inform the design, uptake, and effects of similar future interventions. From November 2021 to April 2022, Scopus, Google, and YouTube were searched for articles and videos describing COVID-19-themed game-based interventions. Information regarding authorship, year of development or launch, country of origin, license, deployment, genre or type, target audience, player interaction, in-game goal, and intended transfer effects was extracted. Information regarding intervention effectiveness was retrieved where possible. A diverse assortment of 23 analog and 43 digital serious games was identified, approximately one-third of them (25/66, 38%) through scientific articles. Most of these games were developed by research institutions in 2020 (13/66, 20%) and originated in Europe and North America (38/66, 58%). A limited number (20/66, 30%) were tested on relatively small samples, using a diversity of research methods to assess the potential changes in participants' knowledge, attitudes, and behaviors as well as their gameplay experience. Although most of the evaluated games (11/20, 55%) effectively engaged and motivated the players, increased awareness, and improved their understanding of COVID-19-related issues, the games' success in influencing people's behavior was often unclear or limited. To increase the impact of similar future interventions aimed at disseminating knowledge and influencing people's attitudes and behaviors during a large-scale crisis, some considerations are suggested. On the basis of the study results and informed by existing game theories, recommendations are made in relation to game development, deployment, and distribution; game users, design, and use; game design terminology; and effectiveness testing for serious games.

Gamified Physical Rehabilitation for Older Adults With Musculoskeletal Issues: Pilot Noninferiority Randomized Clinical Trial

Resource-rich countries are facing the challenge of aging societies, a high risk of dependence, and a high cost of care. Researchers attempted to address these issues by using cost-efficient, innovative technology to promote healthy aging and regain functionality. After an injury, efficient rehabilitation is crucial to promote returning home and prevent institutionalization. However, there is often a lack of motivation to carry out physical therapies. Consequently, there is a growing interest in testing new approaches like gamified physical rehabilitation to achieve functional targets and prevent rehospitalization. The purpose of this study is to assess the effectiveness of a personal mobility device compared with standard care in the rehabilitation treatment of patients with musculoskeletal issues. A total of 57 patients aged 67-95 years were randomly assigned to the intervention group (n=35) using the gamified rehabilitation equipment 3 times a week or to the control group (n=22) receiving usual standard care. Due to dropout, only 41 patients were included in the postintervention analysis. Outcome measures included the short physical performance battery (SPPB), isometric hand grip strength (IHGS), functional independence measure (FIM), and the number of steps. A noninferiority related to the primary outcome (SPPB) was identified during the hospital stay, and no significant differences were found between the control and intervention groups for any of the secondary outcomes (IHGS, FIM, or steps), which demonstrates the potential of the serious game-based intervention to be as effective as the standard physical rehabilitation at the hospital. The analysis by mixed-effects regression on SPPB showed a group×time interaction (SPPB_I_t1=-0.77, 95% CI -2.03 to 0.50, P=.23; SPPB_I_t2=0.21, 95% CI -1.07 to 0.48, P=.75). Although not significant, a positive IHGS improvement of more than 2 kg (Right: 2.52 kg, 95% CI -0.72 to 5.37, P=.13; Left: 2.43 kg, 95% CI -0.18 to 4.23, P=.07) for the patient from the intervention group was observed. Serious game-based rehabilitation could potentially be an effective alternative for older patients to regain their functional capacities. ClinicalTrials.gov NCT03847454; https://clinicaltrials.gov/ct2/show/NCT03847454.

The untapped potential of Games for Health in times of crises. A critical reflection.

Given its promising role in public health to address hard to reach population groups, game-based interventions (i.e., Games for Health, G4H) have experienced growing interest in recent years. Therefore, it is surprising that they have played only a minor role during the COVID-19 pandemic. Hence, the aim of this paper is to reflect the opportunities and challenges of G4H especially during the pandemic but also with regard to future health crises. As commercial video games (i.e., those that primarily aim to entertain its users) were often used to deal with the containment measures during the COVID-19 pandemic, we call for greater cooperation with commercial game makers to distribute health-related messages via entertainment games. With regard to G4H we see a need to (i) strengthen the intervention theory underlying game-based applications, (ii) to enhance the appeal of games in order to maintain the interest of users in the long term, and (iii) to improve the evidence base using appropriate study designs. Finally, we argue for (iv) greater user involvement, both in terms of developing game-based approaches and as co-researchers in solving complex health problems.

