{"title":"Impact of Video-Based Error Correction Learning for Cardiopulmonary Resuscitation Training: Quasi-Experimental Study.","authors":"Yun Wang, Junzuo Fu, Shaoping Wang, Huijuan Wang, Wei Gao, Lina Huang","doi":"10.2196/53577","DOIUrl":"10.2196/53577","url":null,"abstract":"<p><strong>Background: </strong>Video-based error correction (VBEC) in medical education could offer immediate feedback, promote enhanced learning retention, and foster reflective practice. However, its application in cardiopulmonary resuscitation (CPR) training has not been investigated.</p><p><strong>Objective: </strong>The objective of this study is to assess whether the VBEC procedure could improve the training performance of CPR among anesthesiology residents.</p><p><strong>Methods: </strong>A quasi-experimental study was conducted among anesthesiology residents between December 2022 and April 2023. Primary outcomes included a posttraining knowledge test and practical assessment scores. Secondary outcomes included the number of residents who correctly conducted CPR at each step, the rate of common mistakes during the CPR process, and the self-assessment results. A total of 80 anesthesiology residents were divided into a VBEC group (n=40) and a control group (n=40). The VBEC group underwent a 15-minute VBEC CPR training, whereas the control group underwent a 15-minute video-prompting CPR training.</p><p><strong>Results: </strong>The posttraining knowledge test score of the VBEC group was significantly higher than that of the control group (73, SD 10.5 vs 65.1, SD 11.4; P=.002). The residents in the VBEC group had lower error rates in \"failure to anticipate the next move\" (n=3, 7.5% vs n=13, 32.5%; P=.01) and \"failure to debrief or problem solve after the code\" (n=2, 5% vs n=11, 27.5%; P=.01), as well as better performance in the \"secure own safety\" step (n=34, 85% vs n=18, 45%; P<.001) than those in the control group. The VBEC group showed significantly higher confidence in CPR than the control group (n=?, 62.5% vs n=?, 35%; P=.03).</p><p><strong>Conclusions: </strong>VBEC may be a promising strategy compared to video prompting for CPR training among anesthesiology residents.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"12 ","pages":"e53577"},"PeriodicalIF":3.8,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11466053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365303","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}
Hermione Hin Man Lo, Marques Ng, Pak Yiu Hugo Fong, Harmony Hoi Ki Lai, Bo Wang, Samuel Yeung-Shan Wong, Regina Wing Shan Sit
{"title":"Examining the Feasibility, Acceptability, and Preliminary Efficacy of an Immersive Virtual Reality-Assisted Lower Limb Strength Training for Knee Osteoarthritis: Mixed Methods Pilot Randomized Controlled Trial.","authors":"Hermione Hin Man Lo, Marques Ng, Pak Yiu Hugo Fong, Harmony Hoi Ki Lai, Bo Wang, Samuel Yeung-Shan Wong, Regina Wing Shan Sit","doi":"10.2196/52563","DOIUrl":"10.2196/52563","url":null,"abstract":"<p><strong>Background: </strong>Knee osteoarthritis prevalently causes significant pain, activity limitations, psychological distress, and reduced quality of life. Despite lower limb strength training being a core treatment for knee osteoarthritis, adherence remains a challenge, prompting the exploration of virtual reality (VR) to improve exercise compliance. Recent research suggests the potential of VR in providing enhanced pain management and functional outcomes for knee osteoarthritis, necessitating further exploration of immersive VR technology.</p><p><strong>Objective: </strong>We aimed to study the feasibility, acceptability, and preliminary efficacy of an immersive VR-assisted lower limb strength training for knee osteoarthritis (VRiKnee).</p><p><strong>Methods: </strong>A convergent, parallel, mixed methods study was conducted in 30 participants with knee osteoarthritis. After 1:1 randomization, the VRiKnee group (n=15) was assigned to perform repetitive concentric quadriceps and isometric vastus medialis oblique exercise in an immersive environment using a head-mounted display for 12 weeks. The control group (n=15) completed the same exercises without VRiKnee. VRiKnee participants were interviewed at week 12 to study VRiKnee acceptability and user experience. Quantitative data included feasibility outcomes such as recruitment, dropout, and exercise adherence rates, and effectiveness outcomes such as the numeric rating scale, the Western Ontario and McMaster Universities Osteoarthritis Index (100 points) pain and function subscales, and objective physical activity measured by metabolic equivalents of task using an ActivPAL accelerometer. Qualitative data were analyzed by thematic analysis, followed by integration with quantitative data using joint displays.