About ASPIRE

With funding from the Office of Naval Research, we are in the process of designing and developing a prototype game to augment the US Marine Corps’ Operational Stress Control and Readiness (OSCAR) Program. The OSCAR Program is the US Marine Corps effort to provide support directly to Marines from Marines while in-theater, with the overall goals of improving mental toughness, raising awareness of the importance of psychological health, reducing stigma, and reducing long-term deployment-related stress problems. This is achieved using OSCAR Team Members, which are individuals that operate within the deployed unit and are trained in combat/operational stress control. This allows for the early identification of potential stress-related problems so that they can be addressed immediately, ensuring the Marine’s quick and safe return to the unit.

The prototype game we are currently developing, code-named Project ASPIRE, seeks to extend the lessons learned in OSCAR to real-world examples. Players will be tasked with talking to fellow Marines to gauge their psychological well-being. After uncovering their presenting problem and determining the Marine’s location on the USMC Combat Operational Stress Continuum, players will have to decide the correct course of action. Through a conversation-based game mechanic, players will practice taking Marines through brief cognitive interventions. Players will also learn how to teach Marines breathing and relaxation exercises by playing minigames.

ASPIRE Development

ASPIRE was designed and developed with the help of an experienced serious games designer. The content and scenarios were written by clinical psychologists who have experience in treating warfighters.

ASPIRE Development Team

Introductory Note: The “Top Ten Research Findings in Games from 2012″ was presented by Dr. Alicia Sanchez and Dr. Clint Bowers at the Defense GameTech Users’ Conference 2013 in Orlando on April 17, 2013. This blog post highlights the major findings from each paper. The summaries in this post were compiled by Katelyn Procci and are based on the original presentation. For the full study details, such as the literature background and study methodology, please refer to the presentation slides (download here).

Disclaimer: The Top 10 Research Findings for 2012 have been decided by us alone. All papers included have empirical results. Papers were selected not solely based on quality, but on relevance to this particular conference. In some cases we have not presented all of the results that were found by these researchers. We will make our presentation available, but we cannot make the research papers available. Everything in this presentation has been subject to our interpretation.

#10: Learning Style and Gender Consciousness Affects Novice Learning in Games
Wang & Chen (2012)

Eighth grade students learned about Flash development through game-play. Of interest were how the effects of learning style (divergers vs. convergers) and gender consciousness on the comprehension of programming concepts, programming performance, and motivation. Divergers were those who learned best by viewing concrete situations from multiple viewpoints, while convergers preferred finding practical uses for ideas and theories. The results suggested that learning style impacted programming comprehension, and gender consciousness impacted project performance for divergers and convergers differently. The convergers comprehended the abstract programming principles better than the divergers. High gender consciousness convergers outperformed high gender consciousness divergers on project performance, but low gender consciousness convergers and divergers performed equally. The divergers with low gender consciousness outperformed those with high gender consciousness on project performance, but both gender consciousness groups of convergers performed equally. The researchers also found that intrinsic and extrinsic motivation was similar (and positive!) for all four groups.

#9: Video-Game Play Improves Information Processing Abilities
Powers, Brooks, Aldrich, Palladino, & Alfieri (2012)

The researchers conducted a meta-analysis on video game use and cognitive change. Their analysis included 46 true experiments and 72 quasi-experiments. The analysis revealed that there is a moderate to large effect size for games, supporting the hypothesis that games can improve information processing. The largest effects were for the basic abilities of the brain, such as visual processing. The effect sizes were the smallest for the higher-order, executive functions. Older learners also benefited more than younger learners. Interestingly, the effects were much stronger for males.

#8: Well-Designed Quests Improve a Math Game
Chen, Liao, Cheng, Yeh, & Chan (2012)

In a study of Taiwanese 4th grade students, when incorporated into a game to teach math, quests were found to have a positive impact in that they influenced students’ perceptions (enjoyment, goal orientation, and goal intensity) and elicited more active participation. Overall, the study found that quests whose goals align with learning objectives are favored by students.

#7: Action Video Games Improve Task-Switching
Green, Sugarman, Medford, Klobusicky, & Bavelier (2012)

This paper focused on how action video games might lead to enhanced “task-switching” ability. Task switching is essentially multitasking. It is an executive brain function that involves shifting attention and adapting to a variety of different situations. When tasks are switched, performance will decrease. This is the task cost. The researchers conducted a series of four small studies. The results suggested that players of action games had reduced task-switching costs. Even those who were not gamers had improvements after playing 50 hours of an action game.

