Role-playing computer games in disaster medicine education

The COVID-19 pandemic has forced a transition from traditional in-person teaching to virtual learning in disaster medicine education, posing significant challenges. The lack of dedicated teaching platforms, especially those offering immersive experiences in critical decision-making under austere conditions, created a challenging environment for medical students transitioning to disaster settings. The scarcity of resources and complex disaster site management situations, coupled with limited prior experience, further exacerbated the difficulties.¹

To address the challenges in disaster medicine education, we developed Disaster Medicine Game (DMG), a role-playing computer game tailored for pre-clinical medical students. DMG offers immersive disaster scenarios, where players assume the role of a cartoon character engaged in on-site medical rescue. Players navigate through disaster scenes, interact with computer-controlled non-player characters (NPCs), triage and treat casualties using limited medical supplies, and make strategic decisions. Three two-dimensional disaster scenarios—earthquake, chemical incident, and infectious disease outbreak—were created to cultivate clinical decision-making and situational awareness.

To assess the effectiveness of DMG, we implemented a comprehensive evaluation process. This included pre- and post-course online tests to measure students' knowledge gains. Additionally, we administered questionnaires using a 6-point Likert scale to assess students' motivation before and after the course. We also conducted a post-course questionnaire to assess cognitive load and acceptance of the game's technology. This multifaceted evaluation allowed us to gain insights into the impact of DMG on students' learning outcomes and their perceptions of the game.

Following the implementation of DMG, students demonstrated significant improvement in test scores, with the post-test average reaching 83.6%, compared to 70.7% pre-test (p < 0.001). All participants expressed interest in future game-based courses, reporting enhanced understanding and confidence in disaster medicine. Motivation increased significantly (from 3.9 to 5.7 on a 6-point Likert scale, p < 0.001), while the average score for technical acceptance was 5.6, indicating students' positive reception of the game's operation. However, high cognitive load was observed, with an average score of 5.1, highlighting the need for improved balance between complexity and educational goals in future game iterations. Students also expressed a desire for more scenarios, underscoring the relevance and value of this learning approach. This study underscores the potential of role-playing computer games as a valuable educational tool in disaster medicine education, especially in the current hybrid learning environment.

In summary, the DMG, a role-playing computer game designed for pre-clinical medical students provides immersive disaster scenarios, fostering clinical decision-making and situational awareness. Evaluation results indicate significant improvements in students' test scores and increased motivation. Despite challenges such as high cognitive load, students expressed interest in more scenarios. This study highlights the potential of computer games as educational tools in disaster medicine education, particularly in the current hybrid learning environment. Future iterations should focus on balancing complexity and educational goals.

Hai Hu: Conceptualization; software; data curation; investigation; validation; formal analysis; supervision; resources; writing—original draft; methodology; funding acquisition. Yaning Lai: Methodology; data curation; formal analysis; investigation; writing—review and editing; resources; project administration. Chuan Zuo: Writing—review and editing; methodology; validation; formal analysis; data curation.

All authors declare no conflict of interest.