</p><p><strong>Results: </strong>The recruitment rate was 100% (N=30), with enrollment of 30 participants in 7.57 weeks. The median age was 63.5 (IQR 61.8-66.3) years, with 76% (n=23) being female. The response rates were 80% and 93% for the VRiKnee and control groups. Dropout rates were 13% for VRiKnee and 7% for the control group. Median exercise adherence was 77% (IQR 37-104%) for VRiKnee and 62% (IQR 40-166%) for the control group, respectively, with adherence reduction over this study's period and no significant intergroup differences (P=.82). No statistically significant differences were observed in primary and secondary outcomes, though positive trends were observed in pain and stiffness. Cybersickness was reported by 5 (33%) participants in the VRiKnee group. In the qualitative analysis, 4 themes, 11 subthemes, and 16 quotes were generated, identifying facilitators and barriers with practical suggestions to enhance the usability of VRiKnee.</p><p><strong>Conclusions: </strong>VRiKnee demonstrated feasibility, acceptability, and potential efficacy in managing knee osteoarthritis. Future trials of larger sample sizes and better VR designs will confirm its role in clinical practice","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"12 ","pages":"e52563"},"PeriodicalIF":3.8,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142347056","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}
Umar Taj, Aikaterini Grimani, Daniel Read, Ivo Vlaev
{"title":"Using Games to Simulate Medication Adherence and Nonadherence: Laboratory Experiment in Gamified Behavioral Simulation.","authors":"Umar Taj, Aikaterini Grimani, Daniel Read, Ivo Vlaev","doi":"10.2196/47141","DOIUrl":"10.2196/47141","url":null,"abstract":"<p><strong>Background: </strong>Medical nonadherence is a significant problem associated with worse clinical outcomes, higher downstream rehospitalization rates, and a higher use of resources. To improve medication adherence, it is vital for researchers and practitioners to have a solid theoretical understanding of what interventions are likely to work. To achieve this understanding, we propose that researchers should focus on creating small-scale laboratory analogs to the larger real-world setting and determine what interventions, such as nudges or incentives, work to change behavior in the laboratory. To do this, we took inspiration from the literature on serious games and gamification and experimental economics. We call our approach \"gamified behavioral simulation.\" In this paper, we modeled everyday life as the state of being engaged in a simple but addictive game, illness as being interruptions to the functionality of that game, treatment as being a series of actions that can be taken to prevent or mitigate those interruptions, and adherence as sticking to a prescribed rule for the application of those actions.</p><p><strong>Objective: </strong>This study carries out a behavioral diagnosis of the medication adherence problem through a theoretically informed framework and then develops the gamified behavioral modeling approach to simulate medication nonadherence.</p><p><strong>Methods: </strong>A laboratory experiment was conducted using a modified popular and addictive open-source video game called \"2048,\" which created an abstract model for the medication adherence behavior observed in real life. In total, 509 participants were assigned to the control and 4 intervention groups (\"incentive\" group, \"reminder\" group, \"commitment device\" group, and \"elongated duration for symptoms\" group).</p><p><strong>Results: </strong>The results of the modeling experiment showed that having theoretically informed interventions can increase the likelihood for them to be successful. In particular, there is evidence that the use of reminders improves the medication adherence rates for patients, and the same result was found in the modeling experiment, as they improved adherence significantly by 23% (95% CI -33.97% to -11.72%; P<.001). However, providing an incentive did not improve the adherence rate. We also tested the use of commitment devices, which, in line with real-world evidence, did not improve adherence rates. The fourth treatment tested elongated duration for symptoms, which attempted to show the power of modeling experiments where we test a what-if scenario that is extremely difficult to test in a real setting. The results indicated that if symptoms last longer, people did not adhere more to their medication regimen.</p><p><strong>Conclusions: </strong>Gamified behavioral simulation is a useful tool to explain real health behaviors and help in identifying which interventions are most likely to work in a randomized trial.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"12 ","pages":"e47141"},"PeriodicalIF":3.8,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142347057","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}
