Gamification

Amy Kruger Howard

Pediatric Pharmacy Fellow

University of Maryland School of Pharmacy

Our goal as educators is to impart knowledge in a manner that leads to long-term retention, understanding and application. 

Over the last 30 plus years we have experience the emergence of video games and gaming culture.  In the last decade, games have taken on an increasing level of interactivity and hyperrealism, including the use of virtual reality and even incorporating players into physical spaces.  A 2005 National Summit on Educational Games found that attributes of gaming such as “contextual bridging (closing the gap between what is learned in theory and its use)” and ”personalization of learning” were key areas for application to educational resources.  In a participant consensus statement, the group encouraged partnership between the U.S. Departments of Education and Labor and the National Science Foundation, as well as private industry, to support further research and development of learning tools aimed at all levels of education, including adult learners.¹  The 2013-2014 American Association of Colleges of Pharmacy Academic Affairs Committee report also specifically endorsed the use of “serious games to enhance pharmacy and interprofessional education.”²

In the last two years, the American Journal of Pharmaceutical Education has published two educational briefs that address the use of gamification in pharmacy education.  In the 2017 article, Educational Gaming for Pharmacy Students - Design and Evaluation of a Diabetes-themes Escape Room, authors describe how they created an escape room simulation.  In order to unlock the room, student teams were required to complete a series of multi-step puzzles focused on diabetes management, including patient counseling and medication administration.  The competition incorporated use of an electronic tablet which allowed remote interaction with faculty members who provided hints, acted as simulated patients during medication counseling, and observed demonstrations of glucagon administration.  The activity was built to “complement and reinforce nine hours of prior didactic learning.”³

In Teaching About the Healthcare Industry Through Gamification, a student-lead competition was designed to improve knowledge about the healthcare industry utilizing a simulated stock market.  Both students and faculty were invited to take part in an investment fantasy league.  Each competitor was given $50,000 to virtually invest in healthcare companies defined as “the majority income… generated through healthcare-oriented products or services.”  On a weekly basis the competition was supplemented with student-led discussion topics which covered various aspects of investing and the healthcare market.  As an additional participation incentive, actually cash prizes were awarded to the top three competitors.⁴ 

Both studies used pre- and post-activity surveys to assess improvement in students’ knowledge (and self-perception of knowledge) as well as satisfaction/perceived value of the overall activity.  Eukel et al reported a statistically significant increase in knowledge test scores from pre- to post-test and students reported a positive perceived overall value for the exercise.  However, the study did not assess the ability of this interactive competition to lead to greater long-term knowledge retention.  One could reasonably hypothesize that after a 2-hour all-encompassing hands-on learning session about diabetes, students should be able to demonstrate increased understanding about disease management.  

Similarly, Wolf et al reported statistically significant increases in knowledge.  These finding may support the argument that gamification can increase long-term retention since the league took place over several months rather than as a single event.  Also notable was the observation that students applied clinical knowledge to critically evaluate drug trial outcomes as part of their investment strategy.  This integration of cross-over knowledge may support the summit consensus of game-based applications providing contextual bridging.

 

Within University of Maryland School of Pharmacy we have seen increasing use of gaming and competition to drive increased student engagement.  Certainly both studies and anecdotal evidence from classroom activities here, suggest that students find these activities highly engaging and more relatable to their preferred style of knowledge acquisition.  As the cohort of learners matriculating through the PharmD curriculum becomes more and more familiar with and raised in the gaming culture, use of technology and gamification may demonstrate increasing yield.  Knowing that adult learners are more amenable to familiar learning styles, incorporation of gaming is likely to be warmly received.  However, it still remains to be seen whether increased game use and student engagement can be translated into greater understanding and long-term retention.

1. Summit on Educational Games. Harnessing the Power of Video Games for Learning. 2006; Available from: http://www.fas.org/gamesummit/

2. Cain J, Conway JM, Divall M V., Erstad BL, Lockman PR, Ressler JC, et al. Report of the 2013-2014 academic affairs committee. Am J Pharm Educ. 2014;78(10):1–8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4315223/

3. Eukel HN, Frenzel JE, Cernusca D. Educational gaming for pharmacy students - Design and evaluation of a diabetes-themed escape room. Am J Pharm Educ. 2017;81(7). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5663657/

4. Wolf C, Bott S, Hernandez I, Grieve L. Teaching about the health care industry through gamification. Am J Pharm Educ. 2018;82(4):305–7. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5972850/