JMIR Serious Games最新文献

{"title":"Improvement of Game Users' Depressive Symptoms via Behavioral Activation in a Massive Multiplayer Online Game: Randomized Controlled Trial.","authors":"Kenji Yokotani, Masanori Takano, Nobuhito Abe, Takahiro A Kato","doi":"10.2196/73734","DOIUrl":"10.2196/73734","url":null,"abstract":"<p><strong>Background: </strong>Online games developed to improve mental health symptoms are reportedly effective among game users. However, it has not been verified whether massive multiplayer online games (MMOGs) developed for leisure purposes are effective in improving users' mental health symptoms.</p><p><strong>Objective: </strong>Based on 2 theoretical frameworks, this study examined whether MMOGs improve depression and social anxiety. First, behavioral activation theory posits that depressive symptoms improve through the repetition of reward-linked behaviors. Second, inhibitory learning theory suggests that exposure to social stimuli (eg, being the center of attention) previously perceived as threatening reduces fear responses over time.</p><p><strong>Methods: </strong>Participants were Pigg Party users with at least 3 months of previous experience. Overall, 1105 participants were randomly assigned to either the experimental (n=548) or waitlist groups (n=557). Participants in the experimental group were instructed to ring a friend's room bell (an action that clearly draws attention) on weekdays and to customize their avatars on weekends. Those completing ≥60% of the tasks received additional monthly rewards. The waitlist group received no interventions but was given random additional rewards. Both groups completed questionnaires on depression (Quick Inventory of Depressive Symptomatology) and social anxiety (Brief Liebowitz Social Anxiety Scale) at baseline, and again at 1, 2, and 3 months.</p><p><strong>Results: </strong>The experimental group showed a significantly higher frequency of bell ringing compared to that of the waitlist group (standardized mean difference [SMD]=0.13), whereas no significant difference was observed between the groups in avatar customization frequency. As predicted, the experimental group showed a significantly greater reduction in depressive symptoms, with a small effect size observed (SMD=-0.12). However, no significant difference was determined between groups in social anxiety symptoms.</p><p><strong>Conclusions: </strong>This study demonstrated that MMOGs, when combined with administrator-led interventions, can reduce users' depressive symptoms, albeit with a small effect size. Further studies are needed to test the intervention effects on social anxiety symptoms in MMOGs, with improved exposure scenarios.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e73734"},"PeriodicalIF":4.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Gamification Interventions to Improve Physical Activity and Sedentary Behavior in Children and Adolescents: Systematic Review and Meta-Analysis.","authors":"Min Wang, Jisheng Xu, Xulin Zhou, Xingchen Li, Yu Zheng","doi":"10.2196/68151","DOIUrl":"10.2196/68151","url":null,"abstract":"<p><strong>Background: </strong>Physical activity (PA) is critically linked to the health outcomes of children and adolescents. Gamification interventions represent a promising approach to promote PA engagement. However, the effects of these interventions on both PA and sedentary behavior (SB) in this population remain controversial. This review seeks to clarify this controversy.</p><p><strong>Objective: </strong>This systematic review aimed to evaluate the effectiveness of gamification interventions in enhancing PA and reducing SB in children and adolescents, while identifying potential moderators for PA promotion.</p><p><strong>Methods: </strong>We systematically searched PubMed, Web of Science, Embase, EBSCO, and Cochrane Library databases for randomized controlled trials (RCTs) published between January 1, 2010, and August 1, 2024. Included RCTs examined gamification interventions targeting PA, SB, daily step counts, and BMI in children and adolescents. Random-effects meta-analyses were performed using RevMan 5.4 (Cochrane) and Stata 18.0 (StataCorp), with subgroup analyses assessing moderating effects of theoretical paradigms, game elements, and intervention duration. Methodological robustness was evaluated via the Egger regression test, sensitivity analyses (leave-one-out method), and funnel plot inspection for publication bias.</p><p><strong>Results: </strong>A total of 16 RCTs involving 7472 children and adolescents (age range 6-18 y) were included. Our findings showed that the gamification interventions significantly increased moderate-to-vigorous physical activity (MVPA; standardized mean difference [SMD] 0.15, 95% CI 0.01 to 0.29; P=.04) and reduced BMI (SMD 0.11, 95% CI 0.05 to 0.18; P<.001). However, there was no significant improvement in SB (SMD 0.07, 95% CI -0.07 to 0.22; P=.33), vigorous physical activity (SMD 0.12, 95% CI -0.3 to 0.55; P=.56), moderate physical activity (SMD 0.16, 95% CI -0.2 to 0.53; P=.38), light physical activity (SMD -0.00, 95% CI -0.49 to 0.48; P>.99), and daily step count (SMD 0.22, 95% CI -0.51 to 0.94; P=.55). Subgroup analyses revealed significant moderation effects for MVPA improvement by theoretical paradigm, game elements, intervention duration, and study setting.