Informatics, Gaming, and Simulation

Notes from module 7 of the Interprofessional Health Informatics course I’m working on (plus side reading that I did to fill in some blanks/learn more about some things mentioned in the course).

  • Gaming = “playing games developed to teach something or help solve a problem”
  • Simulation = “use of mathematical model to recruit a situation to estimate various outcomes”
  • gaming can help overcome barriers to learning such as mistrust, low literacy, social isolation, and non-traditional learning styles
  • goals of gaming:
    • increase knowledge and/or skills –> healthcare quality, health outcomes
    • increase mental, physical, emotion, and social resilience
  • goals of simulation: improving processes –> improve healthcare quality, health outcomes, at the best price
  • games start with information that is “packaged to promote learning or computed to generate knowledge” and create new data streams that can be used to improve practice, evaluate education, and enable quality and outcomes research
  • simulation research is used to support healthcare information management, decision making, education/learning
  • health games research is an emerging science
    • traditionally, nursing education was “hospitalized nursing education” – education happened in a hospital, where you learned by doing through “task-based education”
    • in the past ~20 year, nursing education has become more academic – more didactic learning (lectures, readings, seminars)
      • early in nursing school – redundant and repetitive and didactic content and then tradition exams test their mastery of the clinical content
      • then they transition to “hands on” clinical work in practicums on-site
    • but deep experiential learning experiences were lost
    • recently, there has been work to re-introduce experiential learning, e.g., through simulationSL - Play2Train
    • learning consists of:
      • context-specific (e.g., learning to do medication management)
      • socially-situated (e.g., in a hospital setting)
      • cycles of meaningful action (e.g., administering the the 5 rights of medication administration) and
      • reflection (what went well, what did not go well?) – this is where learning takes place!
    • reflective learning:
      • reflection-on-action: takes place after an action or when a person ends an action to stop and think
      • reflection in-action: services to reshape what we are doing while we are doing it; leads to “in the moment” experimentation
      • both of these are important
    • game-based teaching in simulation focuses on experiential and reflective learning
    • games allows us to experiment with action and solutions in a safe place (e.g., consequences are less than in the “real world”)
    • experiential and reflective learning seems to work well at the end of the didactic part of their curriculum (in class) and before they go into their practicum settings
    • games simulate the real world

NESIM @ Cousins Pau 1

  • to create games, you look at the real world and transition the design of the real world into a game
    • need a well-ordered problems
    • at an appropirate skill level
    • must be able to test the knowledge of the user in meaningful action
    • must encourage players to engage in reflection-in and -on-action
    • needs meaningful goals
      • clearly defined
      • motivate players to achieve success through problem solving
      • reward players after achievement of the goal
  • “possibility of spaces” – games and simulations should provide many:
    • choices
    • decisions and possibilities for action
    • strategies
    • problem solutions
  • your choices have consequences – you learn based on these
  • games need meaningful feedback and information – this is how you know what the consequences of your choices are (e.g., can be given “achievement points” for doing things “right”)
  • game development:
    • identify audience
    • define objectives
    • determine how to evaluate of students
    • determine resources (e.g., nurses to develop content, game developers who can do the tech parts)
    • develop storylines – can be very time consuming because you need to go through all the choices that the student might make and what happens from there – many, many possibilities
    • program game in a stepwise fashion
    • test the game
    • revised as needed

Computational Modeling and Simulation

  • tools used to improve processes, facility design, develop products to use in healthcare
  • methods include: statistical analysis, advanced workflow modeling, computer simulation, network analysis
  • these advanced methods can be integrated with traditional performance improvement methods, like Lean/Six Sigma
  • helps you to measure the impact of new tech, facilitate design or adoption of a best practice on workflow before having to implement it
  • improved project cycle time, because you get instant feedback from the computer scenario analysis
  • can use it for both clinical and administrative projects
  • e.g., computational modeling:
    • list all the steps, collect data (e.g., how long does it take to this step?), create a probability curve for each step, put it all together = “surrogate system”
    • take the flowchart and put it into your modeling software, then run patients through the simulation model, and collect data on what happens to those simulated patients
    • helps you identify steps that can be combined/eliminated, where are there bottlenecks, etc.
  • dynamic network analysis
    • create a matrix of every element in the network (e.g., all the people vs. all the locations) and then indicate in the cells of the matrix if information flows from that person to that location –> software takes that to create a diagram of the network
    • helps you identify nodes (e.g., clusters, bottlenecks)
    • e.g., create a current state network of all the places that the nurse needs to go to get information and then compare that to post-implementation of an electronic health record (there is advanced software and calculations that can be done.
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