Gamified Inoculation Against Misinformation in India: A Randomized Control Trial

Although the spread of misinformation is a pervasive and disruptive global problem, extant research is skewed towards “WEIRD” countries leaving questions about how to tackle misinformation in the developing world with different media and consumption patterns unanswered. We report the results of a game-based intervention against misinformation in India. The game is based on the mechanism of psychological inoculation; borrowed from the medical context, inoculation interventions aim to pre-emptively neutralize falsehoods and help audiences spot and resist misinformation strategies. Though the efficacy of these games has been repeatedly demonstrated in samples from Western countries, the present study conducted in north India (n = 757) did not replicate earlier findings. We found no significant impact of the intervention on the perceived reliability of messages containing misinformation, confidence judgments, and willingness to share information with others. Our experience presents a teachable moment for the unique challenges associated with complex cultural adaptations and field work in rural areas. These results have significant ramifications for designing misinformation interventions in developing countries where misinformation is largely spread via encrypted messaging applications such as WhatsApp. Our findings contribute to the small but growing body of work looking at how to adapt misinformation interventions to cross-cultural settings.

Examining the relationships between students’ perceptions of technology, pedagogy, and cognition: the case of immersive virtual reality mini games to foster computational thinking in higher education

Researchers are increasingly exploring educational games in immersive virtual reality (IVR) environments to facilitate students’ learning experiences. Mainly, the effect of IVR on learning outcomes has been the focus. However, far too little attention has been paid to the influence of game elements and IVR features on learners’ perceived cognition. This study examined the relationship between game elements (challenge, goal clarity, and feedback) as pedagogical approach, features of IVR technology (immersion and interaction), and learners’ perceived cognition (reflective thinking and comprehension). An experiment was conducted with 49 undergraduate students who played an IVR game-based application (iThinkSmart) containing mini games developed to facilitate learners’ computational thinking competency. The study employed partial least squares structural equation modelling to investigate the effect of educational game elements and learning contents on learner’s cognition. Findings show that goal clarity is the main predictor of learners’ reflective thinking and comprehension in an educational game-based IVR application. It was also confirmed that immersion and interaction experience impact learner’s comprehension. Notably, adequate learning content in terms of the organisation and relevance of the content contained in an IVR game-based application significantly moderate learners’ reflective thinking and comprehension. The findings of this study have implications for educators and developers of IVR game-based intervention to facilitate learning in the higher education context. In particular, the implication of this study touches on the aspect of learners’ cognitive factors that aim to produce 21st-century problem-solving skills through critical thinking.

How to Improve Self-regulation among Preschoolers

In this paper, a thorough review is provided of how different aspects of self-regulation are affecting a child's development and the manner in which they are influenced by various components of self-regulation in the process of development. The ability to self-regulation has been recognized to be one of the most essential components in the development of cognitive, behavioral, and academic abilities. It is noteworthy that there have been only a few studies that have specifically focused on preschoolers, who are proved to be at the perfect age to learn self-regulation. Therefore, the aim of this paper is to critically comment a number of recent studies on how to improve self-regulated skills in preschool children following a systematic review of recent research and gives some constructive opinions. It presents an analysis of three different types of interventions: physical activities, mindfulness practices, and game-based interventions. In spite of the strengths and weaknesses of each form of self-regulation learning, the paper concludes that both physical and game-based activities are more practical and acceptable to preschoolers, while mindfulness is suggested to apply among special groups. Additionally, at the end of the paper, two common disabilities which suffer from hard-wired deficiencies in the ability to self-regulate their development are also mentioned and discussed in order to encourage future research on these special groups. This paper provides some reference for follow-up research.

Criteria for the Dyslexic Games: A Systematic Literature Review

The advancement of technology has witnessed the increasing use of game-based intervention and it is proven beneficial for people with specific learning disorder such as Dyslexia. Initially developed for entertainment, a game is generally considered a tool with the key features of challenge, motivation, and rewards which add more fun and excitement to Dyslexia teaching and learning. Many game applications have been developed in the area; each incorporates several criteria to meet the specific needs of the dyslexics. To date, these criteria are still dispersed in numerous publications, leading to the duplication of basic games that have previously been developed by others. This study aimed to identify the dispersed criteria by adopting PRISMA approach in the systematic literature review, and analyze them to formulate a comprehensive guideline for future design and development of the dyslexic games. Five main databases were chosen which are Scopus, ACM Digital Library, EBSCO-host, Wiley and Web of Science (WOS). Out of 551 articles that have been screened, only 50 articles were eligible to be analyzed based on the relevancy to the criteria, and only 23 articles were included in the study after further screening. A total of 135 criteria were identified with some redundancies, and were further classified into four categories: device and platform; features; interface and gameplay. These criteria can be utilized by the educational game developers as reference when designing the dyslexic games. A better dyslexic-friendly games could be produced when the developers design it with their special learning needs in mind.

