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Background: Gaming can serve as an educational tool to allow trainees to practice surgical decision-making in a low-stakes environment. LapBot is a novel free interactive mobile game application that uses artificial intelligence (AI) to provide players with feedback on safe dissection during laparoscopic cholecystectomy (LC). This study aims to provide validity evidence for this mobile game. Methods: Trainees and surgeons participated by downloading and playing LapBot on their smartphone. Players were presented with intraoperative LC scenes and required to locate their preferred location of dissection of the hepatocystic triangle. They received immediate accuracy scores and personalized feedback using an AI algorithm ("GoNoGoNet") that identifies safe/dangerous zones of dissection. Player scores were assessed globally and across training experience using non-parametric ANOVA. Three-month questionnaires were administered to assess the educational value of LapBot. Results: A total of 903 participants from 64 countries played LapBot. As game difficulty increased, average scores (p < 0.0001) and confidence levels (p < 0.0001) decreased significantly. Scores were significantly positively correlated with players' case volume (p = 0.0002) and training level (p = 0.0003). Most agreed that LapBot should be incorporated as an adjunct into training programs (64.1%), as it improved their ability to reflect critically on feedback they receive during LC (47.5%) or while watching others perform LC (57.5%). Conclusions: Serious games, such as LapBot, can be effective educational tools for deliberate practice and surgical coaching by promoting learner engagement and experiential learning. Our study demonstrates that players' scores were correlated to their level of expertise, and that after playing the game, most players perceived a significant educational value. [ABSTRACT FROM AUTHOR]

Background: While game-based learning has demonstrated positive outcomes for some learners, its efficacy remains variable. Adaptive scaffolding may improve performance and self-regulation during training by optimizing cognitive load. Informed by cognitive load theory, this study investigates whether adaptive scaffolding based on interaction trace data influences learning performance, self-regulation, cognitive load, test performance, and engagement in a medical emergency game. Methods: Sixty-two medical students from three Dutch universities played six game scenarios. They received either adaptive or nonadaptive scaffolding in a randomized double-blinded matched pairs yoked control design. During gameplay, we measured learning performance (accuracy, speed, systematicity), self-regulation (self-monitoring, help-seeking), and cognitive load. Test performance was assessed in a live scenario assessment at 2- and 6–12-week intervals. Engagement was measured after completing all game scenarios. Results: Surprisingly, the results unveiled no discernible differences between the groups experiencing adaptive and nonadaptive scaffolding. This finding is attributed to the unexpected alignment between the nonadaptive scaffolding and the needs of the participants in 64.9% of the scenarios, resulting in coincidentally tailored scaffolding. Exploratory analyses suggest that, compared to nontailored scaffolding, tailored scaffolding improved speed, reduced self-regulation, and lowered cognitive load. No differences in test performance or engagement were found. Discussion: Our results suggest adaptive scaffolding may enhance learning by optimizing cognitive load. These findings underscore the potential of adaptive scaffolding within GBL environments, cultivating a more tailored and effective learning experience. To leverage this potential effectively, researchers, educators, and developers are recommended to collaborate from the outset of designing adaptive GBL or computer-based simulation experiences. This collaborative approach facilitates the establishment of reliable performance indicators and enables the design of suitable, preferably real-time, scaffolding interventions. Future research should confirm the effects of adaptive scaffolding on self-regulation and learning, taking care to avoid unintended tailored scaffolding in the research design. Trial registration: This study was preregistered with the Center for Open Science prior to data collection. The registry may be found at https://osf.io/7ztws/. [ABSTRACT FROM AUTHOR]

Background: In recent years, serious games have been used as an educational method in various fields such as economy, marketing, military, education, and health as a training method. Pressure injuries (PIs) are a significant health problem and clinical quality improvement issue throughout the world. Implementation of prevention strategies has gained importance in all healthcare settings due to the negative effects of PIs. Educating patient relatives on PI prevention is essential. Aims: This study aimed to develop a serious game for the training of patient relatives on PI prevention and evaluate the game in terms of knowledge acquisition and its features. Methods: The study was carried out as a single-group quasi-experimental pre-test and post-test design in three stages between August 1, 2020-April 30, 2022. In the first stage educational content, knowledge assessment test, and game evaluation questionnaire were prepared. A web-based serious game (PreSore: Pressure Injury Prevention Game) was developed in the second stage. The participants played the game in the third stage, and data was collected. The study sample consisted of patient relatives (n=55). A knowledge assessment test (pre-test, post-test, and re-test) and a game evaluation questionnaire were administered for the data collection. Results: It was determined that there was a significant increase in knowledge scores after the PreSore game implementation (p <.001). Most of the participants indicated that the information in the game was easy to understand (98.2%), they wanted to share their educational experience with others with the digital game method (96.4%), and they found the game was authentic (94.5%). Conclusions: The study revealed that the PreSore game is a method that could be used to train patient relatives on PI prevention. Integrating the PreSore into daily practice in healthcare institutions and conducting prospective studies are recommended. [ABSTRACT FROM AUTHOR]

The potential of digital games, when transformed into Serious Games (SGs), Games for Learning (GLs), or game-based learning (GBL), is truly inspiring. These forms of games hold immense potential as effective learning tools as they have a unique ability to provide challenges that align with learning objectives and adapt to the learner's level. This adaptability empowers educators to create a flexible and customizable learning experience, crucial in acquiring knowledge, experience, and professional skills. However, the lack of a standardised design methodology for challenges that promote skill acquisition often hampers the effectiveness of games-based training. The four-step Triadic Certification Method directly responds to this challenge, although implementing it may require significant resources and expertise and adapting it to different training contexts may be challenging. This method, built on a triadic of components: competencies, mechanics, and training levels, offers a new approach for game designers to create games with embedded in-game assessment towards the certification of competencies. The model combines the competencies defined for each training plan with the challenges designed for the game on a matrix that aligns needs and levels, ensuring a comprehensive and practical learning experience. The practicality of the model is evident in its ability to balance the various components of a certification process. To validate this method, a case study was developed in the context of learning how to drive, supported by a game coupled with a realistic driving simulator. The real time collection of game and training data and its processing, based on predefined settings, learning metrics (performance) and game elements (mechanics and parameterisations), defined by both experts and game designers, makes it possible to visualise the progression of learning and to give visual and auditory feedback to the student on their behaviour. The results demonstrate that it is possible use the data generated by the player and his/her interaction with the game to certify the competencies acquired. [ABSTRACT FROM AUTHOR]