Catarina Cederved, Gustaf Ljungman, Jon Back, Charlotte Ångström-Brännström, Gunn Engvall
{"title":"Acceptability of a Serious Game About Proton Radiotherapy Designed for Children Aged 5 to 14 Years and Its Potential Impact on Perceived Anxiety: Feasibility and Randomized Controlled Pilot Trial.","authors":"Catarina Cederved, Gustaf Ljungman, Jon Back, Charlotte Ångström-Brännström, Gunn Engvall","doi":"10.2196/54082","DOIUrl":"10.2196/54082","url":null,"abstract":"<p><strong>Background: </strong>Children who are going to undergo radiotherapy have displayed fear and anxiety. Therefore, a web-based serious game was developed as a psychological preparation to investigate if it could affect anxiety levels. In an earlier stage, children with experience of radiotherapy had been part of the developmental process.</p><p><strong>Objective: </strong>The study aimed to investigate the feasibility in terms of reach, usability, and acceptability of a serious game about proton radiotherapy and to pilot that it did not increase anxiety levels in children aged 5 to 14 years undergoing radiotherapy.</p><p><strong>Methods: </strong>The design was a randomized controlled pilot trial with predefined feasibility criteria. In total, 28 children were assessed for eligibility, and 23 met the inclusion criteria. They were consecutively randomized into 1 of 2 study arms. One child was excluded after randomization. If randomized into arm 1, the children received the intervention before treatment started. Children in arm 2 were treated as controls. Questionnaires with fixed answers were used to assess anxiety levels (an adapted version of the State-Trait Anxiety Inventory for Children) and experiences of gameplay (an adapted version of Player Experience of Need Satisfaction [PENS]). The children were asked to answer questionnaires at 5 different measurement occasions during their radiotherapy treatment.</p><p><strong>Results: </strong>In arm 1, age ranged from 5 to 13 (mean 8.4, SD 2.4) years. In arm 2, age ranged from 5 to 11 (mean 7.6, SD 2.3) years. The sample consisted of 15 girls and 7 boys. The feasibility criterion that the children should play the game for 20 minutes or more was not met. Mean playtime for children in arm 1 was 32.1 (SD 23.8) minutes, where 18 children had played for at least 15 minutes. The criterion that 70% (n=16) or more of the participants should return all of the questionnaires was not met; however, more than 73% (n=16) returned the PENS questionnaires. The State-Trait Anxiety Inventory for Children was returned by 73% (n=16) on day 0, 77% (n=17) on day 1, 82% (n=18) on day 3, 82% (n=18) on day 6, and 86% (n=19) on day 15.</p><p><strong>Conclusions: </strong>All feasibility criteria set for the study were not met, suggesting that adaptions need to be made if a future study is to be undertaken. Further, the analysis revealed that there was no indication that playing increased the children's self-reported anxiety. The PENS questionnaire adapted for children showed promising results regarding player satisfaction when using the serious game. When studying children with severe conditions and young age, 5 measurement occasions seemed to be too many. Measuring both player satisfaction or experience and knowledge transfer would be preferable in future studies.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"12 ","pages":"e54082"},"PeriodicalIF":3.8,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11441341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287711","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}
Joaquín González-Cabrera, Vanessa Caba-Machado, Adoración Díaz-López, Susana Jiménez-Murcia, Gemma Mestre-Bach, Juan M Machimbarrena
