The Effects of Gamification on Computerized Cognitive Training: Systematic Review and Meta-Analysis

Abstract

Background: There has been a growing interest in the application of gamification (ie, the use of game elements) to computerized cognitive training. The introduction of targeted gamification features to such tasks may increase motivation and engagement as well as improve intervention effects. However, it is possible that game elements can also have adverse effects on cognitive training (eg, be a distraction), which can outweigh their potential motivational benefits. So far, little is known about the effectiveness of such applications.

Objective: This study aims to conduct a systematic review and meta-analysis to investigate the effect of gamification on process outcomes (eg, motivation) and on changes in the training domain (eg, cognition), as well as to explore the role of potential moderators.

Methods: We searched PsycINFO, Cumulative Index to Nursing and Allied Health Literature, ProQuest Psychology, Web of Science, Scopus, PubMed, Science Direct, Excerpta Medica dataBASE, Institute of Electrical and Electronics Engineers Xplore, Association for Computing Machinery, and a range of gray-area literature databases. The searches included papers published between 2008 and 2018. Meta-analyses were performed using a random-effects model.

Results: The systematic review identified 49 studies, of which 9 randomized controlled trials were included in the meta-analysis. The results of the review indicated that research in this context is still developing and lacks well-controlled empirical studies. Gamification in cognitive training is applied to a large range of age groups and audiences and is mostly delivered at a research site through computers. Rewards and feedback continue to dominate the gamification landscape, whereas social-oriented features (eg, competition) are underused. The meta-analyses showed that gamified training tasks were more motivating/engaging (Hedges g=0.72) and more demanding/difficult (Hedges g=-0.52) than non- or less-gamified tasks, whereas no effects on the training domain were found. Furthermore, no variables moderated the impact of gamified training tasks. However, meta-analytic findings were limited due to a small number of studies.

Conclusions: Overall, this review provides an overview of the existing research in the domain and provides evidence for the effectiveness of gamification in improving motivation/engagement in the context of cognitive training. We discuss the shortcomings in the current literature and provide recommendations for future research.

Keywords: cognition; gamification; health; meta-analysis; systematic review.

Figure 1

Preferred Reporting Items for Systematic Reviews and Meta-Analyses flowchart of the study selection process.

Figure 2

Forest plot of overall effect sizes comparing gamified condition and control condition (ie, non- or less-gamified version) on motivation/engagement for individual studies in alphabetical order.

Figure 3

Forest plot of overall effect sizes comparing gamified condition and control condition (ie, non- or less-gamified version) on flow/immersion for individual studies in alphabetical order.

Figure 4

Forest plot of overall effect sizes comparing gamified condition and control condition (ie, non- or less-gamified version) on demand/difficulty for individual studies in alphabetical order.

Figure 5

Forest plot of overall effect sizes comparing gamified condition and control condition (ie, non- or less-gamified version) on the cognitive process for individual studies in alphabetical order.

Figure 6

Forest plot of overall effect sizes comparing gamified condition and control condition (ie, non- or less-gamified version) on clinical outcomes for individual studies in alphabetical order.