#6: Tutorials are Effective in Complex Games
Andersen et al. (2012)

The purpose of this study was to determine if including tutorials in games affected engagement and instructional effectiveness. This study featured a massive sample size: The researchers tested 8 types of tutorials across 3 games in 45,318 participants. Tutorials were found to be effective in complex games (and not justified in less-complex games whose mechanics might be more easily discovered through experimentation).

#5: Games Can Promote the Development of New Perspectives
Gonzalez, Saner, & Eisenberg (2012)

The game in this study was a commercial off-the-shelf (COTS) game that allows you to play multiple roles and make decisions related to those roles within the Israeli-Palestinian conflict. Undergraduate students played this game twice during a semester. Players were at first randomly assigned to either being the Palestinian President or Israeli Prime Minister, but ultimately the played both roles during the study. The results suggested that playing the game mitigated the initial religious and political views of its players.

#4: Gamification Can Motivate Some
Thom, Millen, & DiMicco (2012)

The researchers implemented gamification into a social networking system for a large company in order to promote content contribution. For example, users would receive points for posting pictures and comments, which would allow users to earn badges to be posted on their profile. The researchers found that including the gamification dramatically increased content contribution initially, but eventually it was no longer effective. They found that gamification does motivate some, but not all.

#3: Gamers are More Persistent
Ventura, Shute, & Zhao (2012)

The researchers were interested in whether video game experience was related to increased ability to persist with a difficult task. They found a small, but significant relationship between the time dedicated to unsolved problems and self-reported persistence, and that performance-based persistence was related to video game use.

#2: Cooperation and Competition Affects Learning, Motivation, and Self-Efficacy
Smith (2012)

This study focused on a resource management game similar to Diner Dash, except the content area was acquisition. The game modified to be cooperative (two players could work together) or competitive (two players tried to get a higher score). All players had positive learning outcomes. For those who were not given any instructions to compete, the cooperative group reported a larger increase in intrinsic motivation. For those who were told to compete, all groups had increases in intrinsic motivation. Also, winners in the competitive versions of the game had higher self-efficacy than losers, and those winners that were rewarded with a $10 iTunes giftcard had higher self-efficacy than those who played cooperatively. It seems that the use of competition in games is a complex variable that can have impacts on learning, motivation and self-efficacy.

#1: Adaptive Leveling Can Result in Exposure to More Challenge
Sharek (2012)

This study examined Gridblocker, an isometric tile-based puzzle game in which players must move a block until the block ends up standing over a goal. The game featured multiple levels of increasing complexity. In the experiment, there were three conditions: Linear, in which players got a harder level after completing an easier level; Choice, in which players pick whether the next level is easier or harder than the last; and, Adaptive, in which an algorithm determines the difficulty of the next level. The goal of the study was to determine if condition impacted engagement. The results found that those in the Choice and Adaptive conditions did not report higher engagement, higher affect, or lower levels of cognitive load. Those in Adaptive condition played fewer levels, yet achieved greater difficulty than other conditions. Ultimately, there were no differences in length of time played. Adaptive leveling, when done appropriately, can lead to exposure to more challenge (and choice can lead to players selecting less challenge).

Andersen, E., O’Rourke, E., Liu, Y., Snider, R., Lowdermilk, J., Truong, D., Cooper, S., & Popovic, Z. (2012). The impact of tutorials on games of varying complexity. Paper Presented at CHI’12, Austin, TX.

Chen, Z., Liao, C. C. Y., Cheng, H. N. H., Yeh, C. Y. C., & Chan, T. (2012). Influences of game quests on pupils’ enjoyment and goal-pursuing in math learning. Educational Technology & Society, 15(2), 317-327.

Gonzalez, C., Saner, L. D., & Eisenberg, L. Z. (2012). Learning to stand in the other’s shoes: A computer video game experience of the Israeli-Palenstinian Conflict. Social Science Computer View, Sage Publications.

Green, C. S., Sugarman, M. A., Medford, K., Klobusicky, E., & Bavelier, D. (2012). The effect of action video game experience on task-switching. Computers in Human Behavior, 28, 984-994.