Effects of digital games training on hormonal responses and brain plasticity

Digital games are a ubiquitous part of almost all children’s and adolescents’ lives. At the same time gaming industry is ready to unlock new levels of growth in the coming years (Granik et al., 2014). A growing number of studies have already focused on the beneficial effects of digital games on various aspects of cognition and health. However, less emphasis has been given to the physiological biomarkers that operate in the background and cause various modifications in players’ mental and emotional states as well as their ability to be aware and take control over their decisions and actions. Hormones and neurotransmitters regulate homeostasis and determine to a significant extent humans’ health, state of mind, and self-awareness abilities. Neuroplasticity is now recognized as a crucial factor in acquiring new skills and abilities. The present study aims to investigate the impact of digital game-playing on hormone responses and neuroplasticity phenomena. To this objective, we conducted a literature review presenting the most representative experimental studies. The results showed that digital games have significant effects on hormone responses and neuroplasticity phenomena. Finally, we discuss the factors that may contribute to alterations in digital game players’ homeostasis. The findings of this review aim to contribute to the discussion regarding the design of targeted, novel game-based intervention tools that have the potential to improve homeostasis, drive positive neuroplasticity, accelerate metacognitive learning, and thereby promote mental and emotional well-being for both typical populations, but most importantly, for people with learning disabilities, mental and other disorders.

Active learning and education 4.0 for complex thinking training: analysis of two case studies in open education

This article focuses on empirically analyzing the final products designed by 147 academics from 11 countries who participated in an international open education movement workshop by answering the research questions “What are the techno-pedagogical components of the products designed by the participants to encourage the open educational movement? and what practice of the open educational movement is being executed?” The article starts with a conceptual basis that describes the concepts of Active learning, Education 4.0, Complex Thinking and Open Education. It presents (1) the case study methodology on which this research is based, (2) two case studies on open education, (3) a game-based intervention proposal to support instructors in training university students in complex thinking skills based on Education 4.0 technologies and game-based learning principles, (4) and a discussion of the findings and opportunities for further work in the area. The findings of this study reveal that (A) the use of emerging and 4.0 technologies in initiatives of the open education movement continue to increase; (B) most of the open education initiatives designed by academics participating in the workshops were focused on the production of OER; and (C) inclusive access to education and continuing professional development of teachers is a constant concern addressed in open education initiatives. The results of this research suggest that training and development interventions implying the creation or design of open education initiatives should focus on encouraging all kinds of open education practices (i.e. use, production, dissemination and mobilization).

Pilot-testing a Multiplayer HIV and Sexually Transmitted Infection Prevention Video Game Intervention for Black Adolescent Girls: Protocol for a Randomized Controlled Trial.

Black adolescent girls aged between 14 and 19 years are more likely than White girls to be diagnosed with a sexually transmitted infection (STI). As STI diagnosis is associated with an increase in the risk for HIV acquisition, an early intervention specifically tailored to Black adolescent girls is warranted. A web-based video game intervention has the potential to reach this demographic. Because studies of social and behavioral determinants of disease demonstrate the protective role of peer group structures on individual outcomes, a multiplayer game can facilitate opportunities to exchange and evaluate information, learn social norms, develop behavioral skills, and allow peers to influence attitudes and behavior. No prior research has examined the feasibility of a web-based multiplayer game intervention for this population. This study describes the protocol for a randomized controlled trial (RCT) pilot-testing the feasibility, acceptability, and limited efficacy of a multiplayer game-based intervention for increasing HIV and STI testing and condom use in Black adolescent girls. We enrolled 79 Black adolescent girls aged 14 to 19 years residing in the United States into a 2-arm parallel RCT. The intervention is a theory-based, community-informed, multiplayer game that can be played with peers on the web using videoconferencing software. The goal of the game is to empower Black adolescent girls to make healthy decisions regarding dating, relationships, and sex, thus reducing HIV and STI infection. Control condition participants received a list of resources after playing a time and attention control game. All study procedures were conducted via the internet. We conveniently sampled Black adolescent girls using web-based advertisements. Study assessments occurred at enrollment, 1 week, 1 month, and 4 months after enrollment. The primary outcome of this study is increased HIV and STI testing by Black adolescent girls. Secondary outcomes include increased condom use, self-efficacy to use condoms, positive attitudes toward condom use, intentions, harm perceptions, HIV and STI and pre-exposure prophylaxis knowledge, positive sexual norms, sexual communication with partners, and reduced incidence of sexual risk behaviors associated with HIV and STI transmission. Secondary outcomes also included assessment of intervention feasibility and acceptability. From February to April 2022, a total of 79 Black adolescent girls were enrolled, with 40 (51%) having been randomized into the intervention condition and 39 (49%) into the control condition. At baseline, participant ages ranged from 14 to 19 (mean 16.4, SD 1.23) years. Web-accessible game interventions overcome common impediments of face-to-face interventions presenting a unique opportunity to reach Black adolescent girls and improve their sexual health and self-efficacy. Trial data will provide information about the limited efficacy of the intervention and inform future web-based studies and a larger RCT aimed at improving the sexual health of Black adolescent girls. ClinicalTrials.gov NCT04108988; https://clinicaltrials.gov/ct2/show/NCT04108988. DERR1-10.2196/43666.

