Gamification is the application of game elements (e.g., collecting achievements, earning points or team-play) to first aid education with the intent to increase learner engagement. An example of this is a mobile application that tests the ability to assess various scenes for hazards. Gamification in electronic and physical (non-electronic) forms can captivate learners’ interest and provide the opportunity to re-engage with the content on a regular, independent basis. Given the increased popularity of mobile technology, electronic gamification offers the chance to reach a much broader audience, and as such, is the focus of this topic.
Guidelines
Good practice points
- Gamification may be used to deliver first aid content either independently or as part of a comprehensive educational strategy.
- Gamification should be purposeful and supported by an educational approach that identifies its benefits to the intended learning outcomes.
- Online games should be accessible offline.
Chain of survival behaviours
As an educational strategy, gamification can be applied to all domains of the Chain of survival behaviours. For example, a game that shows characters with different signs and symptoms could help learners with early recognition. A scenario app where one must care for multiple injured people at once could create a sense of the stress learners may feel in that situation. However, combining gamification elements with technology (mobile apps, computer games, etc.) may not be as useful to learn first aid steps. It is unclear how well individuals transfer what they learn through a digital medium to a real-world situation.
Education considerations
Context considerations
- Games can be used in learning across high and low resource settings. Consider how the setting of the education (face to face or online) could affect what games can be used.
- Games can be used across all resource settings. Consider how the delivery (face-to-face or online) will influence which games to use.
- Consider how gamification will best serve learners’ needs and preferences. Some gamification elements may be inappropriate in certain contexts. For example, competition between individual learners may be irrelevant for some age groups, religious backgrounds or in cultures that strongly value unity. The use of gamification should respect the local context in which it is used.
- If learning from home or in an independent setting, gamification may be an engaging element to incorporate.
- In times of pandemic, educators may need to adapt or reconsider games in which learners need to share physical spaces or learning aids.
Learner considerations
- Consider the cognitive and physical abilities of learners when designing or choosing appropriate games.
Facilitation tips and tools
- Ensure the learning outcomes are clear and the gamification elements are directly applicable to the learning process (e.g., test and retest or learning to prioritise actions). If not, learners may become disinterested with the content.
- Evaluate the effectiveness of the gamification elements by measuring key learning outcomes such as first aid knowledge, skills and attitudes. Secondary outcomes may include the rate with which learners re-engage with the content or the number of individuals they encourage to complete first aid education.
- Use gamification to motivate learners to revisit the material over time (increasing retention) or engage in additional first aid learning (increasing breadth and depth of learning).
- Use games that build on familiar concepts, such as a common board or card game, for testing knowledge and skills in a refresher course. Learners can physically play the game, using the classroom as the game board, or play on paper or online.
- Use technology that allows you to implement gamification elements that are audience-specific and provide easy access to learning, such as online games that learners can download at home.
- Ensure educators who are using gamification within a broader educational programme understand how to use the technology and integrate the content into the rest of the learning experience.
Benefits and limitations
- Using gamification elements that depend on technology, such as a mobile app, may have high development costs.
- Mixed-reality features, such as computer-enabled manikins or equipment with special sensors, may not be accessible to those learning independently (e.g., at home).
Scientific foundation
We identified four reviews and one literature report of a mobile app for the topic of gamification.
Cross-reality elements
There is limited evidence in favour of using cross-reality elements for learning. A longitudinal prospective study was conducted in two high schools, comparing two mobile phone apps: a cross-reality partner game and an information-based application. The partner game resulted in a statistically significant increase in learners’ ability to predict their own actions and in their confidence to act, compared to the information-based application. The study also showed that using animations as a feedback device can help learners achieve the intended learning outcomes (Semararo et al., 2017).
Points system
There is some evidence in favour of using a points system where learners earn points by completing activities on a mobile phone app. A randomised controlled trial showed that such a method resulted in a statistically significant increase in knowledge scores, compared to a version of the mobile app without the point system (Burgess et al., 2018)
Face-to-face facilitation and a mobile app
There is limited evidence in favour of combining in-person facilitation with a mobile phone app. A randomised controlled trial conducted in a school showed that when an app supported in-person facilitation, there was a statistically significant increase in CPR assessment and achievement scores compared to either method alone. However, the app method alone did not result in a statistically significant difference in compression rate and showed a statistically significant decrease in correct compression depth when compared to in-person facilitation (Yeung et al., 2017).
Using an app for knowledge development in a water safety context
A grey literature report on the development and trial of a water safety app for children (ages 13–14) demonstrated the app is an effective means for knowledge development when compared with facilitator-led learning. The app guides students through mini games that educate them on keeping themselves and others safe during the Emergency Action Plan. It also tests learners’ knowledge in a range of environments and emergencies.
Three approaches (learning using the app, facilitator-led learning and no learning) were tested with the same educational content across the two intervention groups. All intervention participants were assessed one week after learning, while the control group was evaluated without receiving any practical training or use of the app. Results showed that those who used the app demonstrated a similarly high level of knowledge of the critical steps in the Emergency Action Plan and water safety as those who completed the practical session. The app users also demonstrated the highest level of knowledge of potential dangers and hazards, especially near water. Learners in the facilitated group were better able to perform CPR compared to the app group. The app group outscored the control group across all outcome measures (Life Saving Victoria, 2016).
Computer game versus DVD-based learning
Finally, a military-based randomised controlled trial showed no significant difference between a computer game (a 3D video, known as a “serious game”) or DVD-based learning intervention. However, the authors concluded the game could be more engaging (Planchon et al., 2018).
References
Burgess, J., Watt, K., Kimble, R. M., & Cameron, C. M. (2018). Combining technology and research to prevent scald injuries (the Cool Runnings Intervention): Randomized controlled trial. Journal of Medical Internet Research, 20(10), e10361. Retrieved from https://www.jmir.org/2018/10/e10361/
Life Saving Victoria. (2016). Evaluation of the Everyday Lifesaver App. Life Saving Victoria: Port Melbourne. Retrieved from https://lsv.com.au/wp-content/themes/abomb/pdf/education/Everyday_Lifesaver_App_Evaluation_Report.pdf
Planchon, J., Vacher, A., Comblet, J., Rabatel, E., Darses, F., Mignon, A., & Pasquier, P. (2018). Serious game training improves performance in combat life-saving interventions. Injury, 49(1), 86–92.
https://www.researchgate.net/profile/Pierre_Pasquier2/publication/320393198_Serious_game_training_improves_performance_in_combat_life-saving_interventions/links/59e67871aca2721fc227ab52/Seriousgame-training-improves-performance-in-combat-life-saving-interventions.pdf
Semeraro, F., Frisoli, A., Loconsole, C., Mastronicola, N., Stroppa, F., Ristagno, G., Scapigliati, A., Marchetti, L., & Cerchiari, E. (2017). Kids (learn how to) save lives in the school with the serious game Relive. Resuscitation, 116, 27–32.
https://www.sciencedirect.com/science/article/abs/pii/S0300957217302009
Yeung, J., Kovic, I., Vidacic, M., Skilton, E., Higgins, D., Melody, T., & Lockey, A. (2017). The school Lifesavers study – A randomized controlled trial comparing the impact of Lifesaver only, face-to-face training only, and Lifesaver with face-to-face training on CPR knowledge, skills and attitudes in UK school children. Resuscitation, 120, 138–145.
http://wrap.warwick.ac.uk/93282/21/WRAP-school-lifesavers-study-randomised-controlled-trial-comparingYeung-2017.pdf
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Published: 15 February 2021
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