{"title":"The Mediating Role of Problematic Use of Loot Boxes Between Internet Gaming Disorder and Online Gambling Disorder: Cross-Sectional Analytical Study.","authors":"Joaquín González-Cabrera, Vanessa Caba-Machado, Adoración Díaz-López, Susana Jiménez-Murcia, Gemma Mestre-Bach, Juan M Machimbarrena","doi":"10.2196/57304","DOIUrl":"10.2196/57304","url":null,"abstract":"<p><strong>Background: </strong>The video game industry has introduced a new form of monetization through microtransactions. A controversial example has been the so-called \"loot boxes\" (LBs) as virtual objects, which are randomized and bought with legal money. In recent years, LBs have come to connect 2 distinct problem behaviors, namely internet gaming disorder (IGD) and online gambling disorder (OGD). Many association studies have been conducted on the 3 constructs, but few have delved into the relationship of problematic use of LBs (PU-LB) with IGD and OGD.</p><p><strong>Objective: </strong>This study aims to explore the mediating role of the PU-LB between IGD and OGD.</p><p><strong>Methods: </strong>This cross-sectional and analytical study used incidental sampling in 24 Spanish schools. The final sample consisted of 542 participants (male: n=523, 96.5%; age: range 11-30 y) who played video games, bought LBs, and had gambled online in the last 12 months. Participants then completed the Spanish versions of the Internet Gaming Disorder Scale-Short Form, Online Gambling Disorder Questionnaire, and PU-LB scale.</p><p><strong>Results: </strong>IGD scores were found to be significantly associated with both PU-LB (r=0.473, P<.001) and OGD (r=0.209, P<.001). Moreover, PU-LB was significantly associated with OGD (r=0.351, P<.001). The structural equation model results indicated that IGD had no significant direct effect on OGD (P=.903). However, the indirect effect of IGD on OGD through PU-LB was significant (P<.001). Therefore, PU-LB fully mediated the relationship between IGD and OGD. Furthermore, these results were found in the subsamples of both minors (<18 y) and young adults (≥18 y).</p><p><strong>Conclusions: </strong>It is suggested that there is a mediation effect of problematic LB use between internet gambling and online gambling problems in both minors and young adults. This has potential practical implications by providing more evidence on how LBs have become a hinge feature between 2 clinically relevant and independent issues. In this regard, adequate industry self-regulation is needed, and effective legislation for the protection of minors is necessary.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"12 ","pages":"e57304"},"PeriodicalIF":3.8,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11429661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287714","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}
Yanqiu Yu, Anise M S Wu, Vivian W I Fong, Jianxin Zhang, Ji-Bin Li, Joseph T F Lau
{"title":"Association Between Internet Gaming Disorder and Suicidal Ideation Mediated by Psychosocial Resources and Psychosocial Problems Among Adolescent Internet Gamers in China: Cross-Sectional Study.","authors":"Yanqiu Yu, Anise M S Wu, Vivian W I Fong, Jianxin Zhang, Ji-Bin Li, Joseph T F Lau","doi":"10.2196/48439","DOIUrl":"10.2196/48439","url":null,"abstract":"<p><strong>Background: </strong>Adolescent internet gaming disorder (IGD) was associated with severe harm, including suicidal ideation. While suicidal ideation was predictive of completed suicides, further research is required to clarify the association between IGD and suicidal ideation among adolescents, as well as the mechanisms involved.</p><p><strong>Objective: </strong>This study aimed to investigate the understudied association between IGD and suicidal ideation, as well as novel mechanisms associated with it, among Chinese adolescent internet gamers through psychosocial coping resources and psychosocial problems.</p><p><strong>Methods: </strong>An anonymous, self-administered, cross-sectional survey was conducted among secondary school students who had played internet games in the past year in Guangzhou and Chengdu, China (from October 2019 to January 2020). In total, 1693 adolescent internet gamers were included in this study; the mean age was 13.48 (SD 0.80) years, and 60% (n=1016) were males. IGD was assessed by the 9-item Internet Gaming Disorder Checklist of the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders [Fifth Edition]), while a single item assessed suicidal ideation: \"Have you ever considered committing suicide in the past 12 months?\" Univariate and multivariate logistic regression associations were conducted to test the significance and directions of the potential factors for suicidal ideation. The mediation mechanism was examined by structural equation modeling.