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      A Didactic Escape Game for Emergency Medicine Aimed at Learning to Work as a Team and Making Diagnoses: Methodology for Game Development

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          Abstract

          Background

          In the health care environment, teamwork is paramount, especially when referring to patient safety. We are interested in recent and innovative solutions such as escape games, which is a type of adventure game that may be highly useful as an educational tool, potentially combining good communication skills with successful gamification. They involve teams of 5 to 10 individuals who are “locked” in the same room and must collaborate to solve puzzles while under pressure from a timer.

          Objective

          The purpose of this paper was to describe the steps involved in creating and implementing an educational escape game. This tool can then be put into service or further developed by trainers who wish to use it for learning interprofessional collaboration. Therefore, we started with an experience of creating an educational escape game for emergency medicine teams.

          Methods

          We chose to develop an educational escape game by using 6 successive steps. First, we built a team. Second, we chose the pedagogical objectives. Third, we gamified (switched from objectives to scenario). Next, we found the human and material resources needed. Thereafter, we designed briefing and debriefing. Lastly, we tested the game.

          Results

          By following these 6 steps, we created the first ambulant educational escape game that teaches people, or nurses, doctors, and paramedics, working in emergency medicine to work as a team.

          Conclusions

          From a pedagogic point of view, this game may be a good tool for helping people in multidisciplinary fields (medical and paramedical teams) to learn how to work collaboratively and to communicate as a group. Above all, it seems to be an innovative tool that complements medical simulation–based learning and thus consolidates traditional education.

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          Most cited references32

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          Self-determination theory: A macrotheory of human motivation, development, and health.

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            2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS): The Task Force for the diagnosis and management of acute pulmonary embolism of the European Society of Cardiology (ESC)

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              Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review.

              1969 to 2003, 34 years. Simulations are now in widespread use in medical education and medical personnel evaluation. Outcomes research on the use and effectiveness of simulation technology in medical education is scattered, inconsistent and varies widely in methodological rigor and substantive focus. Review and synthesize existing evidence in educational science that addresses the question, 'What are the features and uses of high-fidelity medical simulations that lead to most effective learning?'. The search covered five literature databases (ERIC, MEDLINE, PsycINFO, Web of Science and Timelit) and employed 91 single search terms and concepts and their Boolean combinations. Hand searching, Internet searches and attention to the 'grey literature' were also used. The aim was to perform the most thorough literature search possible of peer-reviewed publications and reports in the unpublished literature that have been judged for academic quality. Four screening criteria were used to reduce the initial pool of 670 journal articles to a focused set of 109 studies: (a) elimination of review articles in favor of empirical studies; (b) use of a simulator as an educational assessment or intervention with learner outcomes measured quantitatively; (c) comparative research, either experimental or quasi-experimental; and (d) research that involves simulation as an educational intervention. Data were extracted systematically from the 109 eligible journal articles by independent coders. Each coder used a standardized data extraction protocol. Qualitative data synthesis and tabular presentation of research methods and outcomes were used. Heterogeneity of research designs, educational interventions, outcome measures and timeframe precluded data synthesis using meta-analysis. Coding accuracy for features of the journal articles is high. The extant quality of the published research is generally weak. The weight of the best available evidence suggests that high-fidelity medical simulations facilitate learning under the right conditions. These include the following: providing feedback--51 (47%) journal articles reported that educational feedback is the most important feature of simulation-based medical education; repetitive practice--43 (39%) journal articles identified repetitive practice as a key feature involving the use of high-fidelity simulations in medical education; curriculum integration--27 (25%) journal articles cited integration of simulation-based exercises into the standard medical school or postgraduate educational curriculum as an essential feature of their effective use; range of difficulty level--15 (14%) journal articles address the importance of the range of task difficulty level as an important variable in simulation-based medical education; multiple learning strategies--11 (10%) journal articles identified the adaptability of high-fidelity simulations to multiple learning strategies as an important factor in their educational effectiveness; capture clinical variation--11 (10%) journal articles cited simulators that capture a wide variety of clinical conditions as more useful than those with a narrow range; controlled environment--10 (9%) journal articles emphasized the importance of using high-fidelity simulations in a controlled environment where learners can make, detect and correct errors without adverse consequences; individualized learning--10 (9%) journal articles highlighted the importance of having reproducible, standardized educational experiences where learners are active participants, not passive bystanders; defined outcomes--seven (6%) journal articles cited the importance of having clearly stated goals with tangible outcome measures that will more likely lead to learners mastering skills; simulator validity--four (3%) journal articles provided evidence for the direct correlation of simulation validity with effective learning. While research in this field needs improvement in terms of rigor and quality, high-fidelity medical simulations are educationally effective and simulation-based education complements medical education in patient care settings.
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                Author and article information

                Contributors
                Journal
                JMIR Serious Games
                JMIR Serious Games
                JSG
                JMIR Serious Games
                JMIR Publications (Toronto, Canada )
                2291-9279
                Jul-Sep 2021
                31 August 2021
                : 9
                : 3
                : e27291
                Affiliations
                [1 ] Emergency Department CHR Metz-Thionville Metz France
                [2 ] Intensive Care and Anesthesiology Pediatric Necker Hospital Paris France
                [3 ] Emergency Department Hospital Center of Verdun Verdun France
                [4 ] Université de Lorraine Nancy France
                [5 ] University of Strasbourg Medical School Strasbourg France
                [6 ] Prehospital Emergency Care Service (SAMU 67) Center for Training and Research in Health Sciences Education Strasbourg University Hospital Strasbourg France
                [7 ] Emergency Department, Lariboisière Hospital Assistance Publique-Hôpitaux de Paris Paris France
                Author notes
                Corresponding Author: Laure Abensur Vuillaume l.abensurvuillaume@ 123456chr-metz-thionville.fr
                Author information
                https://orcid.org/0000-0003-2527-8458
                https://orcid.org/0000-0002-9518-3692
                https://orcid.org/0000-0002-4242-7585
                https://orcid.org/0000-0002-6433-8866
                https://orcid.org/0000-0002-0396-5428
                https://orcid.org/0000-0001-8819-0061
                Article
                v9i3e27291
                10.2196/27291
                8441606
                34463628
                556a1f6d-0728-4ffe-a64e-8335e625a8f2
                ©Laure Abensur Vuillaume, Garry Laudren, Alexandre Bosio, Pauline Thévenot, Thierry Pelaccia, Anthony Chauvin. Originally published in JMIR Serious Games (https://games.jmir.org), 31.08.2021.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Serious Games, is properly cited. The complete bibliographic information, a link to the original publication on https://games.jmir.org, as well as this copyright and license information must be included.

                History
                : 20 January 2021
                : 12 February 2021
                : 30 March 2021
                : 28 June 2021
                Categories
                Original Paper
                Original Paper

                training techniques,educational technique,game theories,emergency medicine,games,education,escape game,simulation-based training,pedagogical,serious games,emergency medicine training

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