Powers, K. L., Brooks, P. J., Aldrich, N. J., Palladino, M. A., & Alfieri, L. (2012). Effects of video-game play on information processing: a meta-analytic investigation. Psychomomic Bulletin & Review, 1-25.

Sharek, D. J. (2012). Investigating real-time predictors of engagement: Implications for adaptive video games and online training (unpublished docotral dissertation). North Carolina State University, Raleigh NC.

Smith, P. A. (2012). Cooperative versus competitive goal structures in learning game (unpublished doctoral dissertation). University of Central Florida, Orlando, FL.

Thom, J., Millen, D. R., & DiMicco, J. (2012). Removing Gamification from an Enterprise Social Networking System. Proceedings ACM Conference on Computers Supporting Collaborative Work. New York: ACM.

Ventura, M., Shute, V., & Zhao, W. (2012). The relationship between video game use and a performance-based measure of persistence. Computers in Education, 60, 52-58.

Wang, L. & Chen, M. (2012). The effects of learning style and gender consciousness on novice’s learning from playing educational games. Knowledge Management & E-Learning: An International Journal, 4(1), 63-77.

There exists much speculation about when the next version of Microsoft’s gaming console, Xbox 720 (aka Durango), will release; however, the Washington based company has already released details about a next-generation immersive gaming system which extends gameplay beyond the television screen. The new system, IllumiRoom, can transform the entire room to become a part of the gaming experience. IllumiRoom accomplishes this by utilizing a Kinect for Windows camera paired with a projector which is connected to the game console and television. Finally, we can let our peripheral vision join in on the fun.

By engaging more of our senses (i.e., haptic controller feedback) and engrossing those sensory modalities to a greater degree, game developers can influence gamers to play longer. This is accomplished by the aspect of gaming known as presence, which is the sensation of being spatially located in the mediated (game) environment. If Microsoft uses projected visualizations to meld the physical and virtual worlds, gamers might find it even easier to become “lost” in a game. What are some of the possible consequences that can arise from inducing a more engaging experience in video game players?

Several studies have examined the link between presence in a virtual environment and learning. Annetta and Holmes [1] found that students with a higher sense of presence in a synchronous, online class reported having a higher degree of satisfaction with the course. Video games can also motivate players to learn by providing a more engaging experience [2]. However, a rich, immersive environment can have unintended consequences. Simulator sickness, a condition caused by disagreement between the movement you see and the vestibular system’s sense of movement, can cause dizziness, fatigue, and nausea. Approximately a third of all people are prone to motion sickness even in mild conditions. The causes of simulator sickness have been found to be bright images, motion at 0.2 hz in moving systems, and wide fields of view (like the kind created by IllumiRoom). The immersion doesn’t stop with IllumiRoom either. Microsoft has also announced the projected release of augmented reality glasses that can be used with or without the Xbox gaming console. How will this affect learning, interpersonal relationships, and the line between fantasy and reality?

1. Annetta, L. A., & Holmes, S. (2006). Creating presence and community in a synchronous virtual learning environment using avatars. International Journal of Instructional Technology and Distance Learning, 3, 27-
43.

2. Annetta, L. A. (2008). Video games in education: Why they should be used and how they are being
used. Theory into Practice, 47(3), 229-239.

On Monday, March 18, 2013, the Selective Mutism app was shown at the Florida Academic Virtual Reality Showcase (FLAVRS) here in Orlando. This event was a part of the IEEE Virtual Reality 2013 conference, which had nearly two-dozen stations featuring VR-related work from a variety of Florida-based universities.

The app was featured in our collaborator Dr. Deborah Beidel’s demonstration of anxiety disorder research, alongside one of her other projects, Pegasus School. Pegasus School, which was developed in collaboration with Virtually Better, is a virtual environment where children with anxiety can practice social interaction skills in a safe space. Children speak to the on-screen avatars, whose responses are controlled by an external agent. The children can practice their developing social skills in a variety of school situations, from talking with a teacher to handling a group of bullies.

Dr. Beidel @ FLAVRS

The event was a huge hit! The event lasted several hours and it seemed that the ballroom was packed the entire time. The highlight of the event was the amount of variety: Not only were there many different research groups and universities represented, the sheer number of the different types of technologies being used in so many diverse and creative ways was astounding. Aside from our laptops and iPads for treating anxiety disorders, other examples included a Kinect used for controlling a UAV via gestures, augmented reality for anatomy training (oh yes, projecting images of organs onto a person’s body, science fiction is becoming reality!), and an animatronic virtual human named Sean that was riding a scooter around the ballroom (which was somewhat unsettling–thanks uncanny valley–but still very cool). I am also pretty sure I saw a car driving itself outside.