Sickle-cell Disease (SCD) is a major public health problem in Africa, and there are significant obstacles to its comprehensive management, particularly in terms of access to appropriate healthcare. This calls for inventive approaches to improve patients' prospects. Among the major challenges to be met are the primary and secondary prevention of certain serious complications associated with the disease, such as neurocognitive, motor and respiratory functional disorders. This perspective argues for the rapid creation of specific, cost-effective, technologysupported rehabilitation centres to advance SCD care, identify patients at high risk of stroke and implement tailored rehabilitation strategies. The TechnoRehabLab in Lubumbashi illustrates this shift in thinking by using cutting-edge technologies such as virtual reality (VR), serious games and mobile health to create a comprehensive and easily accessible rehabilitation framework. Diagnostic tools used to perform functional assessment can be used to identify cognitive, balance and walking deficits respectively. Transcranial Doppler enables early detection of sickle cell cerebral vasculopathy, making it possible to provide early and appropriate treatment. VR technology and serious games enable effective rehabilitation and cognitive stimulation, which is particularly advantageous for remote or communitybased rehabilitation. In the context of African countries where there is a glaring disparity in access to digital resources, the TechnoRehabLab serves as a tangible example, demonstrating the flexibility and accessibility of technology-assisted rehabilitation. This perspective is an urgent call to governments, non-governmental organisations and the international community to allocate resources to the replication and expansion of similar facilities across Africa. [ABSTRACT FROM AUTHOR]

Serious games aim to provide cognitive assessments that are more enjoyable and easier to self-administer, potentially leading to more frequent assessments. We carried out two studies examining the relationship between game-playing enjoyment, game difficulty, and cognitive (game) performance. In the first study, 16 participants played three serious games once a week over four weeks as part of an undergraduate course, but with relatively minor motivation in terms of course credits. In the second study, 14 participants played serious games over six sessions in a period of three weeks. Participants included graduate students receiving credit for the course project (a major component of the grade) and friends and family that they recruited. Performance in the more difficult tasks tended to improve over time in the second study, but not in the first. Participants from the first study showed an overall negative sentiment toward the games. However, participants from the second study enjoyed the majority of games except for the more difficult games that required players to temporarily hold and memorize information. Participants got significantly better in the more difficult working memory games, even though these games were less popular than the simpler games. Our interpretation of the results is that enjoyability is important in encouraging people to keep playing cognitive assessment games as time progresses, and that enjoyability helps in maintaining performance in easy games. Higher motivation on the other hand played a significant role in facilitating learning effects in difficult games as well as in maintaining enjoyability. [ABSTRACT FROM AUTHOR]

Chronic non-specific neck pain (CNNP) poses a substantial health and economic burden in China. This study introduces a gamified motion-sensing health application framework to address the limitations of existing health applications. The gamified cervical spine somatic exercise application employs motion capture technology alongside the smartphone's built-in sensors to simulate accurate somatic interactions. Controlled experiments and data analyses demonstrated that the application significantly outperformed traditional text and video interventions in relieving participants' neck pain by increasing their average daily activity and compliance with the cervical spine exercise routine. The neck pain level of the participants is quantified by the Neck Disability Index (NDI). The results from the controlled experiments demonstrate that this gamified approach significantly decreases the Neck Disability Index (NDI) score from 1.54 to 1.24, highlighting its ability to alleviate neck pain and increase user compliance. [ABSTRACT FROM AUTHOR]

Educational technology has advanced tremendously in recent years, with several major developments becoming available in healthcare professionals' education, including nursing. Furthermore, the COVID-19 pandemic resulted in obligatory physical distancing, which forced an accelerated digital transformation of teaching tools. This review aimed to summarize all the available digital tools for nursing undergraduate education developed from 2019 to 2023. A robust search algorithm was implemented in the Scopus database, resulting in 1592 publications. Overall, 266 relevant studies were identified enrolling more than 22,500 undergraduate nursing students. Upon excluding multiple publications on the same digital tool, studies were categorized into three broad groups: serious games (28.0%), gamified applications (34.5%), and VR simulations and other non-gamified digital interventions (37.5%). Digital tools' learning activity type (categories = 8), geographical distribution (countries = 34), educational subjects (themes = 12), and inclusion within a curriculum course (n = 108), were also explored. Findings indicate that digital educational tools are an emerging field identified as a potential pedagogical strategy aiming to transform nursing education. This review highlights the latest advances in the field, providing useful insights that could inspire countries and universities which have not yet incorporated digital educational tools in their nursing curriculum, to invest in their implementation. [ABSTRACT FROM AUTHOR]

The review explored how serious games are utilized for preventing adolescents' social exclusion. Four original articles were retrieved using six databases. The use of serious games to prevent adolescents' social exclusion was rare, but there are potential areas where serious games could be utilized. Serious games may be a promising new intervention to use in adolescents' social rehabilitation and social work, preventing social exclusion, reducing the risk of unemployment, lack of education and training. These early findings suggest using serious games as a part of adolescents' social work and social rehabilitation to prevent social exclusion among adolescents, along with other methods. [ABSTRACT FROM AUTHOR]

Repetitive tests on a learning material help schoolchildren to memorize and to learn this material. Psychologists call this phenomenon the testing effect. Skilled teachers use learning plays to embed routine tests in an engaging way. To widespread this practice, we propose a framework to digitize learning plays embedding routine tests into educational videogames. We have identified the smallest set of game design elements required to build an educational videogame out of a learning play. We have used the selfdetermination theory to group game design elements, and to define a breakdown structure for engagement engineering. This structure helps select the appropriate design elements for an engagement driver. We have applied the framework to digitize a learning play. We have tested the digital play with 238 schoolchildren who considered it as a video game. The video game tested a proposed pattern to create challenges allowing an engaging flow experience. The pattern increased responses (9%) and created time distortion (24%). Delivering rewards following variable schedules reduced errors (49%) and increased time distortion (16%). This research explores how to digitize learning plays into engaging educational video games and how to design engaging video games to remediate missed learning. [ABSTRACT FROM AUTHOR]

