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Learning Outcomes of a Serious Video Game-Based Experiment: a Battle of the Sexes
Abstract Number: O2-04
Abstract Type: Original Research
Teaching the skills to perform general anesthesia (GA) for cesarean delivery (CD) requires innovative strategies, as trainee exposure to managing such cases has declined.1 High-fidelity simulation (HFS) training in GA for CD improves performance in subsequent simulations.2,3 We developed a serious game (SG), EmergenCSim, with an embedded debriefing and scoring tool, that reproduces a virtual obstetric OR. In the game, the trainee, represented by an avatar, must perform GA for CD for umbilical cord prolapse. We hypothesized that exposure to EmergenCSim improves novice CA1 knowledge and observed behaviors on performing GA for CD and is equivalent to HFS to evaluate competency.
The efficacy of EmergenCSim (a) as an adjunct to a lecture for teaching GA for CD and (b) for use vs HFS to assess CA1 knowledge and skills were evaluated over time. In this RCT, CA1s (N=52) received a lecture on GA for CD; 4 weeks later (Time 1, T1) they all took a 29-item MCQ test.4 They were then randomized to play EmergenCSim (GAME gp) or a SG on anaphylaxis (SHAM gp). Outcomes were measured via the MCQ test in week 8 (Time 2, T2), and again between week 8-28 (Time 3, T3), via a SG score (SGS) produced with both groups playing EmergenCsim (T3), and behavior checklist scores (BCS)5 from participation in a HFS of GA for CD – the average for 2 raters (T3).
At T3, BCS were significantly higher in GAME gp (Mean 226.5, SD 37.2) vs. SHAM gp (Mean 211.8, SD 76.9) (p<0.05), with high inter-rater BCS correlation (r = 0.95). There was a significant correlation between BCS and SGS (r = 0.34; p=0.01, 1-tailed). Mean MCQ scores (Cronbach’s alpha reliability = 0.71; Fig A) were higher at T3 vs T1, and T2 vs T1 in the GAME gp compared with SHAM gp, and the difference was statistically significant in post-hoc comparisons. There was a significant increase in MCQ scores over time among male residents but not females (p=0.035; Fig B).
Exposure to EmergenCsim improved performance on an identical HFS scenario but MCQ scores significantly improved only in males, possibly unveiling gender differences for SG-based learning platforms. SG scores strongly correlated with HFS BCS, suggesting SGs have value as performance assessment tools. Next steps are to refine the MCQ test, define optimal debriefing methods and explore outcome differences by gender.
1. IJOA 2011;20:10-6
2. SiH 2010;5:320-4
3. IJOA 2014;23:341-7
4. JEPM 2018;20:E621
5. Anesthesiol 2006;105:260-6