Game-Based Teaching & Learning for Nursing & Healthcare (NLN/Boise 2014)


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This presentation was given at the 2nd Annual National League of Nursing Boise State School of Nursing Simulation conference in April of 2014. It focused on How to integrate game-based teaching and learning into the curriculum.

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Game-Based Teaching & Learning for Nursing & Healthcare (NLN/Boise 2014)

  1. 1. Eric  B.  Bauman,  PhD,  RN   Paramedic   Game  -­‐  Based  Teaching  and  Learning  for  Nursing  and   Healthcare  Educa?on   The  NLN/Boise  State  University  2nd  Simula9on  Conference:  Exploring  New  Ideas  in  Simula9on   .  .  .  .  .  .  .  .  .  .  .              
  2. 2. Disclosures  &  Affilia?ons   Eric  B.  Bauman,  PhD,  RN,  Paramedic   –  Fellow:  University  of  Wisconsin  School  of   Educa?on  -­‐    Games+Learning+  Society  (GLS)   –  Assistant  Dean:  Ins?tute  for  Research  and   Clinical  Strategy  –  DeVry  Educa?on  Group   –  Associate  Director:  Center  for  Excellence  in   Simula?on  Educa?on  -­‐  DeVry  Educa?on  Group   –  Division  Chief,  EMS  –  Blooming  Grove  Fire  Dept.   –  Managing  Member  –  Clinical  Playground,  LLC   –  Managing  Member  –  Forensic  Analy?cs,  LLC     –  Springer  Publishing  –  Author     –  Relevant  Stock  –  CAE,  Zynga,  GE,  Pfizer   –  Society  for  Simula?on  in  Healthcare  (SSH)    Serious  Games  &  VE  SIG  Co-­‐Chair   –  Interna?onal  Nursing  Associa?on  for  Clinical   Simula?on  and  Learning  (INACSL)   Any  and  all  discussion  and  content  represents  the  views  and  scholarship  of  the  presenters  and  does  not   proclaim  to  and  may  not  represent  the  views  of  any  employer  or  affilia?ons  named  in  these  disclosures  
  3. 3. Objec?ves   •  Par?cipants  will  explore  how  to  use  game-­‐based   learning  in  educa?onal  contexts   •  Par?cipants  will  be  able  to  iden?fy  types  of  content   that  provides  a  good  fit  with  game-­‐based  learning   •  Par?cipants  will  explore  how  game-­‐based  learning   provides  an  expansion  of  the  clinical  learning  space   .  .  .  .  .  .  .  .  .  .  .               ©Bauman  2014  All  Rights  Reserved  
  4. 4. Games  versus  Simula?on   •  Tradi?onal  Perspec?ve  on  Games   – Goal  Oriented   – Rule  Based   – Sense  of  Consequence     •  Rewards  or  otherwise   •  Tradi?onal  Perspec?ve  on  Simula?on   – Imita?on  of  something  real   – Representa?on  of  key  design  elements  or   variables  of  a  system  or  process   .  .  .  .  .  .  .  .  .  .  .              ©Bauman  2014  Rights  Reserved  
  5. 5. Games  versus  Simula?on   •  To  a  large  extent  this  debate  has  been  played   out  among  educators   •  We  want  to  engage  learners  in  a  situated   context   •  Game  Mechanics  work  to  engage  the  learner   within  the  digital  environment   .  .  .  .  .  .  .  .  .  .  .              ©Bauman  2014  Rights  Reserved  
  6. 6. Games  and  Simula?on   Clinical Practice Simulation Experience Knowledge Acquisition Behavior Didactic Illustration  2.1   Rethought  Simulation  to  Practice  Pathway ©  Bauman  2010  ©  Bauman  2012 Games Cognitive  Aid Games
  7. 7. “We  are  entering  the  Ludic  Century…   …  we  will  use  games  to  shape  the  future  of  educa?on”     Ludology   Eric  Zimmerman,  NYU  Games  Center   6/15/2011  at  GLS7   hjp://­‐zimmerman   ©Bauman  2012  Rights  Reserved  
  8. 8. Ludic  Pedagogy   ©Bauman  2014  Rights  Reserved   The  manner  through  which  games  teach  players  to  play  …   The  manner  through  which  games  teach  learners  to  learn   hjp://­‐11092011-­‐154402/unrestricted/jbroussard_disserta?on.pdf  
  9. 9. Gamifica?on   ©Bauman  2014  Rights  Reserved   •           Makes    content  more  engaging   •   Encourages  users  to  engage  in  desired  behaviors   •   Illustrates  a  path  to  mastery  &  autonomy   •   Provides  incen?ve  to  complete  chores  or  tasks  otherwise  seen  as      boring   •   Data  from  “gamified”  applica?ons  can  be  leveraged  for  CQI  Projects,    Curricula  and    ROI  Evalua?on     Examples     Leader  boards,  badges,  level-­‐ups,  puzzles,     ?mers  and  status  bars                                     The  use  of  game  design  elements  in  non-­‐game  contexts  
  10. 10. Badges  etc…  