This paper delves into the potential advantages of integrating gamification into seismic risk management education, with a specific emphasis on the efficacy of serious games in augmenting the learning process. It offers an illustration of gamification within the framework of a seismic risk preparedness project involving multiple countries, languages, and cultures and across the time of the COVID-19 pandemic. The innovation of this approach largely lies in shifting the focus from competition, which is typical in most games, to collaboration. Three digital serious games were implemented to tackle facets of seismic risk management that are particularly favourable for empowering communities at risk. These games were first used in a hybrid event where students from Algeria, Morocco, and Italy engaged in gameplay both in person within their respective classrooms and remotely with classes in each country. The evaluation study showed the positive impact of gamification in captivating young participants and thereby instilling best practices in seismic risk management.

Definition: Game-based learning refers to an educational approach where games (digital or analogue) are used in order to engage students in interactive and immersive experiences designed to teach specific concepts, skills or subjects. Gamification refers to the application of game design elements, such as point systems, rewards, narratives, and competition, to non-game contexts. Game elements, mechanics and structures, when incorporated into the learning process, can enhance student understanding and increase engagement, motivation and retention of educational content. Teaching Biology can present challenges mainly due to the complexity of the subject matter, the different scales of biological organisation, and because it often includes challenging and counterintuitive concepts that may contradict students' preconceived notions. Integrating gaming into the high school Biology curriculum not only tackles the challenges of teaching complex concepts but can also promote student engagement. Customising gaming experiences to Biology intricacies enhances critical thinking and creates a dynamic learning environment tailored to the demands of high school biological education. This entry explores the integration of gaming and gamification in high school Biology education to overcome challenges in sustaining student interest. Additionally, the article highlights the diverse applications of games in education, showcasing their versatility in enriching the educational process. Future research should evaluate specific games, explore design principles, and consider challenges associated with implementation. In conclusion, using games in Biology education promises to enhance engagement, promote active learning, and deepen understanding, contributing to narrowing the gap in biological literacy. [ABSTRACT FROM AUTHOR]

Although user-generated microgames, defined as very simple games made by non-professionals on open platforms, are popular and appear to have considerable advantages in facilitating learning, further exploration is needed to establish their potential in instructional practices. The present study investigates the design, participation and experience of teaching and learning facilitated by user-generated microgames on an open educational platform. Through an exploratory experiment research method, four elementary school teachers designed and implemented microgame-based learning utilising these very small games on GeoGebra Classroom attended by 129 students. Data were gathered from lesson plans, classroom activity records and self-reflection questionnaires. This study revealed that teachers designed learning with various user-generated microgames and debriefing methods respecting learning content, but they shared comparatively similar scenarios by inserting microgame-based learning into the middle of the main session. The completion rate for the debriefing activity is minimum although the total joining times overshoot the number of students. Teachers found that user-generated microgames are acceptable to orchestrate short serious gaming sessions even though they are limited to one player with basic interfaces. Notwithstanding several disadvantages of these microgames recognised by students, such as missing learning instructions and inadequate interfaces, they so far enjoy learning by playing the games. The most critical implication of this study is to provide sufficient instructions and additional time for microgaming sessions in elementary schools to ensure sustainable completion of the briefing, playing and debriefing activities. [ABSTRACT FROM AUTHOR]

In search of a way to bring back the positive aspects of an internship into the curriculum, TU Delft identified serious games as a potential solution. The literature studied showed that games could increase motivation and understanding, leading to improve knowledge retention. This paper has brought these insights together in a framework identifying the benefits that contribute to knowledge retention but also the requirements and risks for the application of serious games to be addressed. These insights were used to explain the success of a longstanding business game course for advanced students first. Next was the development of a virtual reality practice in a first-year course to replace the lost internship. In this case, knowledge retention was improved significantly, albeit only by 5%. Furthermore, in light of the developed framework, the VR simulation is a more balanced approach with fewer risks compared to the more extensive master course. [ABSTRACT FROM AUTHOR]

Background: This study aimed to evaluate the effectiveness of a digital serious game intervention about COVID-19 on pre-registration nursing student knowledge. Method: This study included 282 nursing students from a university in Northern Ireland, with 210 students providing comparable pre-test and post-test results. The 'serious game' aimed to debunk common COVID-19 myths and provide accurate information about the virus. Participants completed a 25-item questionnaire before and after engaging with the game, which included true/false items based on the World Health Organisation's list of top COVID-19 myths. The data were analysed using paired t-tests to assess knowledge changes, and scores were calculated as percentages of correct answers. Results: A statistically significant improvement in COVID-19 knowledge was demonstrated among first-year nursing students who engaged with the serious game. The post-test scores (M = 92.68, SD = 13.59) were notably higher than the pre-test scores (M = 82.64, SD = 13.26), with a p-value less than 0.001. Conclusion: This research suggests that integrating serious games into undergraduate nursing education can effectively enhance COVID-19 knowledge. This approach is aligned with the evolving trend of employing technology and gamification in healthcare education. [ABSTRACT FROM AUTHOR]

This paper investigates the validity of ChatGPT as a tool to generate meaningful input for the serious game design process. Input is collected from game designers, students and teachers via surveys, individual interviews and group discussions inspired by a description of a simple educational drilling game and its context of use. In these mixed methods experiments ChatGPT 3.5 and 4.0 is prompted with the same description to validate findings with expert participants. In addition, the impact on the models' suggestions from integrating the expert's role (e.g., "Answer as if you were a teacher.", "game designer", or a "student") into the prompt is investigated. The findings show that ChatGPT can produce statistically similar input, depending on the group of experts. ChatGPT 3.5 outperforms 4.0 with the student input. The integration of expert's role in prompt is found to be unreliable, and necessary only with game designer input with the version 3.5 of ChatGPT. The practical implications are that multiple ChatGPT versions should be used when collecting input. In addition, it is shown that experts can provide unique insight to the development process. This research opens the discussion on the trustworthiness of ChatGPT generated input for serious game development. [ABSTRACT FROM AUTHOR]

