The Impact of Using a 3D Visual Metaphor Enhanced Serious Game to Teach Clinical History-Taking Content to Medical Students, Compared to Traditional Teaching

Abstract

Aim: To design and develop a novel interactive 3D visual metaphor enhanced serious game to teach medical students history-taking content and determine its impact on multiple learning outcomes compared to current teaching approaches. Methods: The literature on current teaching practices for history-taking content was systematically reviewed and followed by further literature reviews focusing on educational theories as well as the role of visual metaphors and serious games in medical education. A visual metaphor enhanced serious game was designed according to the Cognitive Load Theory design principles with a focus on the cardiac system. A pilot mixed-methods longitudinal study was conducted amongst 46 medical students in year 3 at the University of Auckland to assess the impact of the serious game compared to that of a textual PDF file. Multiple levels of the Kirkpatrick’s training evaluation model were used to assess the impact. Findings: Compared to baseline, both groups showed significant improvement in knowledge and self-efficacy longitudinally (p=<0.0001). Apart from the game group having a statistically significant difference in terms of satisfaction (p=<0.0001), there were no significant differences between groups in knowledge gain, self-efficacy, cognitive load, ease of use, acceptability or OSCE scores. However, qualitative findings indicated that the game was consistently more engaging, enjoyable and served as a visual aid compared with the PDF file. Conclusion: Students favoured learning through utilisation of a serious game with regard to cardiac history taking. This may be relevant to other areas of medicine and highlights the importance of innovative methods for teaching the next generation of medical students.