Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 May 27:5:4.
doi: 10.1186/s41077-020-00123-3. eCollection 2020.

Assessing validity evidence for a serious game dedicated to patient clinical deterioration and communication

Antonia Blanié  1   2   3   4 , Michel-Ange Amorim  3   4 , Arnaud Meffert  1   2 , Corinne Perrot  5 , Lydie Dondelli  5 , Dan Benhamou  1   2   3   4
Affiliations

Assessing validity evidence for a serious game dedicated to patient clinical deterioration and communication

Antonia Blanié et al. Adv Simul (Lond). .

Abstract

Background: A serious game (SG) is a useful tool for nurse training. The objectives of this study were to assess validity evidence of a new SG designed to improve nurses' ability to detect patient clinical deterioration.

Methods: The SG (LabForGames Warning) was developed through interaction between clinical and pedagogical experts and one developer. For the game study, consenting nurses were divided into three groups: nursing students (pre-graduate) (group S), recently graduated nurses (graduated < 2 years before the study) (group R) and expert nurses (graduated > 4 years before the study and working in an ICU) (group E). Each volunteer played three cases of the game (haemorrhage, brain trauma and obstructed intestinal tract). The validity evidence was assessed following Messick's framework: content, response process (questionnaire, observational analysis), internal structure, relations to other variables (by scoring each case and measuring playing time) and consequences (a posteriori analysis).

Results: The content validity was supported by the game design produced by clinical, pedagogical and interprofessional experts in accordance with the French nurse training curriculum, literature review and pilot testing. Seventy-one nurses participated in the study: S (n = 25), R (n = 25) and E (n = 21). The content validity in all three cases was highly valued by group E. The response process evidence was supported by good security control. There was no significant difference in the three groups' high rating of the game's realism, satisfaction and educational value. All participants stated that their knowledge of the different steps of the clinical reasoning process had improved. Regarding the internal structure, the factor analysis showed a common source of variance between the steps of the clinical reasoning process and communication or the situational awareness errors made predominantly by students. No statistical difference was observed between groups regarding scores and playing time. A posteriori analysis of the results of final examinations assessing study-related topics found no significant difference between group S participants and students who did not participate in the study.

Conclusion: While it appears that this SG cannot be used for summative assessment (score validity undemonstrated), it is positively valued as an educational tool.

Trial registration: ClinicalTrials.gov ID: NCT03092440.

Keywords: Patient deterioration; Serious game; Simulation; Validity evidence.

PubMed Disclaimer

Conflict of interest statement

Competing interestsThe authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Screenshots of LabForGames Warning
Fig. 2
Fig. 2
Links between errors (communication and situational awareness) and the clinical reasoning process as demonstrated by principal component factor analysis
See this image and copyright information in PMC

References

    1. Buist M, Bernard S, Nguyen TV, Moore G, Anderson J. Association between clinically abnormal observations and subsequent in-hospital mortality: a prospective study. Resuscitation. 2004;62(2):137–141. - PubMed
    1. Hillman KM, Bristow PJ, Chey T, et al. Duration of life-threatening antecedents prior to intensive care admission. Intensive Care Med. 2002;28(11):1629–1634. - PubMed
    1. Ghaferi AA, Birkmeyer JD, Dimick JB. Complications, failure to rescue, and mortality with major inpatient surgery in medicare patients. Ann Surg. 2009;250(6):1029–1034. - PubMed
    1. De Meester K, Verspuy M, Monsieurs KG, Van Bogaert P. SBAR improves nurse-physician communication and reduces unexpected death: a pre and post intervention study. Resuscitation. 2013;84(9):1192–1196. - PubMed
    1. http://www.has-sante.fr/portail/jcms/c_1776178/fr/saed-un-guide-pour-fac....

Associated data