This paper delves into the potential advantages of integrating gamification into seismic risk management education, with a specific emphasis on the efficacy of serious games in augmenting the learning process. It offers an illustration of gamification within the framework of a seismic risk preparedness project involving multiple countries, languages, and cultures and across the time of the COVID-19 pandemic. The innovation of this approach largely lies in shifting the focus from competition, which is typical in most games, to collaboration. Three digital serious games were implemented to tackle facets of seismic risk management that are particularly favourable for empowering communities at risk. These games were first used in a hybrid event where students from Algeria, Morocco, and Italy engaged in gameplay both in person within their respective classrooms and remotely with classes in each country. The evaluation study showed the positive impact of gamification in captivating young participants and thereby instilling best practices in seismic risk management. [ABSTRACT FROM AUTHOR]

Learning experiences based on serious games are employed in multiple contexts. Players carry out multiple interactions during the gameplay to solve the different challenges faced. Those interactions can be registered in logs as large data sets providing the assessment process with objective information about the skills employed. Most assessment methods in learning experiences based on serious games rely on manual approaches, which do not scalewell when the amount of data increases. We propose an automated method to analyse students' interactions and assess their skills in learning experiences based on serious games. The method takes into account not only the final model obtained by the student, but also the process followed to obtain it, extracted from game logs. The assessment method groups students according to their in-game errors and ingame outcomes. Then, the models for the most and the least successful students are discovered using process mining techniques. Similarities in their behaviour are analysed through conformance checking techniques to compare all the students with the most successful ones. Finally, the similarities found are quantified to build a classification of the students' assessments. We have employed this method with Computer Science students playing a serious game to solve design problems in a course on databases. The findings show that process mining techniques can palliate the limitations of skill assessment methods in game-based learning experiences. [ABSTRACT FROM AUTHOR]

Introduction: Sleep hygiene education (SHE) consists of environmental and behavioral practices primarily intended to reduce sleep problems. Currently considered ineffective as a stand-alone treatment, the manner in which the education is typically delivered may be ineffective for the acquisition of new knowledge. The purpose of this study was to determine if a more engaging teaching medium may improve the efficacy of sleep hygiene education. This study examined the use of game-based learning to teach SHE to individuals with sleep problems. Methods: 35 participants played the SHE games for 30 days. Differences in preand post-state anxiety and sleep quality measures were examined. Results: Participants had significant improvements in sleep quality and state anxiety after using the app for 30 days, although scores for the majority of patients remained elevated. Discussion: This pilot investigation provides initial evidence for the efficacy of a game-based approach to SHE. [ABSTRACT FROM AUTHOR]

Digital game technologies, that is, games and emerging game-based applications, are pervasively spread in society as a means of entertainment, education and exercise, amongst other uses. With this popularity, attention has been directed towards the accessibility of these technologies to people with disabilities to ensure equity, equal access to opportunities and realize earnings from a significant customer group. This study investigates: How is the attention of academic game accessibility research divided across game technologies, disability categories and use domains? And where is attention needed? To answer these questions, I conducted a review of research (162 manuscripts) on game technologies' accessibility published between 2016 and 2020, inclusive. The reviewed literature appears to have a utility focus (e.g. on education and health management) that relatively de-emphasizes the importance of game accessibility for entertainment or fun purposes. Auditory, motor and mobility disabilities, and emerging gamification, exergames, virtual reality (VR) and augmented reality (AR) are especially under researched in the academic domain. [ABSTRACT FROM AUTHOR]

Serious games have been gaining increasing attention in the field of digital game-based language learning (DGBLL). However, to incorporate serious games into foreign/second language (L2) classrooms, teachers must be prepared with requisite knowledge and skills. To this end, following PRISMA guidelines, this study conducted a systematic review of research on serious digital language learning games with two aims. The main objective of this study was to map out the issues pertaining to serious digital language learning games that are currently being addressed in empirical studies in the DGBLL area. The secondary objective was to leverage the findings to inform the development of a research-based framework of expertise for L2 teachers intending to incorporate serious digital game-based language learning (S-DGBLL) in their classrooms. Fifty articles published until April 2023 were analysed in terms of research methodologies, pedagogical characteristics, game design, and outcomes. The findings have implications for the proposal of an S-DGBLL teacher competence framework. [ABSTRACT FROM AUTHOR]

MyStoriesBag is a storytelling and game creation tool that aims to facilitate the sharing of cultural heritage by promoting a collaborative and participatory experience through user-generated content. The guided visual online editor allows users to actively create content and play the games they create. This emphasises the concept of sharing experiences, creating a sense of community, and strengthening the connection between users and their cultural heritage.

Obesity management can effectively reduce the risks and complications associated with obesity and improve the quality of life of patients. After assessing the advantages and limitations of various obesity management approaches, self-management has been strongly recommended due to the advantages of minimal side effects and lower costs compared to treatment via drugs and surgery. However, successfully implementing lifestyle intervention strategies requires scientific guidance and strong determination. With the development of electronic and information technology, lifestyle intervention has transformed considerably. A new concept, called Gamified Digital Therapeutics (GDTx), represents a gaming format with Digital Therapeutics (DTx). It can effectively enhance patient compliance and accessibility to chronic disease management. Here, we review recent studies on the application of GDTx for the self-management of obesity and discuss three aspects surrounding its completion rates, satisfaction levels, and effectiveness. In contrast to traditional approaches to obesity self-management, implementing GDTx effectively corrects unhealthy dietary and lifestyle habits, markedly enhancing the dissemination of nutritional and exercise-related health knowledge. Of particular significance is the evident improvement in the adherence of obese patients to weight loss programs. Despite numerous studies indicating that GDTx may offer an effective solution for obesity self-management, there are still several limitations in the medicalization of GDTx for self-management of obesity. This review aimed to provide a reference for subsequent studies and promote the widespread application of GDTx in obesity self-management to help reduce the obesity rate and alleviate the burden on obese patients.