FLAVRS 2013

The Selective Mutism app is currently undergoing usability testing in groups of both undergraduate students and children. The results of the usability studies will be used to refine the design of the app.

This is part 4 of an on-going series of blogs on using games for training the workforce.

My boyfriend was sitting at the computer and called out to me “We should do this together.”  Naturally, I responded “Do what together?”  He replied, “Learn French.”  Nuh uh, nope, I did not want to do it, I said.  But then I peered at his screen, and on it was a simple request:

[photo source]

Of course I instantly clicked “l’homme” and clicked “Check.”

[photo source]

Violà!  I clicked “continue” and my boyfriend just smiled.  “I thought you didn’t want to learn,” he teased.  I thought I didn’t, either.  What was so exciting about clicking the correct answer?

The Office of Personnel Management states that timely feedback is important.  Why?  Because if something needs to change, the sooner a person knows this, the sooner they can implement this change.  But, why else?  Timely positive feedback is also rewarding.  If a person accomplishes or exceeds a goal, and the quicker he/she receives the positive feedback, the more rewarding it is for that person [1].  (See also Skilan’s blog.)

Could this be enough motivation alone to continue my language training?  A meta-analysis concluded that verbal positive feedback increased intrinsic motivation [2].  But, how much motivation could this contribute, and how can we use this to improve training?

Some training programs can be very boring.  And no one feels motivated to do boring tasks.  But, even boring tasks may seem more appealing when presented in a game-like manner, and people may be motivated to complete the task perfectly to gain that positive feedback.  So, utilizing this knowledge, organizations and educators can structure training or classroom lessons so that learners get instant and positive feedback.  That drive to achieve perfection may also increase learning.  For example, I play a game on my Window’s phone in which you can earn 3 stars per level completed.  If I don’t earn all three stars, you know I’m playing that level over again.  I am therefore practicing playing this game even more, and theoretically, getting better at it….theoretically.

[photo source]

The question is how much transfer is happening via this method?  Does where my motivation comes from affect how much or well I learn?  I smell the next topic in this series.

We’ll see if I can speak French soon.

References

1. U.S. Office of Personnel Management.  Performance Management.

2. Deci, E.L., Koestner, R., Ryan, R.M. (2001).  Extrinsic rewards and intrinsic motivation in education: Reconsidered once again.  Review of Educational Research, 71(1), 1-27.

This is part 4 of an on-going series of blogs on using games for training the workforce.

 
The first 3 parts of this Training the Workforce series has seen us take a look at transfer of training, the potential of using video game training, and how motivation can help transfer of training.  In part 4 we will discuss feedback; how it can help training in general, and why it helps video game training be so effective in particular.

Feedback is a crucial aspect of any training program.  Providing feedback throughout the training process helps to motivate trainees and fosters perseverance on their part [1].  Simply put, by knowing what works and what doesn’t work, trainees can put their knowledge to use immediately to solve problems and overcome obstacles in training. In turn, this can help make trainees want to learn even more.  In fact, in their 2012 meta-analysis, Dean, Pitler, Hubbell, and Stone found about a 28 percentile point difference in average achievement for learners that received feedback compared to those that didn’t [2].

It is possible for there to be negative effects on learning from feedback [3].  However, there are ways to develop feedback in such a way as to prevent these negative effects from occurring.  Goodwin and Miller state, in their Educational Leadership article, that “good feedback is targeted, specific, and timely” [1]. In essence, this means that feedback should be linked to learning objectives, not vague, and given soon after the correct or wrong behavior. If feedback meets this criteria, it will help trainees feel more motivated and engaged in their learning process which should result in increased learning outcomes and more effective training programs.

It is my personal opinion that there are very few types of training that can come close to matching the potential gains from feedback possible with video games.  Video games by their very nature deliver “targeted, specific, and timely” feedback to the person playing the game.  If you perform the correct action you level up, get a rare item, or maybe you receive positive feedback from an NPC (non-playable character) within the game.  On the other hand, when you perform the wrong action you lose health, get yelled at by an NPC or can even lose a life.  This feedback is directly relevant to the game being played, it is very specific, and it happens within moments. As Goodwin and Miller state; “it’s hard to imagine children being glued to these games if, instead of receiving ongoing, real-time feedback, they got their results weeks later in the mail” [1].

