Healthcare professionals caring for newborns at their time of delivery are required to upkeep their proficiency in neonatal resuscitation, in order to carry out resuscitative interventions effectively. However, there are limited opportunities for the practicing of neonatal resuscitation skills. Learners are also required to review the different aspects of neonatal resuscitation regularly in order to ensure familiarity with the procedures.

With these challenges in mind, SGH’s Department of Neonatal and Developmental Medicine set out to develop a serious game to strengthen the competencies of neonatal resuscitation providers. Read on as A/Prof Yeo Cheo Lian, Dr Imelda Ereno and Dr Selina Ho share their game development experience and tips on how to develop your own serious game for learning in healthcare!

Screenshots from the Neonatal Resuscitation Game

1. Tell us more about the neonatal resuscitation game and how does it work?

Our neonatal resuscitation game was designed as a training game for hospital-based resuscitation of high-risk infants. It is a single-player game, where learners take on the role of a team leader, and guide their team members through a series of resuscitation scenarios. Within the given time limits, they practice three categories of newborn resuscitation (term, pre-term and extreme pre-term) and its complications. At the end of the game, learners are scored on their performance and can track their progress over time.  

2. How did the idea of a neonatal resuscitation serious game come about?

As educators of the SGH Singapore Neonatal Resuscitation Course (SNRC), we saw that our learners’ knowledge and skills declined soon after the completion of a training session, especially for those who worked in areas where the need for resuscitative interventions was rare. We wanted to find a solution to help our learners retain their knowledge and skills, but were also aware of constraints that they faced, such as the cost and time needed to undergo refresher courses.
One day, we attended a talk organised by the Serious Games Association (SGA) that opened our eyes to the uses of serious games through computer simulation. Many clear benefits to serious games were presented: learners get to practice specific tasks in a safe environment at their convenience, which leads to improved competencies, productivity and reduced cost of training. It seemed like a good match for the challenges that we were facing, so we decided to explore using serious games to improve our learners’ proficiency in neonatal resuscitation.

3. What were the challenges faced when creating this game?

As educators starting out in serious games, we started out at ground zero. We had to read up on characteristics of effective serious games and think about how they could be applied to neonatal resuscitation. This was a challenge since gamification in neonatal resuscitation training is a very new development.
For example, one of the principles to developing an effective serious game is ensuring the right blend of education and entertainment to motivate learners to learn and play. When developing our neonatal game, we struggled with integrating the right amount of entertainment into the game, as we did not want to distract the learners from the educational aspect of the game.
Another challenge we faced was collaborating with the game designers. As we all came from our own domains of expertise, we tended to use jargon which was unfamiliar to one another. This resulted occasionally in miscommunication. We had to work very closely together, and clarify repeatedly to ensure that everyone was on the same page.

4. What are some common misconceptions about serious gaming in healthcare?
  • “Games are meant to be fun, while learning is a serious experience. Hence, elements like fantasy should not be part of the learning process.”
    The truth is that serious games can help hold the interest and attention of easily distracted learners, making the learning experience enjoyable and fruitful for them.

  • “If the focus of the game is about the rewards, learners may still not be able to apply the experience gained to real-life scenarios.”
    The game needs to be well-designed, i.e., needs to balance desired learning outcomes with game mechanisms, so that learners are prepared to apply their learning experience in a real-life context.

  • “Games do not allow opportunities to build more advanced skills and in-depth knowledge, so the learning needs of advanced/experienced learners are not met.”
    Actually, games are a good way to build up the skills of advanced learners, because you can simulate rare and complex clinical scenarios. Through the game, learners can rehearse responding to these situations in a safe, no-risk environment.

5.  Lastly, what are some tips you would give educators who are thinking about developing a serious game for teaching and learning in healthcare?

a) Focus on one desired outcome at a time.
b) Know your learners’ needs and preferences.
c) Stories improve the quality of the game, so try to structure your game with a compelling story.
d) Incorporate a good mix of challenges and fantasy in the game.
e) Identify the right incentives to motivate the learners during the gameplay.
f) Include a component of feedback on learners’ performance in the game.  
g) Gather feedback from a focus group of learners to evaluate and improve your game’s effectiveness before including it as part of the training curriculum.
Establishing a good partnership with the game designer is also invaluable to the game development process. But having a team committed to the common goal of improving competencies in our healthcare staff is the most important!  


Want to try creating your own serious game for healthcare learning? Take part in the inaugural SIMS Games Challenge 2019! 

Held as part of the S3 Conference 2019, the game challenge aims to explore the innovative application of technologies to enhance learning in healthcare. Form teams and submit your simulation/serious games concepts for the SIMS Games Challenge. Shortlisted teams will enjoy the opportunity to work together with a developer team to create a prototype of their game! 

Submit your concepts here!