This editorial discusses the potential benefits of gamification in promoting mental health. Traditional pharmacological treatments for mental health conditions often focus on managing symptoms but do not address the development of social skills and healthy lifestyle habits. Gamification, which incorporates game elements into educational and therapeutic activities, can make these activities more engaging and enjoyable, leading to improved mental health outcomes. The integration of gamification in mental health care requires further research, collaboration, and ethical considerations to maximize its positive impacts while minimizing potential risks. Embracing gamification has the potential to revolutionize mental health care and make interventions more accessible and effective. [Extracted from the article]

Spatial Computing has been a keen research area for innovations in healthcare due to its perceived virtual world that replicates the real world. The interactions, dimensions, physics can all be based on naturalistic principles. Extended Reality (XR) is a key element of spatial computing that includes Virtual Reality (VR), Mixed Reality (MR) and Augmented Reality (AR). Due to the potential of creation of realistic virtual world, healthcare applications that are gamified have come into light. Visual function testing is one of the applications which has a scope for designing a gamified testing in XR for the users’ portable eye testing at comfort of their home. However, a significant gap exists in the designing and understanding of these applications. This study examines 59 research papers discussing visual function testing and gamification in XR. The corpus has been reviewed for the devices used, accuracy obtained compared to gold standards, usability and game mechanics. Based on these, this review discusses the design consideration needed in developing a gamified XR visual function testing application to enhance the accuracy and engagement of the testing in the users.

Various educational resources have been incorporated into school curricula to support water education and related topics. In this paper, we present and test H2O-EduK, a serious game designed to introduce the urban water cycle to school children. H2O-EduK comprises seven mini-games designed to simulate the journey of pollutants generated from household activities and their impact on water quality. The game replicates this journey through pipes, wastewater treatment plants, and into rivers. To evaluate the game, we implemented two testing scenarios. In the first scenario, during last year’s Science Week, H2O-EduK was installed on two devices for children to play voluntarily. After playing, 18 participants aged 10 to 12 (that passed all the mini-games) answered three questions focused on game enjoyment, mechanics, and clarity of instructions using a smiley face rating system representing five levels of satisfaction. In the second scenario, 74 students aged 10 to 12 from two schools were divided into groups of 10 to 15 members. During one-hour sessions, they individually played the game and completed pre- and post-tests. A t-test was used to evaluate answers collectively and question-by-question independently. In the first test focused on game enjoyment, mechanics, and instructions, nearly 90% of participants expressed high satisfaction with the game, while approximately 70% indicated an understanding of their tasks. The results from the school tests indicate a significant improvement in students’ understanding of water cycle principles after playing the game. Post-test scores averaged 1.054 points higher than pre-test scores. Additionally, the question-by-question evaluation highlights areas of particular efficacy within the game, underscoring its potential to address specific learning needs H2O-EduK demonstrates its suitability for educational purposes, offering an engaging and effective platform for learning.

BACKGROUND: Although regulatory norms on work safety offer guidelines for organizing and preventing accidents, the construction site is an environment susceptible to deviations, sometimes due to the lack of effective training. To this end, technologies such as virtual reality become possibilities for innovations with great advantages, as they allow simulations, modeling, exploratory environments and games, which allow the user to create a greater connection and interest in the subject in question. OBJECTIVE: This study aimed to present the technological advances applied in safety-oriented training in the construction industry worldwide, emphasizing serious games through a systematic review of the literature. METHODS: The review was carried out using five scientific databases, with a research protocol to answer questions about the application of gamification to guarantee the safety of workers. RESULTS: Fifteen articles were evaluated, with descriptive, observational research and case studies. It was found that the use of technologies in construction safety is not yet a common reality in the sector, as it presents challenges and limitations, such as gameplay and issues related to cost. However, they show great potential as a dynamic solution in the training of civil construction workers, effectively collaborating in accident prevention and work safety. CONCLUSION: Several software programs and applications were found for creating three-dimensional scenes and for providing users with a customized experience according to the needs observed in the virtual interaction; building information modeling tools, which promote realistic project modeling; and equipment to visualize the scenes created. Furthermore, the possibility of combining traditional theoretical teaching with serious games was verified. However, gamification applicability is an alternative that still has limitations, in addition to the lack of flexibility in the rules imposed on the game, hampering users' authenticity in making decisions. [ABSTRACT FROM AUTHOR]

Significant research work has been undertaken related to the game-based learning approach over the last years. However, a closer look at this work reveals that further research is needed to examine some types of game-based learning approaches such as virtual reality serious games and LEGO Serious Play. This article examines and compares the effectiveness for learning Scrum and related agile practices of a serious game based on virtual reality and a learning activity based on the LEGO Serious Play methodology. The presented study used a quasi-experimental design with two groups, pre- and post-tests, and a perceptions questionnaire. The sample was composed of 59 software engineering students, 22 of which belonged to group A, while the other 37 were part of group B. The students in group A played the virtual reality serious game, whereas the students in group B conducted the LEGO Serious Play activity. The results show that both game-based learning approaches were effective for learning Scrum and related agile practices in terms of learning performance and motivation, but they also show that the students who played the virtual reality serious game outperformed their peers from the other group in terms of learning performance. [ABSTRACT FROM AUTHOR]