  11. 11. Game  Design  over  Gamifica?on!   ©Bauman  2012  Rights  Reserved   “Games  are  Machines  For  Gaining  Competence”   Reward  should  come  from  Mastery     Game  Does  not  by  Defini?on  =  Fun   Thus  Gamifica?on  is  not  always  Playful   Sebas?an  Deterding   GLS  8  –  June  15,    2012  
  12. 12. Metagaming   ©Bauman  2012  Rights  Reserved   It  is  the  use  of  out-­‐of-­‐game  [out  of  curriculum]  informa?on  or   resources  to  affect  one's  in-­‐game  [prac?ce]  decisions…   Transcends  a  prescribed  rule  set  …uses  external  factors  to   affect  the  game  [prac?ce],  or  goes  beyond  the  supposed   limits  of  the  game  [prac?ce]  environment   hjp://  
  13. 13. Metagaming   ©Bauman  2012  Rights  Reserved   Imagine  a  mobile  applica?on  or  game  that  could  be  leveraged  for   unique  learning  and  later  as  a  cogni?ve  aid  during  actual  prac?ce   hjp://  
  14. 14. hjp://   Metagaming   ©Bauman  2012  Rights  Reserved  
  15. 15. Virtual  Worlds       Game-­‐Based  Plavorm   ©Bauman  2013  Rights  Reserved   Virtual  worlds:  an  environment  that  hosts  a  synchronous  digital  environment,  persistent  network   of  people,  represented  as  avatars,  facilitated  by  networked  computers  (Bell,  2008)   Game-­‐based  pla3orm:  An  environment  that  provides  a  narra?ve  and  system  of  rewards  for   accomplishing  specific  tasks  and  objec?ves.  Game-­‐based  plavorms  use  virtual  environments  to   stage  the  game.  Not  all  virtual  reality  environments  are  game-­‐based  (Bauman,  2010,  p.  186).  
  16. 16. Layered  Learning  Model   Didac?c   Prepara?on   Interac?ve   Applica?on   Task  Trainer   or   Simulator   Real  World   Experience   ©Bauman  2014   Situated  learning  experiences  link  didac?c  content  with  prac?cal  hands  on  experiences    
  17. 17. Game-­‐Based  Learning  and  Reward   ©Bauman  2014  Rights  Reserved   Intrinsic     Extrinsic     Reward  comes  from  Mastery   Tangible  Reward   Goals  are  clear,  meaningful  and  situated   Goals  assigned   Progress  is  intui?ve  apparent  and   immediate  [real-­‐?me  or  just-­‐in-­‐?me]   Progress  is  determined  or  assigned   outside  of  the  current  ac?vity   Endorses  or  reinforces  behavior  you  are   already  commijed  to  or  hope  to  engage   in  the  future  –  Represents  Player  Agency   If  you  complete  this  task  you  will  be  given   access  to  another  task  –  Hierarchical   Direc?on   Autonomous     Directed   Ac?ve  Learning   Compliance   Outcome  Driven  Deep  Meaning   Crea?ve   Shallow  
  18. 18. Good  Fit  for  Game-­‐Based  Teaching  &  Learning   •  Are  you  using  simula?on  to  meet  your  needs  or  your  students  needs   •  Using  technology  for  the  sake  of  technology  oxen  leaves  students  confused   and  faculty  frustrated     •  Understand  that  all  forms  of  technology  have  their  limita?ons   •  Play  down  the  “coolness”  and  “be-­‐all…  end  all”  factor  with  students.     ©Bauman  2014  Rights  Reserved  
  19. 19. Good  Fit  for  Game-­‐Based  Learning  &  Simula?on   R.  Kyle   In  order  to  accomplish  a  good  fit  between  technology  and  curriculum,   the  instruc?on  must  be  effec?ve,  efficient  and  appealing  –  and  that   technology  without  good  fit  becomes  a  distrac?on  to  learning     Ralston-­‐Berg,  P.  &  Lara,  M.  in  Bauman,  E.B.(2012).     ©Bauman  2014  All  Rights  Reserved  
  20. 20. Good  Fit    Game-­‐based  learning  taking  place  in  created   spaces  or  simula?on  occurring  in  digital   environments  are  best  leveraged  for  lessons  that   encompass  designed  experiences  that  focus  on   behavioral  or  decision  aspects  of  prac?ce  and   some  forms  of  targeted  psychomotor  training…   –  Accultura?on   –  Decision  Making   –  Team  Training     –  Workload/Time  Management   –  Procedural  Demonstra?on   .  .  .  .  .  .  .  .  .  .  .              ©Bauman  2014  Rights  Reserved  
  21. 21. Tearing  Down  the  Ivory  Towers   •  Games  can  be  deployed  through   online  Learning  Plavorms   •  Digital  Games  provide  a   distributed  learning  opportunity    Any?me  and  Anywhere  learning   •  Digital  and  Game-­‐Based   Environments   .  .  .  .  .  .  .  .  .  .  .              ©Bauman  2014  Rights  Reserved   Expansion  of  the  Clinical  Space  
  22. 22. Expansion  of  the  Clinical  Space   Created  Space   An  environment  that  has  been  specifically  engineered  to   accurately  replicate  an  actual  exis?ng  space,  producing   sufficient  authen?city  and  fidelity  to  allow  for  the   suspension  of  disbelief.     Bauman  2007   hjp://www.mimicsimula?  