</p><p><strong>Conclusions: </strong>This meta-analysis confirms that gamification interventions effectively increased MVPA in children and adolescents, with sustained effects persisting beyond follow-up. The efficacy of these interventions is significantly moderated by theoretical paradigms, game elements, and intervention duration. However, blinding infeasibility contributed to prevalent performance bias, potentially introducing detection bias for subjective SB and PA metrics. Future research should strengthen blinding protocols for outcome assessors, enhance allocation concealment reporting, and validate conclusions through high-quality RCTs.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e68151"},"PeriodicalIF":4.1,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual Reality for Workplace Violence Training of Health Care Workers: Pilot Mixed Methods Usability Study.","authors":"Daniel Isaiah Jackson, Thipkanok Wongphothiphan, John Luna, Tensing Maa, Mary A Fristad, Yungui Huang, Brittany Schaffner, Jennifer Reese, Jason Wheeler, Brandon Abbott, Emre Sezgin","doi":"10.2196/70817","DOIUrl":"10.2196/70817","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Workplace violence (WPV) is a growing concern in health care, adversely impacting frontline providers, patients, and visitors. Traditional training programs have demonstrated limited long-term effectiveness in equipping health care professionals with de-escalation and crisis management skills. Virtual reality (VR) may offer an opportunity to create an innovative, immersive, and engaging platform for WPV training that could address the limitation of conventional methods.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The aim of this pilot usability study was to assess the user experience of a prototype VR training course designed to prepare frontline health care staff for WPV scenarios. We evaluated the VR system's practicality, engagement, and perceived value and identified areas for improvement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A cross-sectional, mixed methods study was conducted with 13 frontline health care providers. Four pilot-training modules were developed and deployed in a VR environment on stand-alone headsets to address a variety of topics around WPV: Situational Awareness, Self-Awareness and Self-Regulation, Team Dynamics, and Evasive Maneuvers. Participants engaged with each module while providing qualitative feedback during the training. Qualitative feedback was analyzed using a rapid qualitative analysis technique. After completing the pilot training courses, participants completed surveys on usability (System Usability Scale) and user experience (mini Player Experience Inventory) and shared first impressions via Reaction Cards.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Participants found the pilot VR training to be engaging (mini Player Experience Inventory; mean 5.23, SD 1.34), with 89% of Reaction Card responses reflecting positive impressions such as \"valuable,\" \"creative,\" and \"accessible.\" However, the overall System Usability Scale score (mean 63.30, SD 9.53) indicated room for improvement in usability. Although participants identified the VR system as manageable and intuitive, first-time users experienced challenges navigating the virtual environment. We identified four themes from qualitative feedback: (1) Perceived Value, (2) Technical and Navigational Barriers, (3) User Preferences, and (4) Vision. Participants described the VR training modules as refreshing due to the immersion in complex environments and noted areas for improvements in the tone and emotional expressiveness of nonplayer characters.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Despite reported limitations, VR training has the potential to be a useful WPV training tool. It offers an immersive, hands-on, and safe environment for health care professionals to practice but may present challenges in engaging learners with the training objectives initially. While overall engagement and value in the training were high, refining dialogue realism and technical usability will support wider adoption. Future iterations of the pilot material may benefit from exploring r","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e70817"},"PeriodicalIF":4.