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      The Effects of Gamification on Computerized Cognitive Training: Systematic Review and Meta-Analysis

      research-article
      , BBehSc (Hons) 1 , , , PhD 1 , , PhD 2 , , PhD 3 , , PhD 3 , 4 , 5
      (Reviewer), (Reviewer), (Reviewer)
      JMIR Serious Games
      JMIR Publications
      gamification, cognition, health, systematic review, meta-analysis

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          Abstract

          Background

          There has been a growing interest in the application of gamification (ie, the use of game elements) to computerized cognitive training. The introduction of targeted gamification features to such tasks may increase motivation and engagement as well as improve intervention effects. However, it is possible that game elements can also have adverse effects on cognitive training (eg, be a distraction), which can outweigh their potential motivational benefits. So far, little is known about the effectiveness of such applications.

          Objective

          This study aims to conduct a systematic review and meta-analysis to investigate the effect of gamification on process outcomes (eg, motivation) and on changes in the training domain (eg, cognition), as well as to explore the role of potential moderators.

          Methods

          We searched PsycINFO, Cumulative Index to Nursing and Allied Health Literature, ProQuest Psychology, Web of Science, Scopus, PubMed, Science Direct, Excerpta Medica dataBASE, Institute of Electrical and Electronics Engineers Xplore, Association for Computing Machinery, and a range of gray-area literature databases. The searches included papers published between 2008 and 2018. Meta-analyses were performed using a random-effects model.

          Results

          The systematic review identified 49 studies, of which 9 randomized controlled trials were included in the meta-analysis. The results of the review indicated that research in this context is still developing and lacks well-controlled empirical studies. Gamification in cognitive training is applied to a large range of age groups and audiences and is mostly delivered at a research site through computers. Rewards and feedback continue to dominate the gamification landscape, whereas social-oriented features (eg, competition) are underused. The meta-analyses showed that gamified training tasks were more motivating/engaging (Hedges g=0.72) and more demanding/difficult (Hedges g=–0.52) than non- or less-gamified tasks, whereas no effects on the training domain were found. Furthermore, no variables moderated the impact of gamified training tasks. However, meta-analytic findings were limited due to a small number of studies.

          Conclusions

          Overall, this review provides an overview of the existing research in the domain and provides evidence for the effectiveness of gamification in improving motivation/engagement in the context of cognitive training. We discuss the shortcomings in the current literature and provide recommendations for future research.

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          Most cited references67

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          From game design elements to gamefulness

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            A Systematic Review of Gamification in e-Health.

            Gamification is a relatively new trend that focuses on applying game mechanics to non-game contexts in order to engage audiences and to inject a little fun into mundane activities besides generating motivational and cognitive benefits. While many fields such as Business, Marketing and e-Learning have taken advantage of the potential of gamification, the digital healthcare domain has also started to exploit this emerging trend. This paper aims to summarize the current knowledge regarding gamified e-Health applications. A systematic literature review was therefore conducted to explore the various gamification strategies employed in e-Health and to address the benefits and the pitfalls of this emerging discipline. A total of 46 studies from multiple sources were then considered and thoroughly investigated. The results show that the majority of the papers selected reported gamification and serious gaming in health and wellness contexts related specifically to chronic disease rehabilitation, physical activity and mental health. Although gamification in e-Health has attracted a great deal of attention during the last few years, there is still a dearth of valid empirical evidence in this field. Moreover, most of the e-Health applications and serious games investigated have been proven to yield solely short-term engagement through extrinsic rewards. For gamification to reach its full potential, it is therefore necessary to build e-Health solutions on well-founded theories that exploit the core experience and psychological effects of game mechanics.
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              No evidence of intelligence improvement after working memory training: a randomized, placebo-controlled study.

              Numerous recent studies seem to provide evidence for the general intellectual benefits of working memory training. In reviews of the training literature, Shipstead, Redick, and Engle (2010, 2012) argued that the field should treat recent results with a critical eye. Many published working memory training studies suffer from design limitations (no-contact control groups, single measures of cognitive constructs), mixed results (transfer of training gains to some tasks but not others, inconsistent transfer to the same tasks across studies), and lack of theoretical grounding (identifying the mechanisms responsible for observed transfer). The current study compared young adults who received 20 sessions of practice on an adaptive dual n-back program (working memory training group) or an adaptive visual search program (active placebo-control group) with a no-contact control group that received no practice. In addition, all subjects completed pretest, midtest, and posttest sessions comprising multiple measures of fluid intelligence, multitasking, working memory capacity, crystallized intelligence, and perceptual speed. Despite improvements on both the dual n-back and visual search tasks with practice, and despite a high level of statistical power, there was no positive transfer to any of the cognitive ability tests. We discuss these results in the context of previous working memory training research and address issues for future working memory training studies. PsycINFO Database Record (c) 2013 APA, all rights reserved.
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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 2020
                10 August 2020
                : 8
                : 3
                : e18644
                Affiliations
                [1 ] School of Psychology and Counselling Institute of Health and Biomedical Innovation Queensland University of Technology Brisbane Australia
                [2 ] Science and Engineering Faculty Queensland University of Technology Brisbane Australia
                [3 ] Department of Experimental Clinical and Health Psychology Ghent University Ghent Belgium
                [4 ] Department of Clinical Psychological Science Maastricht University Maastricht Netherlands
                [5 ] Department of Behavioural and Cognitive Sciences University of Luxembourg Esch-sur-Alzette Luxembourg
                Author notes
                Corresponding Author: Julie F Vermeir julie.vermeir@ 123456hdr.qut.edu.au
                Author information
                https://orcid.org/0000-0002-2931-6629
                https://orcid.org/0000-0002-4865-8878
                https://orcid.org/0000-0003-1088-3460
                https://orcid.org/0000-0002-4744-8561
                https://orcid.org/0000-0002-4981-8896
                Article
                v8i3e18644
                10.2196/18644
                7445616
                32773374
                59d4d666-afe6-48b1-a415-cb87e6ba4ee2
                ©Julie F Vermeir, Melanie J White, Daniel Johnson, Geert Crombez, Dimitri M L Van Ryckeghem. Originally published in JMIR Serious Games (http://games.jmir.org), 10.08.2020.

                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 http://games.jmir.org, as well as this copyright and license information must be included.

                History
                : 10 March 2020
                : 16 April 2020
                : 21 April 2020
                : 22 April 2020
                Categories
                Original Paper
                Original Paper

                gamification,cognition,health,systematic review,meta-analysis

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