Flow Regulation in Medical Serious Games

Mechanisms of Flow Regulation in a Novel Digital Serious Game for Rehearsing Complex Medical Subjects

The goal of this study is to access the effect of facilitation on amount of psychological Flow generated in medical students playing a medical serious game. Students will be randomly assigned to play a serious game designed to revise diabetes management knowledge with and without a facilitator and the amount of Flow experienced compared. They will then be invited to partake in a focus group discussion to elicit insights into the mechanism of action governing facilitator-induced Flow

Study Overview

• Status: Completed
• Conditions: Diabetes Mellitus; Serious Games; Psychological Flow
• Intervention / Treatment: Other: Medical serious game intervention (educational); Other: Medical serious game intervention (educational)

Detailed Description

The prevalence of diabetes and their complications is set to increase in line with Singapore's aging population, and the increasing complexities of medicine have left healthcare professionals beyond endocrinology reduced time or interest to seek out clinical sources of rehearsal. Despite having been taught diabetes management, knowledge not practiced fades over time, and delays or errors wrought by uncertainties may result in preventable loss of life or limb. Additionally, while many digital products exist to assist diabetes patients and caregivers, few cater to busy healthcare professionals and fewer account for differing levels of competency amongst them.

To address these needs, the study proposes the development and feasibility testing of a simulation-based diabetes management digital game incorporating a feature allowing for a human facilitator to moderate and personalise the rehearsal activity with consideration for a learner's strength and weaknesses.

The proposed mixed methods study thus presents the following aims:

Feasibility examination of the developed game intervention as an appropriate rehearsal tool for medical students

Comparing the degree of Flow (a state of total cognitive immersion in an activity) experienced by students who play the intervention with and without a facilitator

Generation of preliminary training data to guide either the development of more refined interventions wherein formal training data may be collected, or the direct training of a machine intelligence to assume the place of the human facilitator Map, where possible, the structure of the mechanism of action governing the interaction of facilitation and Flow in rehearsal-based digital serious games The study aims to accomplish these aims by first conducting a two-arm superiority randomised control trial (RCT) comparing the Flow Short Scale (7-point Likert scale survey measuring Flow) scores and in-game game analytics, such as number of correct decisions and reaction times, between students assigned to the facilitated and non-facilitated conditions.

Following this, students assigned to both conditions will be either be invited to partake in a focus group discussion, or given an open-ended questionnaire structured to solicit their attitudes, perceptions, and opinions of the game that may reveal insights into the mechanism of action governing facilitator-induced Flow.

• Study Type: Interventional
• Enrollment (Actual): 53
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Singapore
  • Singapore, Singapore, 308232
    • Lee Kong Chian School of Medicine

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 19 years to 30 years (Adult)
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Subjects enrolled in M1 through to M5 of the MBBS program under LKCMedicine.

Exclusion Criteria:

• Students who have previously partaken in play testing of the intervention
• Students not enrolled in the Bachelor of Medicine and Bachelor of Surgery (MBBS) program under LKCMedicine

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Control; Serious game intervention to be played as is, without facilitation.	Other: Medical serious game intervention (educational); Medical serious game designed to facilitate the rehearsal of diabetes management knowledge. Players are presented with a colony of individuals, all of whom have some form of diabetes, and are tasked to manage food, insulin, and medication intake throughout the day. The intervention may be played with a facilitator.; Other: Medical serious game intervention (educational); Medical serious game designed to facilitate the rehearsal of diabetes management knowledge. Players are presented with a colony of individuals, all of whom have some form of diabetes, and are tasked to manage food, insulin, and medication intake throughout the day. The intervention may be played alone.
Active Comparator: Intervention; Serious game intervention to be played with facilitator present in game environment.	Other: Medical serious game intervention (educational); Medical serious game designed to facilitate the rehearsal of diabetes management knowledge. Players are presented with a colony of individuals, all of whom have some form of diabetes, and are tasked to manage food, insulin, and medication intake throughout the day. The intervention may be played with a facilitator.; Other: Medical serious game intervention (educational); Medical serious game designed to facilitate the rehearsal of diabetes management knowledge. Players are presented with a colony of individuals, all of whom have some form of diabetes, and are tasked to manage food, insulin, and medication intake throughout the day. The intervention may be played alone.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Flow Short Scale (FSS) scores	The FSS comprises 13 items on a 7-point Likert scale ranging from 1 ("not at all) to 7 ("very much"). It demonstrates good construct validity, psychometric properties, and a stable three-factor structure comprising fluency of performance, absorption by activity, and perceived importance or outcome importance of said activity.	Immediately upon conclusion of the game activity

Collaborators and Investigators

• Sponsor: Nanyang Technological University

Study record dates

Study Major Dates

• Study Start (Actual): February 1, 2023
• Primary Completion (Actual): September 6, 2023
• Study Completion (Actual): September 6, 2023

Study Registration Dates

• First Submitted: November 24, 2022
• First Submitted That Met QC Criteria: November 24, 2022
• First Posted (Actual): December 5, 2022

Study Record Updates

• Last Update Posted (Actual): March 21, 2024
• Last Update Submitted That Met QC Criteria: March 19, 2024
• Last Verified: March 1, 2024

More Information

Terms related to this study

• Other Study ID Numbers: IRB-2022-739

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No