The influence of a serious game's narrative on students' attitudes and learning experiences regarding delirium: an interview study

Kiki R Buijs-Spanjers, Anne Harmsen, Harianne H Hegge, Jorinde E Spook, Sophia E de Rooij, Debbie A D C Jaarsma, Kiki R Buijs-Spanjers, Anne Harmsen, Harianne H Hegge, Jorinde E Spook, Sophia E de Rooij, Debbie A D C Jaarsma

Abstract

Background: Delirium is a neuropsychiatric syndrome that affects patients' attention and awareness as a result of a physical condition. In recent years, persistent gaps in delirium education have led to suboptimal delirium care. Still, little is known about what are the most important aspects of effective delirium education. Serious games are both entertainment and an interactive, safe learning environment where players can experiment and create new knowledge. They have the potential to contribute to improved delirium education. We used a video-based serious games' narrative to explore aspects essential to enhance students' attitudes and learning experiences regarding delirium.

Methods: We created a semi-structured interview guide and interviewed seven nursing and nine medical students about their attitudes and learning experiences, after they had played the game. A qualitative descriptive design and inductive content analysis with constant comparison were used.

Results: The patient's and nurse's perspective, interactivity to experiment, realistic views on care options, and feedback on care actions were important for enhancing students' attitudes and learning experiences regarding delirium. Students felt these aspects encouraged them to get actively involved in and experiment with the study material, which in turn led to enhanced reflection on delirium care and education. Our findings highlight the importance of a more patient-oriented focus to delirium education to drive attitudinal change. Students' learning experiences were further enhanced through their affective responses provoked by the perspectives, interactivity, realism, and feedback.

Conclusions: Students considered the characters' perspectives, interactivity, realism, and feedback important aspects of the game to enhance their attitudes towards delirious patients and enrich their learning experiences. A patient-oriented narrative provides a clinically relevant experience in which reflection plays an important role. The serious game also serves as medium to actively experiment with care solutions to create better understanding of how healthcare professionals can influence a delirious patient's experience.

Keywords: Delirium; Education; Narrative; Serious game.

Conflict of interest statement

The serious game, Delirium Experience, is owned by Stichting Effectieve Ouderenzorg (a Dutch foundation for improving elderly care by research and education). SEdR is an unpaid member of the supervisory board of Stichting Effectieve Ouderenzorg, which waived the licensing fee required for the use of intellectual property for the purposes of this research. The game is currently commercialized, but the revenues are solely used to improve current elderly care by gamification. All other authors have no competing interests.

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