Serious games (i.e., digital games designed for educational purposes) can foster positive learning attitudes and are increasingly used as educational tools. Foodbot Factory is a serious game application (app) that helps children learn about healthy eating based on Canada's Food Guide principles and has demonstrated to increase nutrition knowledge among this group. This paper describes the process followed to expand Foodbot Factory's educational content and integrate immersive technologies and innovative features into the app. The revision process, which was guided by the Obesity-Related Behavioral Intervention Trials model, included the following phases: first, an interdisciplinary team of nutrition scientists, education experts, and computer scientists analyzed data from the original pilot study, recently published literature, and feedback from stakeholders to define areas to improve Foodbot Factory. The five original Foodbot Factory modules were evaluated by the team during weekly meetings, where the educational content, interactive features, and other elements that required updates (e.g., aesthetics and accessibility) were identified. Second, prototypes were created and refined until a final version of Foodbot Factory was approved. Nineteen children tested the updated Foodbot Factory and found it "easy to use" (89%) and "fun" (95%). The new version of Foodbot Factory contains 19 learning objectives, including 13 original and six new objectives. Interactive engagement features in the updated Foodbot Factory included augmented reality incorporated into two learning modules; new mini-games were created, including a memory game; an overhaul of the aesthetics; (e.g., new food images); and accessibility features were included to support users with cognitive and vision disabilities. [ABSTRACT FROM AUTHOR]

In this article we present a web-based e-book used in educational context for teaching road safety to first grade students. The tool is a collection of situations that are presented in a game-based form. The players solve each situation in order to receive points. At the end of the course there is a final evaluation based on the training gaming situations. We use Unity game engine and WebGL for the development of the educational tool. In addition, the tool is cross-compiled for android mobile devices. We evaluate the learning effectiveness of the web-based tool via the t-test, analyze the results and draw conclusions. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study was to assess the current curricular status of content on infection prevention in hospitals during medical education prior to the development of a serious game on infection prevention in hospitals. In addition, the data collected was to be contrasted with the training for a specialist nurse in hygiene and infection prevention (FKHI). Methodology: In an online survey, persons in charge of medical degree programs and continuing education centers for FKHI, SkillsLabs and professional associations in Germany were asked to answer 28 questions on framework conditions, teaching, examinations, and gamification. Results: Data was collected for 22 medical degree programs and 5 FKHI continuing education centers. Due to the low response rate, the data for the FKHI was only analyzed in summary form. On average, 13.5 teaching units (median) are available in medical studies. Six degree programs have a longitudinal curriculum. In 7 of the 22 degree programs, teaching is based on the National Competency-Based Learning Objectives Catalogue (NKLM). Almost all locations teach this content in lectures (n=18) and/or in internships (n=13). Teaching and examinations are most common in the third year of study (n=12). In addition to practical OSCE examinations (n=5), written (n=12) and computer-based (n=8) examinations are used in particular. Gamification is known as a didactic approach to some extent but is not used for teaching infection prevention. Conclusions: Infection prevention in hospitals is given relatively low priority in medical education. Teaching and examinations are based on traditional knowledge-oriented formats, although practical teaching and practical examinations are established at some locations. In contrast to the FKHI, learning objectives currently appear to be less standardized. Further interprofessional development of teaching would be desirable in the future. [ABSTRACT FROM AUTHOR]

This study investigates the impact of game-based learning (GBL), an increasingly popular educational approach, on the development of self-directed learning (SDL) skills in complex scenarios, particularly in undergraduate logistics education. A key component of the three year study is LOST (Logistics Education Simulator), a serious game platform, deployed in an undergraduate engineering course in Mexico. An extensive literature review was carried out using Scopus to examine recent works published between 2019 and 2024, providing a state-of-the-art overview of the field. Subsequently, a survey based on the scale created by Fisher, King and Tague (2001), known for its extensively evaluated internal consistency, revealed five distinct factors of self-directed learning. The findings underscore that the LOST platform significantly enhances self-directed learning, promoting the development of Self-management Skills, Openness to Learning Opportunities, Initiative and Independence in Learning, Self-concept as an Effective Learner, and Love of Learning. The students demonstrated a significant increase in their perception of these skills over the course of the study, highlighting the effectiveness of GBL in promoting such learning skills. These findings highlight the multidimensional nature of learning skills that can be fostered through GBL. The study concludes by discussing the vital role of GBL in complex scenarios, particularly in enhancing the development of self-directed learning skills in undergraduate logistics education. [ABSTRACT FROM AUTHOR]

It has been reported that electrical engineering schools might be facing a decline in newly enrolled students combined with an increase in the number of dropouts due to motivation and engagement problems. At the same time, companies in the electric power industry require safe and realistic training environments for their trainees to reduce induction program times, costs, and accidents. Game‐based learning (GBL) applications offer alternatives in both sectors, that is, education and training, for increasing engagement, motivation, and knowledge transfer in controlled environments. This paper aims to show applications of GBL techniques towards educational and training objectives in electrical power and energy systems in the period spanning from 2002 to 2021. This review points to two main research questions: what GBL tools have been used for education and training purposes in electrical power and energy systems during 2002 to 2021? Also, what are the methodologies used for assessing the efficacy of using GBL applications in electrical power and energy systems? A structured review methodology was applied to identify how GBL has been used in electrical power and energy systems. A total of 81 papers were selected for full review. The procedure included the formulation of research questions, identification and selection of studies, and data synthesis of results. Our review showed that most GBL applications in electrical power and energy systems were developed with education purposes (63%), from which 29% used graphic user interfaces and 23% used serious games. On the other hand, for training purposes, the most popular GBL tool was virtual reality, applications of which were discussed in 56% of the reviewed papers. The review also showed that only 42% of the education papers and 37% of the training papers performed learning efficacy analyses; in which qualitative postevaluations or postsurveys were the most popular methodologies used in over 50% of those papers. [ABSTRACT FROM AUTHOR]

In recent years, there has been a rising interest in using gamification to promote local intangible cultural heritage. Gamification can make cultural heritage more accessible and relatable by transforming traditional practices into interactive digital experiences. Traditional hand-woven fabrics of tribal communities of Northeast India represent their cultural expression and identity. However, industrialization and globalization have negatively affected the inheritance of the traditional weaving practice. Their traditional fabrics also carry a rich legacy of oral narratives, which are underappreciated and at risk of being lost due to lack of adequate documentation. This paper proposes a gamified system model to disseminate the oral cultural expressions associated with tribal fabrics and their textile heritage. It also integrates instructional design approach for creating a gamified learning environment for fostering cultural awareness and education among young generation of the tribal communities. This model may also offer a new approach for digitally archiving indigenous intangible cultural heritage.