Effects of free play or artificial rules on young soccer players' individual tactical behaviour: a one-by-one analysis.

This study assessed the effects of playing freely and introducing artificial rules on individual tactical behaviour during the team-possession game phase in two youth soccer categories. Thirty-two developmental players from U-14 and U-16 teams participated in the study, which consisted of four identical training sessions and two test sessions performed before and after the intervention. Each team was divided into two balanced groups, free-play and conditioned, that faced each other during three eight-a-side games (Gk + 7 vs 7 + Gk) in all training sessions. The free-play groups played freely, while the conditioned ones did so constrained by artificial rules. Individual tactical behaviour was assessed during a non-constrained eight-a-side match by the distance to centroid, spatial exploration index, their entropy measures, and the regularity of each player's displacement on the length and width of the pitch using a local positioning system. In addition to the average outcomes of all the players all together, the one-by-one analysis considered the mean values of each player to appraise individual responses. While the average outcomes of all the players in both groups and categories barely changed (Cohen's d ≤ small), with a very high inter-player variability, the one-by-one analysis revealed that the training intervention affected each player's tactical behaviour differently. Introducing artificial rules decreased and raised considerably (Cohen's d ≥ moderate) in-width and exploratory regularities of most U-14 and U-16 players, respectively. Therefore, assessing the training effects of game-based interventions from the individual to the whole team may provide unique and meaningful insight regarding the tactical competence of each player.

Penggunaan Permainan Tic Tac Toe dalam Meningkatkan Kompetensi Pedagogik Mahasiswa PAI UIN Malang

Education in the 21st century demands developing strong pedagogical skills, including critical thinking, problem-solving, and communication abilities. This study explores using the Tic Tac Toe game as a learning method to enhance the pedagogical competence of Islamic Education students at UIN Malang. This research was conducted using an experimental method with the design of a Single Subject Experiment. This research demonstrates that this game-based intervention positively impacts students' pedagogical competence. The results show a significant average score increase from the baseline to the intervention phase, indicating that the Tic Tac Toe game can facilitate active learning, motivate participation, and assist in developing critical and strategic thinking skills. Although these results highlight the potential of games as effective learning tools, further research is needed to understand how and why this game impacts students' pedagogical competence in various contexts and disciplines

Magis – A magical adventure: Using a mobile game to deliver an ACT intervention for elementary schoolchildren in classroom settings

Studies of the effects of the COVID-19 pandemic have shown that this health emergency has affected especially young people. Supporting the well-being of children is thus particularly urgent. However, the high prevalence of ill-being among children requires novel approaches to providing help. Health care resources are limited, and many children did not receive support even before the pandemic. The current study presents a novel approach to delivering brief interventions for school-aged children. A mobile game based on acceptance and commitment therapy was used to increase psychological flexibility and well-being among 10 to 12-year-old schoolchildren. A sample of 106 students played the game in four weekly sessions as part of normal teaching practice in school. The effectiveness of the brief game intervention was examined as a universal intervention among the whole sample and among subgroups created on the basis of baseline psychological flexibility (i.e., based on the need for an intervention). The results show that higher psychological flexibility was associated with less emotional and behavioral problems, higher health-related quality of life, mood, and school satisfaction, and less loneliness (r = 0.46–0.63). While a significant effect was not detected in the whole sample, the subsample of children with initially high psychological inflexibility benefitted from participating in the intervention (Cohen's d = 0.35). These preliminary findings suggest that the brief game-based intervention can increase psychological flexibility among children when the need for an intervention is considered. Further research is necessary to examine the stability of improvements in psychological flexibility.