</p><p><strong>Results: </strong>Among all participants, the prevalence of IGD and suicidal ideation was 16.95% (287/1693) and 43.06% (729/1693), respectively. IGD cases were 2.42 times more likely than non-IGD cases to report suicidal ideation (adjusted odds ratio [OR] 2.42, 95% CI 1.73-3.37). Other significant factors of suicidal ideation included psychosocial coping resources (resilience and social support, both adjusted OR 0.97, 95% CI 0.96-0.98) and psychosocial problems (social anxiety: adjusted OR 1.07, 95% CI 1.05-1.09; loneliness, adjusted OR 1.13, 95% CI 1.10-1.16). The association between IGD and suicidal ideation was partially mediated by 3 indirect paths, including (1) the 2-step path that IGD reduced psychosocial coping resources, which in turn increased suicidal ideation; (2) the 2-step path that IGD increased psychosocial problems, which in turn increased suicidal ideation; and (3) the 3-step path that IGD reduced psychosocial coping resources which then increased psychosocial problems, which in turn increased suicidal ideation, with effect sizes of 10.7% (indirect effect/total effect: 0.016/0.15), 30.0% (0.05/0.15), and 13.3% (0.02/0.15), respectively. The direct path remained statistically significant.</p><p><strong>Conclusions: </strong>IGD and suicidal ideation were alarmingly prevalent. Evidently and importantly, IGD was a significant risk factor for suicidal ideation. The association was partially explained by psychosocial coping resou","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"12 ","pages":"e48439"},"PeriodicalIF":3.8,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11450365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287712","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}
Jan Egger, Christina Gsaxner, Gijs Luijten, Jianxu Chen, Xiaojun Chen, Jiang Bian, Jens Kleesiek, Behrus Puladi
{"title":"Is the Apple Vision Pro the Ultimate Display? A First Perspective and Survey on Entering the Wonderland of Precision Medicine.","authors":"Jan Egger, Christina Gsaxner, Gijs Luijten, Jianxu Chen, Xiaojun Chen, Jiang Bian, Jens Kleesiek, Behrus Puladi","doi":"10.2196/52785","DOIUrl":"10.2196/52785","url":null,"abstract":"<p><p>At the Worldwide Developers Conference in June 2023, Apple introduced the Vision Pro. The Apple Vision Pro (AVP) is a mixed reality headset; more specifically, it is a virtual reality device with an additional video see-through capability. The video see-through capability turns the AVP into an augmented reality (AR) device. The AR feature is enabled by streaming the real world via cameras on the (virtual reality) screens in front of the user's eyes. This is, of course, not unique and is similar to other devices, such as the Varjo XR-3 (Varjo Technologies Oy). Nevertheless, the AVP has some interesting features, such as an inside-out screen that can show the headset wearer's eyes to \"outsiders,\" and a button on the top, called the \"digital crown,\" that allows a seamless blend of digital content with the user's physical space by turning it. In addition, it is untethered, except for the cable to the battery, which makes the headset more agile, compared to the Varjo XR-3. This could actually come closer to \"The Ultimate Display,\" which Ivan Sutherland had already sketched in 1965. After a great response from the media and social networks to the release, we were able to test and review the new AVP ourselves in March 2024. Including an expert survey with 13 of our colleagues after testing the AVP in our institute, this Viewpoint explores whether the AVP can overcome clinical challenges that AR especially still faces in the medical domain; we also go beyond this and discuss whether the AVP could support clinicians in essential tasks to allow them to spend more time with their patients.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"12 ","pages":"e52785"},"PeriodicalIF":3.8,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11447423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287713","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":"Electronic feedback alone vs. electronic feedback plus in-person debriefing, for a serious game designed to teach novice anesthesiology residents to perform general anesthesia for cesarean delivery: a randomized controlled trial.","authors":"Allison Lee, Stephanie Goodman, Chen Miao Chen, Ruth Landau, Madhabi Chatterji","doi":"10.2196/59047","DOIUrl":"10.2196/59047","url":null,"abstract":"<p><strong>Background: </strong>EmergenCSimTM, is a novel researcher-developed serious game (SG) with an embedded scoring and feedback tool that reproduces an obstetric operating room environment. The learner must perform general anesthesia (GA) for emergent cesarean delivery (CD) for umbilical cord prolapse. The game was developed as an alternative teaching tool because of diminishing real-world exposure of anesthesiology trainees to this clinical scenario. Traditional debriefing (facilitator-guided reflection) is considered to be integral to experiential learning but requires the participation of an instructor. The optimal debriefing methods for SGs have not been well-studied. Electronic feedback is commonly provided at the conclusion of SGs, so we aimed to compare the effectiveness of learning when an in-person debrief is added to electronic feedback compared to using electronic feedback alone.