Using a multidisciplinary approach, the current study examined the roles of psychological factors and serious games in the promotion of physical activity and wellbeing. The aim was to investigate the use and evaluation of a Web-based application named BehaviourCoach through the following research questions: How do users experience and evaluate this web-application for health promotion? How do elements of serious games and participants’ health status relate to intention to use this web-application? Participants (N = 55) engaged with BehaviourCoach for a duration of 45 minutes. Physical activity, psychological wellbeing, user experience, evaluation and intention to use a digital tool for health as well as demographic information were self-reported. On average, participants were sufficiently active as a group to meet the guidelines of 150 minutes per week of activity. They also reported moderate psychological wellbeing. The evaluation of the web application was positive, with participants expressing enjoyment, reporting that they found the game to support social interaction, and that the web application interface’s navigation was user-friendly. These factors were found to be positively related to intention to use the digital tool for health promotion in the future. In addition, participants’ levels of overall health and subjective wellbeing were predictive of intention to use the web-application for quick results. The study's implications for e-health interventions are discussed, as well as future directions.

Gamification, or gameful design, refers to the strategic application of game design principles, mechanics, and elements into non-game environments. It is often facilitated using digital platforms, aiming to solve problems, increase engagement, and motivate individuals towards their goals. The technique fosters a gameful and interactive experience, enhancing perceived autonomy, competence, and relatedness among users. With roots in fields like education, business, marketing, and services, gamification is a versatile tool that serves to enrich user experience and create value in a multitude of settings. The widespread impact of gamification across various sectors has transformed traditional methods of engagement, notably in education.

Educational technology has advanced tremendously in recent years, with several major developments becoming available in healthcare professionals’ education, including nursing. Furthermore, the COVID-19 pandemic resulted in obligatory physical distancing, which forced an accelerated digital transformation of teaching tools. This review aimed to summarize all the available digital tools for nursing undergraduate education developed from 2019 to 2023. A robust search algorithm was implemented in the Scopus database, resulting in 1592 publications. Overall, 266 relevant studies were identified enrolling more than 22,500 undergraduate nursing students. Upon excluding multiple publications on the same digital tool, studies were categorized into three broad groups: serious games (28.0%), gamified applications (34.5%), and VR simulations and other non-gamified digital interventions (37.5%). Digital tools’ learning activity type (categories = 8), geographical distribution (countries = 34), educational subjects (themes = 12), and inclusion within a curriculum course (n = 108), were also explored. Findings indicate that digital educational tools are an emerging field identified as a potential pedagogical strategy aiming to transform nursing education. This review highlights the latest advances in the field, providing useful insights that could inspire countries and universities which have not yet incorporated digital educational tools in their nursing curriculum, to invest in their implementation.

Definition: Gamification, or gameful design, refers to the strategic application of game design principles, mechanics, and elements into non-game environments. It is often facilitated using digital platforms, aiming to solve problems, increase engagement, and motivate individuals towards their goals. The technique fosters a gameful and interactive experience, enhancing perceived autonomy, competence, and relatedness among users. With roots in fields like education, business, marketing, and services, gamification is a versatile tool that serves to enrich user experience and create value in a multitude of settings. The widespread impact of gamification across various sectors has transformed traditional methods of engagement, notably in education. [ABSTRACT FROM AUTHOR]

The use of game-related assessments (GRAs) in personnel selection is increasing. However, the type of GRA under investigation should be considered. This study focuses on game-based assessments, which closely resemble leisure-oriented videogames. We specifically examined a serious game that assesses personality traits (assertiveness, sociability, tolerance, and rules). We analyzed its predictive validity, applicant reactions, and the impact of personal and job-related factors on scores. The study included 182 participants who played the GRA and completed a Big Five questionnaire. Findings revealed that the game predicts adaptive performance, offering incremental value over the Big Five (ΔR2 =.107). Additionally, candidates reacted more positively to the GRA in terms of comfort and fit, although the effect size was small (d = -0.1757 and -0.3119, respectively). Relating to personal and job-related characteristics, only job experience significantly affected the assertiveness score, albeit with a small effect size (d = -0.3870). [ABSTRACT FROM AUTHOR]

Aim: This commentary discusses the concept of 'gamification' as referred to implicitly or explicitly in the occupational therapy literature. Although occasionally noted to be a new frontier for occupational therapy, our analysis suggests that game mechanics and gamification elements are, in fact, a 'road long traveled' by occupational therapists and that gamification evokes the core aims and vision of occupational therapy. Gamification has been implicitly incorporated into the occupational therapy literature for years, and its benefit of enhancing therapeutic outcomes is evident in many instances. We contend that a more explicit use of the term gamification within the occupational therapy literature will lead to a framework in which both practitioners and researchers can structure and evaluate therapeutic outcomes. [ABSTRACT FROM AUTHOR]

This explorative case study investigates a game-based approach to the professional development of in-service teachers in Self-Regulated Learning. The impact of this approach was assessed in terms of acceptance of the game, knowledge gain and changes in teachers' beliefs concerning the importance of nine design principles that can be adopted to foster the development of students' SRL skills. Our findings suggest that the game-based approach adopted in this study was well-accepted, with Wilcoxon tests revealing that the mean rating is significantly different from the median point of the scale for all items measured after game use. As for teachers' learning gains and changes in beliefs, a questionnaire submitted to participants before and after the gameplay showed significant changes in knowledge and a more varied but generally positive trend in terms of changes in beliefs. Thus, the study's findings advocate for increased dedication to researching and experimenting with the incorporation of games in teacher professional development, potentially extending these efforts to other educational domains. [ABSTRACT FROM AUTHOR]

Extended Reality (XR) is an emerging technology that enables enhanced interaction between the real world and virtual environments. In this study, we conduct a scoping review of XR engines for developing gamified apps and serious games. Our study revolves around four aspects: (1) existing XR game engines, (2) their primary features, (3) supported serious game attributes, and (4) supported learning activities. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) model to conduct the scoping review, which included 40 primary studies published between 2019 and 2023. Our findings help us understand how current XR engines support the development of XR-enriched serious games and gamified apps for specific learning activities. Additionally, based on our findings, we suggest a set of pre-established game attributes that could be commonly supported by all XR game engines across the different game categories proposed by Lameras. Hence, this scoping review can help developers (1) select important game attributes for their new games and (2) choose the game engine that provides the most support to these attributes. [ABSTRACT FROM AUTHOR]