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: FITLIGHT Training and Its Influence on Visual-Motor Reactions and Dribbling Speed in Female Basketball Players: Prospective Evaluation Study.","authors":"Ahmad K Hassan","doi":"10.2196/82614","DOIUrl":"10.2196/82614","url":null,"abstract":"","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e82614"},"PeriodicalIF":4.1,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12431159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145053318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ADRENALINE, a Learning Game to Improve Prescribing Skills in Undergraduate Medical Students: Descriptive Study.","authors":"Cecile Marie Yelnik, Aurélie Daumas, Yanele Poteaux, Annie Standaert, Natacha Grimbert, Raphaël Favory, Pierre Ravaux, Marc Lambert, Katia Quelennec","doi":"10.2196/66334","DOIUrl":"10.2196/66334","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Junior doctors often demonstrate insufficient prescribing skills, highlighting the need to enhance undergraduate medical training in this area. Serious games (SGs) have proven effective in teaching knowledge and skills across various medical specialties including surgery and emergency care. To our knowledge, no SG specifically dedicated to prescribing has been developed to date. Our objective was to develop a new educational program, based on a learning game designed to enhance medical students' competencies in safe and effective prescribing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to describe ADRENALINE, a learning game designed to promote safe and effective prescribing, and to report feedback from sixth-year undergraduate medical students at our medical school after the first year of its implementation in the therapeutics curriculum.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study implemented an interactive educational program based on Kolb experiential learning theory to enhance safe and effective prescribing skills among sixth-year medical students. The program followed 3 phases: a preliminary in-person lecture introducing the SG ADRENALINE, autonomous gameplay, and a final debriefing lecture. ADRENALINE, accessible via university platform Moodle (Andrews Lyons) on multiple devices, was developed using MOSAIC software (Katia Quelennec), a software program created to develop evolutive SG based on real-life professional situations, and includes 20 realistic clinical scenarios of varying difficulty, requiring students to make therapeutic decisions and receive immediate feedback. Players advance through levels based on performance, with ongoing support from professors via feedback and a dedicated forum. The program was integrated into the therapeutic curriculum of Lille University, and participation was voluntary. All 598 sixth-year students were invited to access the game via email and to participate in pre- and postintervention surveys assessing usage patterns, satisfaction, and learning outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Between November 2023 and March 2024, 272 sixth-year students accessed the ADRENALINE program. Of these, 201/272 (73.9%) students completed at least one scenario and obtained scores ranging from 16.5 to 100 out of 100. Pretest survey responses (n=99 answers) indicated that 92/99 (93%) students identified as gamers and believed that SGs could be relevant for their medical education. Posttest survey responses (n=50 answers) reflected a high level of satisfaction among participants. Most students reported that ADRENALINE helps them apply academic knowledge in real-world context, feel more confident with prescribing and managing adverse drug reactions, improve their prescribing skills, and better prepare for the national Objective Structured Clinical Examination.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;We developed a learning game focused on medical prescribing, designed to be easily shared","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e66334"},"PeriodicalIF":4.1,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12437880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilizing Gamification, Artificial Intelligence, and mHealth for the Professional Development of Maternal Care Providers: Exploratory Pilot Cross-Sectional Study Assessing Providers' Satisfaction in Primary Health Care Centers in Lebanon.","authors":"Mohamad Alameddine, Nadine Sabra, Nour El Arnaout, Asmaa El Dakdouki, Mahmoud El Jaouni, Randa Hamadeh, Abed Shanaa, Shadi Saleh","doi":"10.2196/53735","DOIUrl":"10.2196/53735","url":null,"abstract":"<p><strong>Background: </strong>High maternal morbidity and mortality rates globally, especially in low-income and lower-middle-income countries, highlight the critical role of skilled health care providers (HCPs) in preventing pregnancy-related complications among disadvantaged populations. Lebanon, hosting over 1.5 million refugees, is no exception. HCPs face significant challenges, including resource constraints and limited professional development opportunities, underscoring the need for continuous learning and innovative educational interventions. Artificial intelligence (AI) and gamification show promise in enhancing clinical performance and evidence-based practice.</p><p><strong>Objective: </strong>Considering the limited evidence on the effectiveness of integrating gamification and AI in a mobile app for professional development of HCPs providing maternal health services, this pilot study aims to assess the satisfaction and acceptability of HCPs with a novel mLearning tool, titled the \"GAIN MHI\" app (gamification, artificial intelligence, and mHealth network for maternal health improvement), at selected primary health care centers in Lebanon.