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U of M nursing school developing games to teach future caregivers

MINNEAPOLIS - After years of brutalizing virtual monsters, soldiers and zombies, gamers can finally begin to make amends - at least the nurses. The University of Minnesota School of Nursing is helping to develop several simulation games in which ...

MINNEAPOLIS - After years of brutalizing virtual monsters, soldiers and zombies, gamers can finally begin to make amends - at least the nurses.

The University of Minnesota School of Nursing is helping to develop several simulation games in which future health care providers will apply detailed knowledge of medical procedures to care for virtual patients.

Tom Clancy, a clinical professor at the University's nursing school, has been working with the software company VitalSims and the Minnesota Hospital Association on these "serious games," which he said are in preliminary development stages. Clancy said that it marks a shift in the way games are viewed - they are starting to be taken seriously as educational tools.

Clancy said simulation is not new in health care.

Expensive training mannequins and virtual simulations have been used to train doctors and nurses for some time.


While these are proven effective, their high cost hinders availability. Nora Olson, a nurse at St. Mary's Hospital, recalled having only one opportunity to train in a simulation center during her schooling.

While basic simulation software was available online, Clancy called it passive simulation. It was designed to demonstrate various biological functions, but he said it lacks the narrative and user engagement games offer.

"Serious games have been used for years by the military," he said. "They've had tremendous success. There's no reason other industries can't have success with it too."

According to Clancy, serious games provide the same kind of learning found in shadowing or lab training.

But with these traditional methods, Clancy said educators can't guarantee that nursing students experience a wide variety of situations, while with a game, "you can control all of the different events." Users can train for complex treatments or stick to the basics.

"When you're in that environment, you often have to make decisions under pressure," he said. "It's the same learning that's going on with a game."

Clancy said gaming is not set to replace any of the familiar components of education, but it will supplement book work and lectures.

"Every time you go from one modality to another, you're doing a different kind of learning," he said. Clancy said adding gaming to students' curricula may seem inefficient, but it reduces the time needed in other educational settings. VitalSims' CEO Chris Duncan cited a 2008 study that showed serious gaming to assist information retention 91 percent more effectively than lecture attendance.


"We're still trying to tease out exactly how to implement gaming in education." Serious gaming is, Clancy said, "in its infancy."

Clancy opened an early version of his program and chose "Myocardial Infarction" (heart attack) from a list of injuries and ailments on the game's main menu.

"You'll have to excuse the graphics; they're kind of old," Clancy said.

The heart attack mission opens with a cutscene, or non-interactive scripted event, in which two identical nurses banter before entering the emergency room.

Soon after, they enter the ER, and from then on it's strictly business. The game is played from a first-person perspective, with the player positioned over the patient. Intense music accents the time pressure, as do occasional comments from the assistant nurse.

There is a "toolbox" at the bottom of the screen in which the player selects from an array of instruments divided by category.

Clancy used his magnifying glass by finding it in a sub-menu and dragging it to the patient's mouth. When he determined she wasn't breathing, he opened another menu, equipped an oxygen pump and selected the appropriate rhythm from a list. He then equipped a heart monitor, which brought up a cardiogram on the side of the screen.

"That rhythm," Clancy explains, "happens to be very deadly."


Next he demonstrated the scoring system by purposely administering random drugs and using incorrect instruments. The patient eventually died.

These games will include multiplayer and cover a wide variety of cases, hopefully ensuring that students are given breadth of experience, Duncan said.

He said cultural considerations are also planned, such as settings that account for different languages and religious beliefs, which will help make it more accessible. There will also be leaderboards, which Clancy said he believes will encourage students to improve through competition.

The new games are part of a growing trend of using gaming for professional development.

Linda Olson Keller, another professor of nursing at the university, is supportive of Clancy's and the MHA's project. She described a similar initiative by the U.S. Centers for Disease Control and Prevention to use games to promote public health. One game, called HealthBound, challenges players to solve health-related problems and then scores their results and encourages them to get involved in various community programs.

Another, from the Chicago Department of Public Health, is designed to prepare players for a possible anthrax outbreak.

Keller described this method of education as "the way of the future."

Clancy foresees games becoming commonplace in other fields.


"We're seeing this continuum of different ways of education, and gaming has its place in here now," he said. "We're still learning where exactly that place is."

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