Why are games useful?* Promote cooperative learning* Motivate and engage learners* Add elements of fun and the challenge of competition in a non-stressful environment* Allows the teacher to use creative teaching techniques and technology* Allows students to be active participants in their own learning

Educational Games For All Students: Using A Question And Answer “Game Show” Format To Teach Psychiatry To Medical Students

Carolina Retamero, M.D., Rose Julius, D.O., Ruth Lamdan, M.D.Temple University School of Medicine, Philadelphia, Pennsylvania

Results* The graphic shows the distribution of student responses in 2 categories: disagree (includes disagree and strongly disagree responses) and agree (includes agree and strongly agree responses).* 77.3% of the students believed that they recall more information from the game show format as compared to the lectures(X2 = 18.32; p < .001).* When asked to rank 9 educational techniques in order of their contribution to the psychiatric competency developed during the clerkship, 24.1% ranked “game show participant” as number 1, while only 10.7% of the students ranked “didactic lectures” as number 1.* 86.4% of the students believe that they learn more when they have lectures and game show format activities combined. * Subjective feedback has been extraordinarily positive.

DiscussionEducational Games in the literature* For Medical Students:

* Who wants to be a physician for pulmonary physiology and Survivor for pulmonary physiology

* Fun, more understanding and retention of information. * Extremely useful, well presented, thorough in its content, valuable in the mechanisms it reinforced from their previous course in pulmonary physiology, * Enjoyed the interaction and collaboration that this educational game encouraged.

* T and B cell ontogeny game: * Pre-post test design: studentsʼ test grades improved significantly

* Game to educate about ectopic pregnancy* As effective as standard lecture in educating students about ectopic pregnancy, while being more enjoyable and stimulating.

* A card game to teach about host defense:* Significant increase in test scores, from 39% to 58% correct in the 8th graders, from 47% to 59% among 10th graders, and from 80% to 88% among the medical students.

* For residents: * Mind Games* Jeopardy to teach clinical pharmacology and therapeutics:

* Post-game survey results: 100%: enjoyable and useful way to learn pediatric CP&T and 100% wanted to do it again sometime. * Teaching methods on a 5 point scale for their effectiveness and ability to stimulate interest: JEOPARDY game format (4.7), case presentations (4.3), lectures (3.9), and journal club (3.3).

* Interactive game show type format to teach neuroanatomy* RITE: primary outcome measure: an interactive game show-type format is more effective than faculty-prepared lectures for improving resident understanding of basic and clinical neurophysiology.

MethodsGame Description* Students divide in 6 teams. We ask them to name their groups: “The Manic-Panicʼs, Pink Freudʼs, Freudian slips, Cluster Aʼs, Delirious, Haldol Stat, Munchausenʼs, Haldol Darts, The Psychlones, The DSM force, CFTʼs (Cold Freudian Turkeys).” 3 semifinals (multiple choice).* The winners of these 3 games will play on the final (single choice) and one team will be Champion of the Psych Game* We use our own PowerPoint template created to be similar in structure to the popular TV show Jeopardy©.* For the eliminatory questions game questions we use previous PRITE questions and original questions. All the final game questions are original questions.* Buzzer systemEvaluation of the teaching method* Pretest survey (handed during orientation)* 2-part posttest survey (one before the NBME exam and one after the NBME exam)* N=201 3rd year medical students

AbstractIntroductionThe use of interactive games to teach basic and clinical sciences has been described in the literature. Active or Adult Learning Theory supports a learning system that is self-motivated, gives immediate feedback and involves interactive participation. MethodsWe developed a game-show-like educational activity to teach psychiatry to 3rd year medical students, however, our program can involve learners at all levels, including attending physicians. It demonstrates to students competitive, interactive play, good spirit, enjoyment of learning and laughter. In front of a group of medical students, residents or mixed learning groups, participants are given a series of questions in Psychiatry, compete to be the first to answer questions correctly and then can look to the audience to respond to unanswered questions. Scores are tabulated and a small prize is given as additional playful incentive. Faculty works together to develop questions to stretch the learning objectives and maximize specific teaching points. Games are played over a Block or other teaching period - giving students time to study and actively compete with their knowledge base. ResultsOverall, the Game Show is enthusiastically endorsed by students. Adding educational games to a psychiatry curriculum can promote camaraderie amongst peers and other learner groups, engages them in a fun, enjoyable way to review and learn the Psychiatry curriculum. ConclusionsThis paradigm should be considered a valuable tool to enrich students at all levels of training and experience and promote interest in Psychiatry as a discipline.