</p><p><strong>Methods: </strong>This is a cross-sectional study that presents data collected from 12 participating HCPs, primarily obstetricians and midwives who have been using the GAIN MHI mobile app for professional development and learning. The survey used included Likert scale questions to assess HCPs' satisfaction, engagement, and evaluation of the gamification and AI components of the app. Open-ended questions gathered qualitative feedback on app preferences and potential improvements. Statistical analysis was performed to derive insights from the quantitative data collected. Subsequently, a descriptive analysis was performed, presenting the frequencies and percentages of various participant characteristics, as well as responses to the survey across all sections.</p><p><strong>Results: </strong>A total of 85% (n=10) of the HCPs, including midwives and doctors, were satisfied with the GAIN MHI mobile app, the user interface, and various content features. Engagement levels were robust (64.6%, SD 6.2%), notably impacting clinical routines and theoretical knowledge. The gamification and AI components garnered strong positive feedback, enhancing learning enjoyment (11/12, 92%). From a qualitative perspective, users expressed appreciation for the app's diverse content, user-friendliness, and motivation for continuous learning. Suggestions for expanding the content included a wide range of health topics, highlighting the app's potential applicability in various health care fields.</p><p><strong>Conclusions: </strong>HCPs, especially those practicing in underserved areas, face challenges in accessing professional development opportunities, highlighting the need for innovative pedagogical approaches using mobile technologies. This pilot study underlines the potential of using AI-based digital solutions","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e53735"},"PeriodicalIF":4.1,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12422396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of a Board Game on Tic Management and Psychosocial Functioning in Adolescents With Tourette Syndrome: Randomized Controlled Trial.","authors":"Mei Yin Lee, Huei Shyong Wang, Chung Yueh Lien, Zhi Hong Chen","doi":"10.2196/76208","DOIUrl":"10.2196/76208","url":null,"abstract":"<p><strong>Background: </strong>Tics and comorbidities significantly impact the social interactions and mental health of adolescents with Tourette syndrome (TS). Psychoeducation is an initial intervention for TS. Gamification is a common psychoeducational intervention for youths with chronic conditions. However, the effectiveness of board games in improving tic severity and mental health in adolescents with TS remains underexplored.</p><p><strong>Objective: </strong>We developed a serious board game to investigate its effects on tic severity, mental health, social adjustment, and depression in adolescents with TS.</p><p><strong>Methods: </strong>A single-blinded, 2-arm, parallel randomized controlled study was conducted. From September 2022 to July 2024, participants were recruited from a medical center in northern Taiwan. Seventy-nine adolescents with TS aged 12 to 18 years were randomly assigned to either a control group (n=39) or an intervention group (n=40). Both groups received care as usual (daily pyridoxine [50 mg] and psychoeducation), while the intervention group additionally participated in a weekly 60-minute board game session over a 4-week period. Outcome measures included the Yale Global Tic Severity Scale, Positive Mental Health Scale, Social Adjustment Scale for Adolescents with TS, and Beck Youth Inventory II - Depression scale.</p><p><strong>Results: </strong>Generalized estimation equation results showed that, compared to the control group, the intervention group demonstrated significant improvements in positive mental health at the postintervention (β=5.19, 95% CI 0.36 to 10.02, P=.04) and follow-up (β=7.14, 95% CI 2.15 to 12.14, P=.005), with time-dependent effects. The intervention group also showed significant improvements in social adjustment (β=4.24, 95% CI 1.79 to 6.69, P<.001) and depression (β=-3.06, 95% CI -6.04 to -0.11, P=.04) at follow-up. No significant differences were observed between the 2 groups in tic severity.</p><p><strong>Conclusions: </strong>The serious board game developed in this study significantly enhanced psychosocial functioning in adolescents with TS. As an alternative to verbal and written health communication, the board game serves as an innovative psychoeducational instrument for health care professionals to help adolescents with TS in tic management and mental health promotion. Future studies can develop and validate the feasibility of a digital version of the board game.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT05566236; https://clinicaltrials.gov/study/NCT05566236.