  23. 23. Expansion  of  the  Clinical  Space   Designed  Experience   …is  engineered  to  include  structured  ac?vi?es  targeted  to  facilitate   interac?ons  that  drive  an?cipated  experiences.    These  ac?vi?es  are   created  to  embody  par?cipant  experience  as  performance.     Squire,  2006  
  24. 24. Good  Game  –  Well  Played  or  Not   Entertainment  Game   Strives  to  keep  the  player  in  the  game-­‐based  environment.    Players  need   to  feel  like  the  cost  of  the  game  (money  and  commitment)  was   worthwhile.    This  encourages  subscrip?on  fees  and  future  franchise   purchases.   Educa9onal  or  Learning  Game   Prepares  learners  through  game-­‐play  and  game  mechanics  for  and  out   of  game  experience.  It  strives  to  prepare  for  some  other  type  of  success.  
  25. 25. Good  Game  –  Well  Played  or  Not   Educa9onal  or  Learning  Games:    Solve  a  problem    Map  back  to  the  curriculum    Must  be  evaluated  for  efficacy  and  correla?on  with  outcomes   It  is  possible  to  repurpose  Commercial  Games  for  learning    It  is  about  the  context,  objec?ves,  and  narra?ve   Remember  in  Healthcare  and  Educa?on  –  Do  No  Harm   hjp://­‐studio-­‐workshop-­‐with-­‐will-­‐evans-­‐of-­‐the-­‐library-­‐corpora?on/  
  26. 26. Good  Game  –  Well  Played  or  Not   In  a  2010  survey  of  two  medical  schools,  students  responded   they  would  use  serious  games  under  the  following  condi?ons:      97%  if  game  is  fun    77%  if  helped  to  accomplish  an  important  goal    90%  if  helped  to  develop  skills  in  pa?ent  interac?ons   hjps://­‐basedlearninginmedicaleduca?on.pdf   Knosp,  B.,  Hamill,  G.,  Correl,  J.  &  GIR  Ed  Tech  Work  Group  (2013)   Among  the  more  than  200  medical  students  surveyed,  77  percent   said  they  would  par?cipate  in  a  mul?-­‐player  online  health  care   simulator  provided  it  helped  them  to  accomplish  an  important   goal.   Nauert,  R.  (2010)   hjp://­‐school-­‐educa?on-­‐from-­‐video-­‐games/16680.html  
  27. 27. Pu{ng-­‐It-­‐Altogether   ©Bauman  2014  Rights  Reserved   Ecology  of  Culturally  Competent  Design   Addresses  the  rigors  and  challenges  of  accurately  situa?ng   culture  within  virtual  environments  using  a  four-­‐element   model  that  emphasizes  the  importance  of  ac:vi:es,  contexts,   narra:ves,  and  characters. -­‐  Bauman  &  Games  2010;  Games  &  Bauman,  2011  -­‐     hjp://     What  Makes  a  Good  Game  
  28. 28. Pu{ng-­‐It-­‐Altogether   ©Bauman  &  Ralston-­‐Berg  2013  All  Rights  Reserved   Virtual   Environment   Game   Environment   Created  Space   Designed   Experience   Mini-­‐Games   Meta-­‐ gaming  
  29. 29. 3DiTeams-­‐Healthcare   Team  Training  in  a  Virtual   Environment   Jeff  Taekman,  et  al   Duke  University  Medical  Center   Examples  and  Demos  Team  Training  &  Decision  Making  
  30. 30. Demos   Skill  &  Knowledge  Development  
  31. 31. DEMO   iPad  Skin  Prep  Applica?on   ©Bauman  2014  All  Rights  Reserved   Mobile  App  
  32. 32. Demos   CliniSpace  Applica?ons   ©Bauman  2014  All  Rights  Reserved   Virtual  World  
  33. 33. Demos   Anatomy  Browser   ©Bauman  2013  All  Rights  Reserved   Mobile  App  &Skill  Development  
  34. 34. Demos   Zombies  –  PrgeneratorX   ©Bauman  2014  All  Rights  Reserved   Use  of  Narra?ve  
  35. 35. Second  Life/Virtual  Environment   Nigh?ngale  Isle   Jone  Tiffany,  DNP,  RN     New  World  Clinic   Gerald  Stapleton  MS   ©Bauman  2012  Rights  Reserved   Behavioral/Decision  Making  
  36. 36. Second  Life/Virtual  Environment   ©Bauman  2012  Rights  Reserved   Behavioral/Accultura?on   .  .  .  .  .  .  .  .  .  .  .              