</p><p><strong>Objective: </strong>We hypothesized that an in-person debriefing in addition to the SG-embedded electronic feedback will provide superior learning than electronic feedback alone.</p><p><strong>Methods: </strong>Novice 1st year anesthesiology residents (CA-1) (n=51) (i) watched a recorded lecture on GA for emergent CD, (ii) took a 26-item multiple-choice question (MCQ) pre-test, and (iii) played EmergenCSimTM (maximum score 196.5). They were randomized to either the control group which experienced the electronic feedback alone (Group EF, n=26) or the intervention group, which experienced the SG-embedded electronic feedback and an in-person debriefing (Group IPD+EF, n=25). All subjects played the SG a 2nd time, with instructions to try to increase their score, then they took a 26-item MCQ post-test. Pre-and post-tests (maximum score of 26 points each), were validated parallel forms.</p><p><strong>Results: </strong>For Groups EF and IPD+EF respectively, mean pre-test scores were18.6 (SD 2.5) and 19.4 (SD 2.3), and mean post-test scores were 22.6 (SD 2.2) and 22.1 (SD 1.6); F=1.8, P =.19. SG scores for Groups EF and IPD+EF respectively were - mean 1st play SG scores of 135 (SE 4.4) and 141 (SE 4.5), and mean 2nd play SG scores were 163.1 (SE 2.9) and 173.3 (SE 2.9); F= 137.7, P < .001.</p><p><strong>Conclusions: </strong>Adding an in-person debriefing experience led to greater improvement in SG scores, emphasizing the learning benefits of this practice. Improved SG performance in both groups suggests that SGs have a role as independent, less resource-intensive educational tools.</p><p><strong>Clinicaltrial: </strong>None.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Roberta Bevilacqua, Marco Benadduci, Federico Barbarossa, Giulio Amabili, Valentina Di Donna, Clotilda Martella, Giuseppe Pelliccioni, Giovanni Renato Riccardi, Elvira Maranesi
{"title":"Effectiveness of Technological Interventions for Older Adults With Parkinson Disease: Systematic Review.","authors":"Roberta Bevilacqua, Marco Benadduci, Federico Barbarossa, Giulio Amabili, Valentina Di Donna, Clotilda Martella, Giuseppe Pelliccioni, Giovanni Renato Riccardi, Elvira Maranesi","doi":"10.2196/53431","DOIUrl":"10.2196/53431","url":null,"abstract":"<p><strong>Background: </strong>Among the older population, Parkinson disease (PD) stands out as a leading contributor to disability. Clinically, the foremost objectives in managing PD involve proactively delaying and preventing disability. Understanding the pivotal role of gait and balance in daily functionality holds substantial clinical significance, signaling imminent disability and prompting a reevaluation of management approaches. A key priority lies in identifying novel and effective interventions for symptoms that substantially contribute to disability.</p><p><strong>Objective: </strong>This paper presents a systematic review that critically examines the existing body of literature on the use of technology in the rehabilitation of older patients with PD. By synthesizing current evidence, we aim to provide insights into the state of the field, identify gaps in knowledge, and offer recommendations for future research and clinical practice.</p><p><strong>Methods: </strong>A systematic review of the literature was conducted in September 2023 analyzing manuscripts and papers of the last 5 years from the PubMed, Scopus, Embase, Web of Science, and CINAHL databases following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A total of 14 papers were included. The inclusion criteria are as follows: (1) randomized controlled trial, (2) PD in people aged 65 years and older, and (3) use of technology in the rehabilitation training in the older population.</p><p><strong>Results: </strong>A large portion of effective interventions relies on the incorporation of technology, particularly through virtual reality exergames. This technology appears to have effects not only on the cognitive aspect but also on the physical domain. The analysis of the results clearly indicates that, in terms of gait and balance performance, the technological intervention outperforms the traditional approach, irrespective of the specific technology employed.