I believe that when these principles of feedback in training and video games merge, such as we see in the Serious Game genre, the future of employee training looks very bright indeed.

References

1. Goodwin, B. (2012). Good Feedback Is Targeted, Specific, Timely. Educational Leadership, 70(1), 82.

2. Dean, C., Pitler, H., Hubbell, E., & Stone, B. (2012). Classroom instruction that works: Research-based strategies for increasing student achievement (2nd ed.). Alexandria, Va. : ASCD,  c2012

3. Shute, V. J. (2008). Focus on Formative Feedback. Review Of Educational Research, (1), 153.

This is part 3 of an on-going series of blogs on using games for training the workforce.

In my previous blog, I talk about my experiences with two organizations and the effectiveness of training types and feedback procedures presented to the trainee. This blog however, will diverge from the main topic of transfer of training to a minor tangent on the trainee/employee mindset when approaching the job tasks following training. Transfer of training is not only a contributor to a knowledgeable employee but it is highly important in instilling motivation.

To start out, a simple definition of the term motivation is the aspiration to do something or to get something done. The motivation to do such a “thing” is, usually, accompanied by a goal or a significant outcome. To break it down, people are motivated by intrinsic and extrinsic factors. Intrinsic factors are those in which motivate the person to perform to satisfy internal goals and aspirations, such as: the need for achievement, autonomy, and referring to Glenn Llopis in his text “The Top 9 Things That Ultimately Motivate Employees to Achieve,” he mentions career advancement, making an impact on the organization and the need to prove others wrong concerning their abilities [1]. Agreeing with Gail Cengia in her article “Need for Achievement and Motivation,” an employee that has a high need for achievement will always want to be challenged with new tasks [2]. Taking note of employees that ask for more work, they may not be satisfied by their workload and could ultimately lead to feelings of ineptness. Extrinsic factors are motivators, unrelated to the task, in which people perform to attain such as awards, rewards, or compensation. Some examples of extrinsic factors are extended vacation, pay raise, bonuses, public attention, etc.

Is motivation transferred by giving them a cupcake (extrinsic) after every sale or is it by increasing the awareness of the employees’ ability to reach harder goals, which boosts ones need for achievement (intrinsic)? There are a number of ways to increase an employees’ motivation but to fine tune to each individual is not a mundane task. According to Llopis, being a good leader starts with understanding your employees; get to know them and you will pick up on what motivates them as an individual[1]. After all, a healthy company is one with great camaraderie.

So can money buy happiness? Or does a healthy career emit happiness? I’d enjoy receiving insightful information from people in all fields of work as to what drives them to perform.

2. Cengia, G. (2012, April). Need for Achievement and Motivation. TNS Blog Employee Insights.

The 3rd Annual Serious Games and Virtual Environments Showcase was held this past Monday (1/28/2013) in Orlando, Florida at the International Meeting on Simulation in Healthcare 2013, sponsored by the Society for Simulation in Healthcare. The arcade featured games from both academic labs and commercial organizations. During the awards ceremony, our prototype app for treating selective mutism won Best of Show Academic in the Student category.

The app was developed for Dr. Deborah Beidel and Brian Bunnell of the UCF Anxiety Disorders Clinic. They have had great success treating patients suffering from selective mutism by using off-the-shelf iPad apps. Essentially, the treatment protocol calls for shaping behavior over time with rewards. By using very specific apps from the App Store, children engage in these behaviors through gameplay. With the anxiety of speaking lessened by the fun, engaging experience of playing the games, they have found these apps to be valuable tools for making this therapy effective.

RETRO was approached by their team to create a prototype app that would serve as both a patient management framework as well as deliver apps designed to be fun tools for therapy. Imagine a situation in which you are a clinical psychologist working at a general clinic that does not specialize in anxiety disorders. If your patient is suffering from selective mutism, you may be at a loss as how to treat them. This app, paired with a descriptive treatment protocol, would help walk the clinician through treatment by providing fun apps that can be used as a part of therapy as well as tools to track their patient’s progress through time.

At this point, this app is just a prototype that we are using for demonstration purposes. Although populated with fake patients and fake data, we did develop one game as an example. Lift-Off! is a game that takes one tool used in classic treatment, the use of a tape recorder to get patients comfortable with playing their recorded voices for others, and turned it into a game where the player must record their voice and play it louder and louder in order to inflate a hot air balloon.