  37. 37. Take  Home  Message   Game-­‐Based  Learning  leverages  created   environments  so  that  learning  takes  place  as   performance  though  carefully  designed   experiences  that  oxen  use  a  contextually  situated   narra:ve  to  promote  curriculum  objec?ves   ©Bauman  2012  Rights  Reserved  
  38. 38. Ques?ons?   R.  Kyle   ©Bauman  2012    Rights  Reserved  
  39. 39. Eric  B.  Bauman,  PhD,  RN   hjp://   hjp://   Contact  Informa?on   @Bauman1967   Clinical  Playground,  LLC  
  40. 40. Bauman,  E.  (2007).  High  fidelity  simula?on  in  healthcare.  Ph.D.  disserta?on,  The  University  of  Wisconsin-­‐Madison,  United  States.  Disserta?ons  &  Thesis  @  CIC  Ins?tu?ons   database.  (Publica?on  no.  AAT  3294196)     Bauman,  E.  B.  (2012).  Game-­‐based  Teaching  and  Simula:on  in  Nursing  &  Healthcare.  New  York,  NY:  Springer  Publishing  Company.     Bauman,  E.  (2010).  Virtual  reality  and  game-­‐based  clinical  educa?on.  In  Gaberson,  K.B.,  &  Oermann,  M.H.  (Eds)  Clinical  teaching  strategies  in  nursing  educa:on  (3rd  ed).New   York,  Springer  Publishing  Company.   Bauman,  E.B.  and  Games,  I.A.  (2011).  Contemporary  theory  for  immersive  worlds:  Addressing  engagement,  culture,  and  diversity.  In  Cheney,  A.  and  Sanders,  R.  (Eds)  Teaching   and  Learning  in  3D  Immersive  Worlds:  Pedagogical  models  and  construc:vist  approaches.  IGI  Global.     Bauman,  E.  B.  and  Ralston-­‐Berg,  P.  (In  Press).  Serious  Gaming  using  Simula?ons.  In  Jeffries,  P.  (Ed).  Advanced  Simula:on  in  Nursing.  Na?onal  League  of  Nursing.     Bauman,  E.  B.  and  Ralston-­‐Berg,  P.  (In  Press).  Virtual  Simula?on  and  Game-­‐Based  Learning.  In  J.  Palaganas,  J.  Maxworthy,  C.  Epps,  and  M.E.  Mancini  (Eds).  Defining  Excellence   in  Simula:on.  Wolters  Kluwe  –  Lippincoj  Williams  &  Wilkins.     Benner,  P.  (1984).  From  novice  to  expert:  Excellence  and  power  in  clinical  nursing  prac:ce.  Menlo  Park,  CA:  Addison-­‐Wesley.   Benner,  P.,  Tanner,  C.,  &  Chesla,  C.  (2009).  Exper:se  in  nursing:  Caring,  clinical  judgment,  and  ethics.  New  York:  Springer  Publishing  Company     Culhane-­‐Pera,  K.A.,  Reif,  C.,  Egli,  E.,  Baker,  N.J.,  and  Kassekert  (1997).  A  curriculum  for  mul?cultural  educa?on  in  family  medicine.  Family  Medicine,  29(10),  719-­‐723.   Faragher,  J.F.,  Boese,  T.,  &  Decker,  S.,  Sando,  C.  (2011).  Standards  of  best  prac?ce:  Simula?on.  Simula:on  in  Nursing,  7(4),  S1-­‐S20.   Fitz-­‐Walter,  Z.  (2012hjp://   Foronda,  C.  &  Bauman,  E.  (In  Press).  Strategies  to  incorporate  virtual  simula?on  in  nurse  educa?on.  Clinical  Simula:on  in  Nursing.   Foronda,  C.,  Gajamorta,  K.,  Snowden,  K.,  &  Bauman,  E.  (2013).  Use  of  virtual  clinical  simula?on  to  improve  communica?on  skills  of  RN  to  BSN  students:  a  pilot  study.  Nurse   Educa:on  Today,  doi:10.1016/j.nedt.2013.10.007     Selected  References  &  Recommended  Readings   ©Bauman  2012  Rights  Reserved  
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