</p><p><strong>Conclusions: </strong>This systematic review seeks to shed light on the evolving landscape of technology-assisted rehabilitation for older individuals with PD. As we delve into the available evidence, we will assess the extent to which technology can serve as a valuable adjunct to conventional therapy, offering new avenues for optimized care and improved outcomes in this growing patient demographic. As we sift through the existing evidence, our goal is to evaluate the potential of technology as a valuable supplement to traditional therapy, presenting fresh opportunities for enhanced care and better outcomes in this expanding patient demographic.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"12 ","pages":"e53431"},"PeriodicalIF":3.8,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11430395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154142","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}
Ebrahim Mahmoudi, Paul Yejong Yoo, Ananya Chandra, Roberta Cardoso, Carlos Denner Dos Santos, Annette Majnemer, Keiko Shikako
{"title":"Gamification in Mobile Apps for Children With Disabilities: Scoping Review.","authors":"Ebrahim Mahmoudi, Paul Yejong Yoo, Ananya Chandra, Roberta Cardoso, Carlos Denner Dos Santos, Annette Majnemer, Keiko Shikako","doi":"10.2196/49029","DOIUrl":"10.2196/49029","url":null,"abstract":"<p><strong>Background: </strong>Children with disabilities face numerous challenges in accessing health services. Mobile health is an emerging field that could significantly reduce health inequities by providing more accessible services. Many mobile apps incorporate gamification elements such as feedback, points, and stories to increase engagement and motivation; however, little is known about how gamification has been incorporated in mobile apps for children with disabilities.</p><p><strong>Objective: </strong>This scoping review aims to identify and synthesize the existing research evidence on the use of gamification in mobile apps for children with disabilities. Specifically, the objectives were to (1) identify the categories of these mobile apps (eg, treatment and educational) (2), describe the health-related outcomes they target, (3) assess the types and levels of gamification elements used within these apps, and (4) determine the reasons for incorporating gamification elements into mobile apps.</p><p><strong>Methods: </strong>We searched MEDLINE, PsycINFO, CINAHL, Embase, the ACM Digital Library, and IEEE Xplore databases to identify papers published between 2008 and 2023. Original empirical research studies reporting on gamified mobile apps for children with disabilities that implemented at least 1 gamification strategy or tactic were included. Studies investigating serious games or full-fledged games were excluded.</p><p><strong>Results: </strong>A total of 38 studies reporting on 32 unique gamified mobile apps were included. Findings showed that gamified apps focus on communication skills and oral health in children with autism spectrum disorder while also addressing self-management and academic skills for other disability groups. Gamified mobile apps have demonstrated potential benefits across different populations and conditions; however, there were mixed results regarding their impact. The gamification strategies included fun and playfulness (23/32, 72%), feedback on performance (17/32, 53%), and reinforcement (17/32, 53%) in more than half of apps, whereas social connectivity was used as a gamification strategy in only 4 (12%) mobile apps. There were 2 main reasons for integrating gamification elements into mobile apps described in 16 (42%) studies: increasing user engagement and motivation and enhancing intervention effects.</p><p><strong>Conclusions: </strong>This scoping review offers researchers a comprehensive review of the gamification elements currently used in mobile apps for the purposes of treatment, education, symptom management, and assessment for children with disabilities. In addition, it indicates that studies on certain disability groups and examinations of health-related outcomes have been neglected, highlighting the need for further investigations in these areas. Furthermore, research is needed to investigate the effectiveness of mobile-based gamification elements on health and health behavior outcomes, as well as t","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"12 ","pages":"e49029"},"PeriodicalIF":3.8,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11415723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140154","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}