I would like to thank everyone from Dr. Beidel’s team, including both Brian Bunnell who came up with the treatment protocol as well as Nina Wong. From the RETRO development team, I would like to thank our programmers Greg Pardo, who came up with the idea for the game, and Jenny Vogel. A special thanks goes out to our wonderful artist, Danielle Chelles, who not only did a great job with the art for the entire app, but she also provided the voice for Lift-Off!‘s main character. Thanks to our RETRO usability team, including Shan Lakhmani and Arun George. And, of course, thank you to both Clint and Jan, our lab’s founders, for giving the opportunity to us students to do awesome things like this.

Imagine you’re trying out a new recipe for a sauce. The tomatoes and onions have been chopped and added, the fresh basil and thyme mixed in, and the mixture simmers on the stove. You’re left with nothing to do for several hours except clean up and maybe work on that bottle of Pinot Noir sitting on the counter. The kitchen smells great, but will your palate agree with your nose? Do you try a taste now or wait another three hours until the sauce is done and ready for consumption?

Of course, you try the sauce now and flavor it to your preferences. This is similar to iterative usability testing. Usability is how easy and intuitive (or not) an object is to use and learn to use. The object can be a tool, vehicle, consumer electronic, website, or software application. Have you ever become frustrated while having a difficult time using a product or navigating a website? Usability, if done well, is rarely noticed. You probably haven’t forgotten the frustration of using a bad product and have avoided using the product ever since. Common sense dictates that if companies want to make desirable products then they should engage in usability testing and many companies do. The enemy to usability, however, is cost. In order to save money, some companies engage in usability testing at the end of a product’s development cycle and sometimes not at all. This would be similar to not tasting your sauce until it’s in the finished recipe and sitting on the table in front of your dinner guests.

Usability testing by itself is not enough. Instead of one round of usability testing, the process must be iterative and universal throughout the design and development cycle of a product. Testing your sauce is very inexpensive but more product testing means more money spent on testing; however, some usability experts argue that iterative usability testing doesn’t need to be expensive. In Don’t Make Me Think!, Steve Krug argues that unless your product is only being used by usability experts, then you’re wasting your money. Any person who can reasonably be expected to use your product, and is probably a member of the intended consumer base anyway, will do. The testing can be done inexpensively and in a short time period, about as long as it takes to make that sauce. How much would you charge to test out Samsung’s newest smartphone prototype or the latest version of the Xbox console (aka, “Durango” or is it “720”)? How long do you think it would take you to notice whether or not using the product is a frustrating experience?

All of those hours spent with a controller in your hand might make you better suited for learning certain tasks in the medical profession. Last Month, Wired UK published an article in which they reported on a study by Dr. Sami Kilic from the University of Texas Medical Branch, in which he and his colleagues found that gamers may learn how to perform robotically-assisted surgery faster than their non-gamer peers.

Robotic surgery is minimally-invasive. Rather than creating large incisions to allow a surgeon to manually manipulate tools, smaller incisions are used to insert devices that are operated by the surgeon, often remotely. Depending on the surgery, this means that the surgeon could be using anything from very long handles or facsimile tools to joysticks, often in conjunction to some sort of viewing apparatus, to get the job done. The da Vinci Surgical System is one example of how robots can be used to assist surgery. A surgeon looks into a viewing device and uses the controls at his station, while the robotic arms, guided by others, perform the surgery based on the surgeon’s inputs.

the da Vinci Surgical System from Intuitive Surgical

Kilic and colleagues’ study pitted US high school and college students against residents studying surgery. Both groups completed a series of tasks in a da Vinci Surgical System training simulator. Those high school students that spent at least 2 hours a day gaming, and those college students that spent at least 4 hours a day gaming, were just as surgically-adept as the residents, sometimes more-so. When the simulated task was switched to non-robotically-assisted surgery, a task that requires surgical skill and knowledge rather than hand-eye coordination and control, the residents easily outperformed the high school and college students.

The robotically-assisted laparoscopic surgical simulator featured several training exercises (which you’ll see in the video below are more like minigames to learn how to use the controls) before the actual test of skill in a simulated laparoscopic surgery. It may be that those who play games around 2 hours a day are able to pick up on this training faster than others due to their gaming experience. As suggested below, having residents play games for 2 hours a day may help train the skills needed to more easily master robotic surgery.

