Gaming the System

Peter Kallio, DNP, CRNA, APNP, associate program director in the College of Nursing’s Department of Nurse Anesthesia, worked with Benjamin Wahlman, DNP ’26, CRNA, and others in his doctoral cohort to create serious games to teach medical skills as scholarly projects. Here they talk about how computer gamification sharpens skills learned from textbooks and lectures before students move on to high-fidelity manikin simulations and real-life patients.

Peter Kallio: We started doing serious games a few years ago. We have 10 or 15 games now that we use in simulation.

Benjamin Wahlman: The games bring real-world applications into what we’re trying to learn. We made a simulation of a patient with three scenarios: aortic stenosis, which is an issue with a heart valve; myocardial infarction, which is a heart attack; and one about managing a congestive heart-failure patient. They were supposed to replicate something that can actually happen. So, when you are with a real patient and this happens, you’ve already thought about the steps.

PK: The aortic stenosis scenario is preoperative, getting patients the right tests, getting the severity down. Is it mild? Can we take him to the operating room? Do we need another intervention first? Too many wrong decisions, and you can get booted out of the game and have to start over. You try it again, and do something different at the point where you were kicked out for making a bonehead move.

BW: We gave students a pre-test, then they ran through the scenario and took a post-test to see what they’d learned.

PK: What did you guys come up with?

BW: From all our games, it was pretty astounding evidence that playing through a realistic scenario was helpful. On the aortic stenosis game, we saw a 20% improvement after playing the scenario.

PK: That’s a big increase. If you look at the learning hierarchy of what teaching strategies work for retention purposes, the ones that work least are lectures and reading. Was that your experience as a student?

BW: Absolutely. You retain 10% of what you read in a book or hear in a lecture, but the hands-on experience of simulation is almost 90%.

PK: Those hands-on experiences tend to stick.

BW: You remember your mistakes more than you remember your wins. In real life I have more or less 12 seconds to respond before serious adverse effects happen to the patient.

PK: Even in the scenarios, the patient can die.

BW: That’s part of the learning for sure. Because they can die in real life.