In a recent report, medical students report significantly higher rates of burnout when compared to age-matched fellow college graduates. Too often medical students lose their motivation because of emotional exhaustion, depersonalization and a diminished sense of personal accomplishment. Medical students should no longer see their education as a challenge to overcome. They should see it as a game that can be won.
Gamification is the concept of applying game-design elements (e.g. point scoring, competition, rewards) to drive game-like behavior in non-game settings to make them more fun and engaging. Already video games aimed at teaching medical education are making their ways into schools. These games do not replace lectures; instead they reinforce the curriculum in a way that is both interactive and entertaining.
Medical reasoning does not develop spontaneously, and so achieving short- and long-term educational goals is dependent on a student’s own motivation to learn medicine. Games motivate people in ways that other activities often do not. Students continue playing games despite encountering obstacles, yet these same students may not demonstrate the same persistence in response to setbacks in studying. Applying game concepts to medical school makes sense because medicine and games both involve mastering certain skills before advancing to the next difficult level.
There are three approaches by which games could foster medical thinking and medical education. First, technology typically applied to video games can be directed towards providing students a platform for visualization of and interaction with medical material. Second, games that promote the development of skills, attitudes and knowledge that are useful for medical thinking and practice can be incorporated into small group classes. Third, an overarching incentive system would allow for reinforcing information, monitoring of progress and mastering of skill levels.
At the foundation of this groundbreaking medical school would be innovative technological advancements that engage students in their education. These technologies involve simulations that allow students to make predictions, manipulate components and observe effects in order to understand complex body systems and disease processes. Oculus Rift, a virtual reality display, would help students better understand anatomy, pathology and embryology by transporting them into a virtual body. Medical students would follow a clot from a deep vein in the leg all the way to the lung to comprehend the idea of a pulmonary embolism. Students would arrange muscles on a virtual skeleton to understand kinesiology, or manipulate the germ layers of a gastrula to understand embryology. Although a virtual cadaver would never be able to replace the real experience of the anatomy lab, technology could enhance that experience.
Applying gamification to classes can encourage students to participate more in small group problem-based learning exercises. Traditionally, the whole group plays doctor as they seek to diagnose a patient from their chief complaint. Instead, take a game approach: split the group into two teams, disease versus doctors, and have them compete. The disease team represents an underlying medical condition whose objective is to make the “patient” ill. They receive points for every symptom the patient exhibits, with more points awarded for the more common symptoms. The doctors ask for history, labs and imaging to generate differential diagnoses. For every correct request and diagnosis, they receive points. Even once the diagnosis is confirmed, the doctors must suggest a plan, treatment and long-term complications as the disease team continues to afflict the patient. This exercise utilizes narrative elements to motivate the students to research pathophysiology, pharmacology and patient management in order to build a better simulation and win the game.
Grades and the promising future medical career that follows from them have long been the only incentive for medical students. But to gamify medical education, more direct and tangible rewards are necessary as students are rewarded on both a group and an individual level. For the group level, the school would divide students into houses at the beginning of medical school. A leaderboard would keep scores between the houses. For every ‘A’ the student receives on an exam, her house receives a certain number of points. Students also gain points through volunteer work, leadership opportunities and attending lectures. Houses compete with each other throughout the year and the winning house would throw a party for its members. This house system would not only encourage some friendly competition, it would promote a communal atmosphere between students of different years.
There could also be an individual incentive system. Medical schools would provide students with question apps on their smart devices that correlate to the medical curriculum. After the students answer a certain percentage of the questions correctly, they would unlock achievements and the chance to win certain rewards. For example, if they answer 70 percent of the questions correctly, they might have the random chance to win a free lunch at the cafeteria or points for their house. If they answer 85 percent of the questions correctly, they unlock the random chance to retake a previous quiz. This incentive program is both calculated and random. The program is calculated because the rewards would be more desirable as more levels were unlocked, while the rewards are randomly won by students who unlock that level. As the students study to unlock the levels and win those prizes, they are more motivated to learn.
Whether medical schools incorporate gamification remains to be seen. More than three-quarters of medical students answered that they would use a video game on their own time to improve their medical knowledge. Through games and other digital media, students experience opportunities for autonomy, competence and connection to others. Providing these same opportunities in the classroom acknowledges that these elements of games are part of the students’ reality, and that this reality affects who students are as learners. Gamification effortlessly incorporates problem-based learning, student-centered learning and integrated teaching into the medical curriculum. Games impart to students a sense of competence, self-efficacy and mastery. Gamification of medical school can deliver and reinforce critical concepts while providing educators with new tools to enhance traditional medical education.