A systematic review and meta-analysis of randomized controlled trials on the effect of serious games on people with dementia.

An increase in dementia prevalence has been accompanied by increasing interest in new rehabilitation methods, such as serious games. Serious games hold the potential to postpone functional and cognitive declines in people with dementia by increasing their independence and engagement; however, the efficacy of serious games remains underexplored. This review was conducted to quantify the effects of serious games in people with dementia, including several newly published trials, with the hopes of contributing to evidence-based practice by offering support for clinical decision-making. Only randomized controlled trials (RCTs) assessing the impacts of game-based intervention programs compared with conventional therapy on cognitive function, instrumental and non-instrumental activities of daily living, or depression among people with dementia were included in this review. Meta-analyses were performed to determine the pooled standardized mean difference (SMD) of each outcome using a random-effects model. The final search identified 12 studies that met our criteria. Overall, serious games were found to improve cognitive function (pooled SMD: 0.34; 95% CI: 0.07-0.61) and alleviated depression (pooled SMD: -0.131; 95% CI: -1.85 to -0.77) in people with dementia. Serious games improve cognitive function and reduce depression in people with dementia. Future studies in this field should aim to evaluate and determine the long-term effect of these games.

Designing Computer Games to Teach Finance and Technical Concepts in an Online Learning Context: Potential and Effectiveness

Designing computer games to educate students is not a new technique. Not all disciplines, however, embed the same degree of cognitive load, and not all game design approaches are appropriate across contexts. Teaching technical business disciplines, such as finance, using a game imposes specific challenges, especially when the subject is offered online and to students who may not be from relevant technical backgrounds. However, there has only been limited attention concerning the use of game-based learning (GBL) for teaching finance at the higher education level, especially when delivered online. This article explores the potential of GBL to teach finance at an Australian university. We further present the outcomes of a survey of students’ experiences concerning the unique business simulation tool. The results reveal that while a game-based intervention can positively affect students’ learning in a technical discipline, such as finance, the design also needs to be such that the players can relate the experience to learning goals and practical needs for satisfactory outcomes. A defining aspect of this research is using Bayesian analysis, capable of gaining insights irrespective of sample size, yet not widely used in the higher education research area in favour of the frequentist analysis. Bayesian analysis shows a high probability of the educational game achieving positive or satisfactory ratings. Further, two aspects of a game—functionalities and usability and perception of impact—are particularly noted to influence the game’s overall rating. Overall, the outcomes from this research call for careful consideration of the learners’ requirements and capability towards ensuring an enjoyable outcome rather than just focusing on a game’s content or context.

Do games reduce maths anxiety? A meta-analysis

In this paper, we present the first meta-analysis of the efficacy of game-based interventions on reducing students’ levels of maths anxiety. After searching for randomised studies describing game-based interventions to reduce maths anxiety, 22 effect sizes with 913 participants described in 15 peer-review articles met the selection criteria. A random effects meta-analysis indicated a reduction of maths anxiety with a small effect size (mean effect size ES = −0.24, CI = [ − 0.47, −0.01]), marginally significant at 0.05 level but not robust to a leave-one-out sensitivity analysis. Several factors moderated the results: non-digital games were more effective, while digital games had a negligible mean effect size of ES = −0.10, CI = [ − 0.24, 0.03]. The effect size was also moderated by the total duration of the intervention, to the advantage of longer interventions, and by the type of gameplay: games had a greater effect on maths anxiety reduction when they promoted collaborative and social interactions. Such features were mainly present in non-digital games, while all bar one of the digital interventions used single-player games. The results obtained, which were particularly weak for digital games, indicated the need to develop and test games explicitly designed for maths-anxious students to increase the impact of game-based interventions. This will require investigation into the relationship between game features and maths anxiety through analysis of the behaviour of anxious and non-anxious students at play. Among the features that an anxiety-aware game could employ, we suggest collaborative gameplay, social interactions, adaptability, features promoting intrinsic motivation and embedding real-time measurements of maths anxiety in the game.