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e76208"},"PeriodicalIF":4.1,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual Reality for Analgesia During Intrauterine Device Insertion: Randomized Controlled Trial.","authors":"Chloe Higgins, Claudia Zecena Morales, Judi Hocking, Kate Tyson, Cheryl Leung, Luke Larmour, Paul Leong, Beverley Vollenhoven","doi":"10.2196/72917","DOIUrl":"10.2196/72917","url":null,"abstract":"<p><strong>Background: </strong>Intrauterine devices (IUDs) are safe and effective long-acting reversible contraceptive therapies that are also used as minimally invasive treatment for heavy menstrual bleeding, endometrial hyperplasia, and early-stage endometrial cancer. Despite many advantages, IUDs are underused predominantly due to patient discomfort. Although many techniques have been explored previously in the literature, there is currently little consensus on effective analgesic strategies. Virtual reality (VR) has demonstrated moderate benefits in acute pain management and has been explored for outpatient hysteroscopy.</p><p><strong>Objective: </strong>This study aims to explore the effectiveness of VR in improving patient pain and anxiety during outpatient IUD insertion.</p><p><strong>Methods: </strong>This randomized controlled trial compared the use of a VR headset to standard care during IUD insertion in the outpatient clinic setting. VR content was delivered via smartphone and headset, providing patients with a relaxing 3D video environment. Outcomes measured were patient-reported pain and anxiety, as well as satisfaction reported using a questionnaire. Secondary outcomes included clinician-reported ease of insertion and time required to complete the procedure.</p><p><strong>Results: </strong>A total of 70 patients were recruited, with 34 randomized to the control group and 36 randomized to VR headset use. Patients with VR headsets reported a mean pain score of 5.5 (SD 3.2) during IUD insertion, which was not significantly different to 4.3 (SD 3.2) for the control group (P=.15). Mean anxiety scores during the procedure were 4 (SD 3) in the VR group, compared to 4.8 (SD 3.5) in the control group, which was also not significantly different (P=.37). Anxiety was the most significant predictor of pain, and this, in turn, significantly increased insertion time (P<.001). Among patients who responded to and benefitted from VR use, baseline anxiety was significantly lower than in those who did not (P<.001). Satisfaction with the use of VR headsets was overall high, and recommendation scores for the use of VR headsets were also high. There were no significant adverse effects experienced with the use of the intervention, with only 1 patient reporting nausea after IUD insertion.</p><p><strong>Conclusions: </strong>The use of VR headsets did not significantly alter the pain or anxiety experienced by patients during IUD insertion; however, satisfaction and recommendation that others use VR were high, which may suggest other benefits to their use. In addition, preprocedural anxiety appears to have a significant adverse impact on pain scores and the ability of patients to benefit from the VR headsets. This is an important contribution to the previously ambiguous data regarding VR use for gynecological procedures and highlights a new avenue for improving the patient experience.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e72917"},"PeriodicalIF":4.1,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Impact of Home-Based Serious Smartphone Resuscitation Gaming on Stress Among Nursing Students Practicing Simulated Adult Basic Life Support: Randomized Waitlist Controlled Trial.","authors":"Nino Fijačko, Benjamin S Abella, Špela Metličar, Leon Kopitar, Robert Greif, Gregor Štiglic, Pavel Skok, Matej Strnad","doi":"10.2196/67623","DOIUrl":"10.2196/67623","url":null,"abstract":"<p><strong>Background: </strong>Simulation-based training is widely used in resuscitation education, yet limited research exists on how serious smartphone games-especially when used independently at home-impact stress levels during simulated adult basic life support (BLS). Understanding this relationship may offer new approaches to preparing health care students for high-stress clinical situations.</p><p><strong>Objective: </strong>This study aimed to evaluate the impact of a home-based serious resuscitation game, MOBICPR, on physiological stress markers among nursing students performing simulated adult BLS.</p><p><strong>Methods: </strong>In this single-center, randomized, waitlist controlled trial, 43 first-year nursing students were assigned to either an intervention group (IG) or a waitlist control group (WL-CG). Stress was measured at baseline and 2-week and 4-week follow-ups using electrodermal activity (EDA), blood volume pulse (BVP), heart rate (HR), and body temperature (BT) collected via the Empatica E4 wearable (Empatica Inc., USA). Each data collection point included 3 phases: mandala coloring before and after simulated adult BLS performance, and the adult BLS scenario itself. The MOBICPR game-a serious mobile game designed per the 2021 European Resuscitation Council adult BLS guidelines-was played at home over 2 weeks by IG (weeks 0-2) and WL-CG (weeks 2-4). A random forest classifier, trained on the AffectiveRoad dataset, predicted stress levels (none, moderate, and high) based on physiological signals.