B.C. students use games to level up virtual training for doctors

Local students from Vancouver’s Centre for Digital Media are using game design to address a health-care challenge for internationally trained doctors now working in Canada. 

The game is a multiplayer simulation that allows doctors to “play” through potential situations and experience how patients in Canada, controlled by instructors in their program, might respond.

Students from the CDM are partnering with the University of British Columbia’s faculty of medicine to develop this simulation to teach international medical graduates, or “IMGs”, about communicating in Canadian health-care settings.

“We’re trying to get them to understand the Canadian culture and how they practice in Canadian environments,” said Hee Su Kim, a developer on the team called HI-BC, which stands for “Helping IMGs in British Columbia.”

Training for this previously happened in person, where participants would learn the nuances of spoken and body language through role-play exercises. After moving the training online to Zoom during the pandemic, basics like reading body language and unspoken communication became more difficult to understand and absorb. 

And the game is just the solution for it.

“It would involve functionality such as sitting down, raising up arms, or undressing if it’s for like breast examinations,” said Kim.

There are a variety of cultural differences that doctors who are new to Canada may not be aware of beforehand. But games, like the students’ simulation, can provide an appropriate setting for doctors to practice getting used to them.

Emma Liu, who works on the project’s user experience, highlighted the different expectations in her country, China, as an example. She said most doctors can’t spend a lot of time with each person due to the high volume of patients they have, which can influence how they usually conduct patient examinations.

“In my country, [the doctor] won’t ask, like, ‘Can I touch you?’ And they may just directly, you know, exam you. But here, before the doctor exam the patient, he has to ask, ‘Is that okay if I touch you here? I’m going to do this, do that, is that okay for you?,” she said. 

The students have included common game-play elements in their simulation to help doctors immerse themselves in these scenarios, like the ability to control a character and monitor their progress in real time.

“You can click on the buttons, you know, feels like you’re playing a game. But we just put the features and function from the game and build out, like an interactive platform,” said Liu.

But this is no Fortnite or League of Legends.

It’s not all fun and games

“Gamification is a little bit different than games,” said Lillian Hung, an assistant professor at the UBC’s school of nursing. Hung led the development of an award-winning app that quizzes staff on the best responses to scenarios when caring for dementia patients, teaching them how to appropriately and clearly communicate with their clients.

“Because it can be games or it can be just applying their approach. You motivate people to do things,” she said. 

Hung’s app rewards the highest-ranking players with the chance to win custom-designed water bottles, which led to increased engagement with staff training.

Games can have other benefits beyond motivation, according to Jason Lee Elliott, instructor of game design at the Centre for Digital Media. He said that gamification can simplify tedious tasks.

“If you’re ever going to have to give someone medicine, you hide it,” said Elliott. “Put a little honey on that pill and then it goes down sweet. That’s what games are, games are the honey.”

How useful is gamification for teaching complex topics like health care? A lot of it comes down to how well it’s designed.

“That’s the main challenge we have, is trying to find that balance between is it more fun and more engaging. But it’s also primarily getting the results that are needed from the medical side of the standpoint,” added Elliott.

He believes that good gamification should be equally capable of being both engaging and educational. If these elements are properly balanced, gamification could be applied effectively to any topic.

Taking it to the next level

For students like Kim and her design team, gamification is an exciting subject not only for tech-based developers, but also the general population.

Kim believes the pandemic has opened doors for more people, especially for anyone less familiar with digital tools, to try out new approaches to learning.

“I think this is a great opportunity for them to kind of get more involved with technology. And maybe even after COVID, more simulation platforms like this could pop up, and they might have to use it in the future.”

As their design team gauges the success of the program, the students already have ideas for further improvements. These include using recorded conversations to build an artificial intelligence to operate the virtual characters, which are controlled by real people in the current version.

While their project is still in development, the students are planning to measure their success in two ways: through feedback from participants, and through evaluation of how well the doctors perform after their final training assessment.

And if it proves to be effective, the possibilities are rich in a variety of training settings.

Other projects like Hung’s quiz-based app are already an example of this. Since its initial development in 2018, her game teaching best practices for carers of dementia patients has since been integrated into staff orientations in multiple health authorities, including Vancouver Coastal Health, Fraser Health and Vancouver Island Health.

Hung is optimistic about the future of gamification in health care and believes that support will grow as public awareness of its potential increases.

“When you think about how Pokemon [Go] came and how people went out and tried to catch Pokemon, and people were starting to adopt those language and behaviour, right? If you get a lot of people to talk about the game that they play, that’s a lot of potential.”