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#KeyLIMEPodcast 205: Mario, Battleship and Poker – What can games teach #MedEd?

Are serious games an effective teaching modality in #meded? Read on, and check out the podcast here.


KeyLIME Session 205:

Listen to the podcast.


Tsoy E et al. Creating GridlockED: A Serious Game for Teaching About Multipatient Environments Acad Med. 2019


Jonathan Sherbino (@sherbino)


True story: The biggest controlled trial I have ever run is modelled after a bar trivia game. I’m about to launch a new research trial modelled after a game show.

Another true story: Over the holiday break, I was locked into a rubric’s cube death match
tournament with my nine-year old daughter. My frustration at losing to her required me to go online and seek out hacks and tricks to beat her at this game.

So… what does this have to do with #meded? Are games trivial pursuits (see what I did there?) that distract from more serious learning? Maybe not. If you’re interested in the role that games play in learning, this episode is for you.


This innovation report describes

“a peer-reviewed, collaborative, strategy game … that emulate the multipatient environment of the [Emergency Department].. to teach players about managing multiple patients .. while considering various factors that can hinder or enhance patient flow.”

Key Points on Method

Serious games are loosely defined as those with a pre-defined learning outcome (beyond entertainment) with rules that limit player’s options towards achievement of the outcome with variable levels that impact game difficulty.

  1. The authors researched serious, collaborative games to understand core gameplay elements.
  2. A game prototype was developed that included:
    • Characters
    • Goals
    • Resources
    • Feedback
    • Challenges
  3. The prototype was revised using a systematic quality improvement process (PDSA cycle).
  4. The game was evaluated by experienced clinicians, who completed a postgame survey regarding the utility of the game to teach about managing patient flow in an emergency department. IRB approval was granted for this evaluation.

Total budget for the game was $200 for materials with the provision of in-kind subject matter expertise and graphic design.

The GridlockED game was published by The Game Crafter, Madison, Wisconsin. Retail cost is $90.

Key Outcomes

18 gameplay sessions with 32 testers (emergency physicians, nurses and residents) were conducted. Only 4% had played a serious game before.

75% endorsed the game as a useful teaching tool and 56% felt it had the potential to improve patent flow in the ED. 87% found the game easy to play. Exemplar quotations from the evaluation survey suggest that the game is valuable to medical students and junior residents, although the game does not perfectly simulate the complexity of emergency department patient flow and resource allocation.

Future plans include “expansion packs” for rare scenarios (e.g. mass casualty) or for increased complexity to challenge experienced clinicians.

Key Conclusions

The authors conclude…

“We feel that by incorporating elements of educational games as well as simulation-based learning, we have created a safe simulated environment wherein educators can introduce and teach concepts of the multiprovider and multipatient environment.”

Spare Keys – other take home points for clinician educators

This is a great example of co-creation – a student initiated project support by established Clinician Educators and PhD education researchers to address an unmet learning need.


Access KeyLIME podcast archives here

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