</p><p><strong>Results: </strong>Of 124 students invited, 43 participated (22 in IG, 21 in WL-CG; 38/43, 88% female; mean age of 19, SD 0.6 years). EDA, BVP, and BT significantly changed across measurement phases in both groups (P<.05), while HR did not show consistent differences (P>.05). Stress classification showed a significant decrease in stress after simulated adult BLS in the IG at the 2-week follow-up (P=.04), but not in the WL-CG. After 2 weeks of gameplay, 12 of 22 participants in the IG had lower stress levels after performing simulated adult BLS compared to before, suggesting an adaptive stress response. No significant group-level stress reductions were observed over time.</p><p><strong>Conclusions: </strong>Short-term, home-based gameplay using a serious resuscitation game modestly influenced physiological indicators of stress during simulated adult BLS among nursing students. While overall group stress levels remained stable, individualized responses suggested improved coping for some. Incorporating serious games into curricula could offer learners safe, gamified environments to rehearse stressful clinical scenarios. Future research should explore optimal game frequency and content depth to maximize educational and emotional resilience outcomes.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e67623"},"PeriodicalIF":4.1,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of an Immersive Virtual Reality Application to Educate Medical Students in Patient Handover: Pilot Study.","authors":"Laura Isabel Hanke, Patrick Schwoerer, Florentine Huettl, Lukas Vradelis, Kai-Uwe Strelow, Christian Boedecker, Patrick Saalfeld, Vuthea Chheang, Holger Buggenhagen, Hauke Lang, Christian Hansen, Tobias Huber","doi":"10.2196/73907","DOIUrl":"10.2196/73907","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Patient handover is a daily task for doctors and nurses, and structured handovers have been proven to positively impact patient outcomes. To teach the handover procedure, different communication tools have been applied, such as the ISBAR (introduction and identification, situation, background, assessment and actions, and recommendation) method.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to assess the effectiveness and user engagement of the first-time use of supplementary handover training in virtual reality (VR) for medical students as an addition to an existing curriculum. Furthermore, the VR program was tested for its usability, immersion, visually induced motion sickness (VIMS), and eye strain. Participants were evaluated for their motivation, time spent studying, and experience in VR, as well as their impressions of the use of VR in medical education.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Handover training using the ISBAR method and patient actors is part of the curriculum in surgery of the eighth semester of human medicine studies in Mainz. Knowledge is tested via an Objective Structured Clinical Examination (OSCE) using patient actors. We developed an immersive VR application using 360° video surroundings with structured patient cases. This application was offered as an optional supplementary training in groups of three with a peer tutor. Parameters evaluated included participants' characteristics, usability, and VIMS. Furthermore, a survey of the entire semester was conducted regarding their experience using VR and their enjoyment of studying. Finally, OSCE scores were collected and compared between the groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study was conducted over two semesters, and 92 of 385 (23.9%) volunteering students were recruited. The median age was 25 (IQR 23-25) years, and the majority were female (n=61, 68.5%). There were few to no issues regarding VIMS and eye strain (median eye strain 1, IQR 1-2; median VIMS 1, IQR 1-2). There was no significant difference in students' motivation (mid rank participant 107.84; mid rank nonparticipant 122.61; P=.11) and the amount studied for the subject (mid rank participant 113.88; mid rank nonparticipants 119.42; P=.54). Students felt significantly more confident in patient handover after the additional training (7-point Likert scale; mean pretraining 3.96, SD 1.39; mean post-training 3.17, SD 1.41; P&lt;.01) and reported significantly more fun studying than their peers who did not participate in the additional training (mean participants 2.8, SD 1.54; mean nonparticipant 3.69, SD 1.73; P&lt;.01). OSCE scores did not differ between the groups (median score 17 in both groups, IQR participants 16-19; IQR nonparticipants 16-18; P=.62).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study shows that applications in VR, if implemented in a structured curriculum, can be a helpful and safe addition to the teaching of communication skills. VR applications should be consid","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e73907"},"PeriodicalIF":4.1,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12384679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}