This study explores the application of Large Language Models (LLMs), such as ChatGPT, in designing educational board games, and be deployed as objects-to-think-with It aims to guide educators through three pivotal design phases: ideation, where ChatGPT suggests themes and mechanisms aligned with learning goals; customization, providing templates for tailored games; and feedback on prototypes to enhance game components and mechanisms. We also compared the use of ChatGPT in a game ideation process, contrasting with a traditional game design approach. Although offering a dynamic platform blending computational prowess and creativity, ChatGPT and similar LLMs pose challenges. They can exhibit biases from training datasets, affecting game inclusivity. They may also generate inaccurate details, propose counter-intuitive rules, and misinterpret feedback, resulting in unintended dynamics. Addressing these challenges necessitates a designer critical evaluation of LLM suggestions and the infusion of human creativity and intuition. This research advances discussions on AI in education by highlighting both the potential and the challenges of employing such innovative tools in developing serious games, aiming to foster a balanced and informed approach to integrating LLMs in educational game design. [ABSTRACT FROM AUTHOR]

In the last years, the promotion of practical, engaging, and enjoyable learning experiences has led to a shift in educational practices in the context of Higher Education. Currently, active learning participative approaches are prioritized involving in these methods the use of technological tools. In response to this shift, simulators and serious games have emerged as effective strategies in education. Serious games offer numerous benefits, including the promotion of critical thinking, creativity, problem-solving skills, and better knowledge retention. However, it is crucial to ensure that serious games are well-designed to maintain their appeal and playful nature. The establishment of definitions, especially during the initial stages of development, can prevent rework issues and lead to faster project goal achievement. This article emphasizes the importance and proposes the establishment of a methodology for creating computer games used for purposes beyond entertainment, focusing on learning, training, behavior change, or skill development. This systematic approach increases the likelihood of generating engaging, effective, and learning-friendly games. [ABSTRACT FROM AUTHOR]

Serious games (SGs) provide an opportunity to address social issues in an interactive environment that is particularly appealing and engaging for school-aged children. Gender stereotypes are one of the most prevalent gender-related issues in current society. Stereotypes appear at early ages and are a global problem, even if they are particularly prevalent in certain cultures and countries. This paper presents an early acceptance evaluation of Kiddo, a serious game, to address gender stereotypes in Mexico. The game has been designed to address four of the main gender stereotypes still present in children in Mexico, and it is intended to be used in classes by teachers to provide a common experience for the class and to start a discussion about gender stereotypes. The evaluation was carried out with a prototype of the game and consisted of two separate stages. First, we verified both the usability of the game and its acceptance with a sample including teachers and gender experts (10 participants). Second, we carried out a complete formative evaluation with teachers (32 participants) who will oversee the later application of the game to ensure their acceptance of the game as a tool to use in their classes. The initial results of both usability and acceptance questionnaires are promising and have provided a useful insight into the strengths and areas of improvement for the game, and they are being incorporated into the final version of Kiddo. Besides improving the game, these results are additionally being used to better understand teachers' perspectives and enrich the companion teacher pedagogic guide to simplify the game application in the classroom. [ABSTRACT FROM AUTHOR]

A gap between knowledge and adaptive action remains and psychological distancing has been proposed to explain peoples’ inaction. This presents a challenge to climate change communication and particularly to the conventional ways of providing scientific information. Serious games have proliferated in the last ten years with a focus on improving the way in which climate change is communicated with different types of audiences. However, empirical evidence for whether serious games focusing on the local understanding of barriers to action offers an opportunity to reduce the psychological distancing from climate change is lacking. This paper presents a case study of Minions of Disruptions, a collaborative board game developed by the Dutch NGO Day of Adaptation, which gamifies climate action by letting the players choose their own adaptation strategy and co-create their organizational story that is based on their local knowledge. The results of this paper show that the game experience succeeds in reducing psychological distance and cultivates agency. This finding provides a pathway toward communication strategies that provide a safe and fun environment in which participants interact to identify organizational and community-based issue areas where more resilience can be built.

Abstract Unlike traditional video games developed solely for entertainment purposes, game-based learning employs intentionally crafted approaches that seamlessly merge entertainment and educational content, resulting in captivating and effective learning encounters. These pedagogical methods include serious video games and gamification. Serious games are video games utilized as tools for acquiring crucial (serious) knowledge and skills. On the other hand, gamification requires integrating gaming elements (game mechanics) such as points, leaderboards, missions, levels, rewards, and more, into a context that may not be associated with video gaming activities. They can be dynamically (game dynamics) combined developing various strategic approaches. Operatively, gamification adopts simulation elements and leverages the interactive nature of gaming to teach players specific skills, convey knowledge, or address real-world issues. External incentives stimulate internal motivation. Therefore, these techniques place the learners in the central role, allowing them to actively construct knowledge through firsthand experiences. Anesthesia, pain medicine, and critical care demand a delicate interplay of technical competence and non-technical proficiencies. Gamification techniques can offer advantages to both domains. Game-based modalities provide a dynamic, interactive, and highly effective opportunity to learn, practice, and improve both technical and non-technical skills, enriching the overall proficiency of anesthesia professionals. These properties are crucial in a discipline where personal skills, human factors, and the influence of stressors significantly impact daily work activities. Furthermore, gamification can also be embraced for patient education to enhance comfort and compliance, particularly within pediatric settings (game-based distraction), and in pain medicine through stress management techniques. On these bases, the creation of effective gamification tools for anesthesiologists can present a formidable opportunity for users and developers. This narrative review comprehensively examines the intricate aspects of gamification and its potentially transformative influence on the fields of anesthesiology. It delves into theoretical frameworks, potential advantages in education and training, integration with artificial intelligence systems and immersive techniques, and also addresses the challenges that could arise within these contexts.