ConclusionsEducational games have been used to teach nurses, medical students and residents. Although the literature of the usefulness of these games is scarce, the positive impact in learners is widely described. As the classroom lectures are likely to disappear from the medical students curriculum in the incoming years, educators will need to use other methods that are likely to be fun, promote long term retention of information and are well liked by learners. Educational games should be consider a valuable tool for teachers along with Team Based Learning, workshops and seminars.

IntroductionGoals as Educators* “Real” goals: - Increase shelf examination scores - “Psychiatry is great. I want to come back for more” - To have a great time* “Alleged” goals: - Life long learners - Problem solvers - To be the kind of physicians we want to go to

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How can we overcome these educational challenges?* Use assumptions of Adult Learning Theory: - Adults need to know why should they learn something - Adults are self directed and independent, taking responsibility for their own learning and the direction in takes. - Adults are experienced, and they want to be able to use what they know and be acknowledged - Adults will be ready to learn something when they feel they “need” to learn it - Adults are more interested in immediate problem centered approaches rather than subject centered approaches - Adults are more motivated to learn by internal drives than external drives* Apply other methods: discussion, case based learning, team based learning, simulation techniques, role playing, games

Challenges to our Goals* Large classrooms receiving conventional lectures* Increase of clinical revenues in academic centers: - Decrease time for teaching - Increased demands for clinical time* Limited training in educational techniques and theories* Introduction of technology to medical education* Students are “Adults” and want to be in control* There is an “inequivalence” on sites

How to Create an Educational Game* Incorporate the right amount of challenge, curiosity, fantasy and control* Set up adequate game goals and rules and provide feedback whether these are being achieved or not* Winning has to be possible for everyone. Winners as well as losers must be able to learn the same* If props are used they have to relate directly to the gameʼs purpose* Keep the students interested* Be original* Incorporate clinical cases, two-way questions, multiple choice questions and single answer questions

Advantages of Educational Games

Disadvantages of Educational Games

• Provide a structure for reinforcing pre-learned concepts as well as acquire new knowledge and skills

• Reduces stress and anxiety

• Promotes assimilation of content

• Decreases boredom as it actively involves all students

• Motivate participants• Adds entertainment in the

classroom• Students like games and

forming teams as it promotes communication and social interaction

• Students are “in control”

• May embarrassed and stress students when incorrect answers are given

• Competition may be seen as threatening

• May be expensive• May involve extensive

preparation and be time intensive

• May be difficult to assess individual competencies

• May loose the “serious” component

• It’s very difficult to apply in large group classrooms

• They may require special equipment

Educational Games

References1.Blakely G et al: Educational gaming in the health sciences: a systematic review. Journal of Advanced Nursing: 65(2), 259-269, 20082.David TJ, Patel L. Adult Learning Theory, Problem Based Learning, and Paediatrics. Archives of Disease in Childhood: 73(4), 357-363, 19953.Girardi FM et al: T-and B- Cell Ontogeny: An Alternative Teaching Method: T-and B-Cell Ontogeny Game. Teaching and Learning in Medicine, 18(3):251-260, 20064.Howard MG, Collins HL, DiCarlo SE: "Survivor" torches "Who Wants To Be A Physician" in the educational games rating war. Advan Physiol Educ: 26: 30-36, 20025.Kaufman DM. ABC of Learning and Teaching in Medicine. Applying Educational Theory in Practice. BMJ: 326: 213-216, 20036.Krueger et al: To the point: Reviews in medical education teaching techniques. American Journal of Obstetrics and Gynecology: 191: 408-411, 2004 7.Laidley TL, Braddock III CH. Role of Adult Learning Theory in Evaluating and Designing Strategies for Teaching Residents in Ambulatory Settings. Advances in Health Sciences Education: 5: 43-54, 20008.Moy JR et al. Who Wants To Be a Physician? An Educational Tool For Reviewing Pulmonary Physiology. Adv Physiol Educ: 24: 30-37, 20009.O'Leary MD et al. Educational games in an obstetrics and gynecology core curriculum. American Journal of Obstetrics and Gynecology: 193: 1848-1851, 200510.Purcell K. Teaching Clinical Pharmacology and Toxicology (CP&T) to Pediatric Residents: Use of a Jeopardy Game Format. American Society of Clinical Pharmacology and Therapeutics: 65: 173, 199911.Schuh L et al. Learning Clinical Neurophysiology: Gaming is Better than Lectures. Journal of Clinical Neurophysiology: 25(3): 167-169, 200812.Steinman RA, Blastos MT. A trading-card game teaching about host defense. Medical Education: 36, 1201-1208, 2002

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25.0

50.0

75.0

100.0

% of students

418

3 3

88 86 89

96

82

97 97

12 1411

DisagreeAgree

Student responses regarding the game show format

Keeps meawake Cover topics

throughly Is intellectually stimulating Is fun

Is less effective than lectures

Is too chaotic for concentration Is a distraction

from course content