So does being a gamer actually give you improved hand-eye coordination and fine motor skills, which in turn gives you an edge when learning a task such as robotically-assisted surgery? Maybe.

It’s difficult to dig into this study. According to a press release, the findings were presented at the American Gynecologic Laparoscopists’ 41st Annual Global Congress on Minimally Invasive Gynecology in Las Vegas this past November, but I can’t find a way to actually read the paper itself (it might have only been a presentation). I am only able to rely on press releases, YouTube videos, and pop psychology articles to give you this information. But still, there is a history in the literature of similar findings related to motor skill acquisition for tasks specific to this type of surgery and gamers.

PC gamers are faster at completing tasks in surgical simulators. In a study of individual differences, (e.g., gender, visuospatial skills, and gaming experience) on performance in a virtual endoscopy training simulator, PC gamers were found to be better at one of the skills tested and completed the virtual endoscopy tasks nearly a minute and a half faster than non-gamers [1].

Experience with gaming positively correlates with laparoscopic surgical skill. This study was conducted in a sample of 33 surgeon and included both experienced attending physicians (average number of laparoscopic surgeries under their belts = 239) and learning residents (average number of surgeries = 46). Surgeons who were classified as game players, whether they had played in the past or were still active gamers, made fewer errors and completed training tasks in the simulator in less time than those who did not play games at all. As a side note, those who played in the past had slightly fewer errors than those who were current players. Still, it seems that those with gaming experience, regardless of when, were able to train faster and better than those without [2].

Gamers reach proficiency faster in training simulators. Surgeons who were classified as gamers were compared to non-gamers in a laparoscopic surgery training simulator. Their time to meet benchmark proficiency in the simulator was recorded. Gamers were able to become proficient in the simulator on training tasks faster than non-gamers. Even more interesting was that female non-gamers performed worse than male non-gamers, however there was no difference between genders in gamers. Perhaps gaming experience not only reduces the time to reach proficiency in laparoscopy training simulators, but it also may mitigate some sort of gender-based training effect [3].

Training with games first can improve performance during training on laparoscopic training simulators. A sample of medical students that had never trained on a virtual reality-based endoscopy training simulator completed training and surgical procedures as a baseline assessment in two different laparoscopic training simulators. Then they were either assigned to only play Half-Life, to only play Chessmaster, or to not play games at all. Previous gaming experience was distributed evenly throughout all three groups and it was not a variable of interest in this study. Those in the game-playing conditions had to play their game between 30 and 60 minutes a day, five days a week, for five consecutive weeks. After this training period, the medical students once again used two laparoscopic training simulators. They all received verbal instruction, followed by a 45-minute familiarization period, before completing procedures within the simulation. In one of the simulators, both groups who played games had improvement over their baseline performance compared to those that did not play games (they did not improve at all). In the second simulator test, only those in the Half-Life group improved, while those in the Chessmaster and control group did not. So, regardless of previous experience, there was a slight increase in performance during training for those who played games, with Half-Life potentially having an edge over Chessmaster [4].

While a single study is never a definitive statement, there may be something to the idea that being a gamer does potentially give learners an edge in surgical training simulators in that they are able to complete training tasks faster and better than their non-gamer peers. Furthermore, simply training with games may be an effective way to prepare learners to use these simulators. More research is needed to replicate current findings (especially in larger samples), to clarify the role of previous gaming experience in reducing time to train, and to determine the return-on-investment for a game-playing pre-training intervention. Lastly, longitudinal studies that control for previous gaming experience (as well as potentially manipulate game pre-training) that measure not only performance during training in the simulator but track actual patient outcomes from surgeries would also be helpful in determining if gaming not only results in faster training, but also better surgeons. A researcher’s work is never over.

1. Enochsson, L., Isaksson, B., Tour, R., Kjellin, A., Hedman, L., Wredmark, T., & Tsai-Fellander, L. (2004). Visuospatial skills and computer game experience influence the performance of virtual endoscopy. Journal of Gastrointestinal Surgery, 8(7), 874-880.

2. Rosser, J. C., Lynch, P. J., Cuddihy, L., Gentile, D. A., Klonsky, J., & Merrell, R. (2007). The impact of video games on training surgeons in the 21st century. Archives of Surgery, 142, 181-186.

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