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. 2023 Nov 9:11:e44708.
doi: 10.2196/44708.

Case-Based Serious Gaming for Complication Management in Colorectal and Pancreatic Surgery: Prospective Observational Study

Sophie-Caroline Schwarzkopf  1 , Marius Distler  1   2 , Thilo Welsch  1   3 , Grit Krause-Jüttler  1   4 , Jürgen Weitz  1   2 , Fiona R Kolbinger  1   2   4
Affiliations

Case-Based Serious Gaming for Complication Management in Colorectal and Pancreatic Surgery: Prospective Observational Study

Sophie-Caroline Schwarzkopf et al. JMIR Serious Games. .

Abstract

Background: The potential risk and subsequent impact of serious complications after pancreatic and colorectal surgery can be significantly reduced through early recognition, correct assessment, and timely initiation of appropriate therapy. Serious gaming (SG) is an innovative teaching method that combines play with knowledge acquisition, increased concentration, and quick decision-making and could therefore be used for clinically oriented education.

Objective: This study aims to develop a case-based SG platform for complication management in pancreatic and colorectal surgery, validate the application by comparing game courses of various professional groups in the health care sector, and test the acceptance of the developed platform in the context of clinical education by measuring levels of usability and applicability within the framework of a validity and usefulness analysis.

Methods: In this observational trial, a novel SG for management of postoperative complications was developed and prospectively validated in a cohort of 131 human caregivers with varying experience in abdominal surgery. A total of 6 realistic patient cases were implemented, representing common complications after pancreatic and colorectal surgery. Cases were developed and illustrated using anonymized images, data, and histories of postoperative patients. In the prospective section of this study, following a brief case presentation, participants were asked to triage the virtual patient, make an initial suspected diagnosis, and design a 3-step management plan, throughout which the results of selected diagnostic and therapeutic actions were presented. Participants' proposed case management was compared to ideal case management according to clinical guidelines. Usability, applicability, validity, and acceptance of the application were assessed using the Trier Teaching Evaluation Inventory as part of a noncomparative analysis. In addition, a comparative analysis of conventional teaching and learning formats was carried out.

Results: A total of 131 cases were answered. Physicians selected more appropriate therapeutic measures than nonphysicians. In the Trier Teaching Evaluation Inventory, design, structure, relevance, timeliness, and interest promotion were predominantly rated positively. Most participants perceived the application to be superior to conventional lecture-based formats (training courses, lectures, and seminars) in terms of problem-solving skills (102/131, 77.9%), self-reflection (102/131, 77.9%), and usability and applicability (104/131, 79.4%).

Conclusions: Case-based SG has educational potential for complication management in surgery and could thereby contribute to improvements in postoperative patient care.

Keywords: Serious game; clinical reasoning; colorectal surgery; computer-based learning; decision-making; educational games; medical education; pancreatic surgery; postoperative complications; surgical education.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Serious gaming case structure. Introductory part: from the collection of demographic data of the participant to the first decision level. Main part includes 3-step case management and validity and usefulness analysis.
Figure 2
Figure 2
Interprofessional evaluation of the initially specified suspected diagnosis by suspected organ system across all serious gaming cases. Specification of the organ system was mandatory, while specification of complication mechanism and exact complication were voluntary.
Figure 3
Figure 3
Interprofessional evaluation of the initially specified suspected diagnosis by suspected complication mechanism across all serious gaming cases. Specification of the organ system was mandatory, while specification of complication mechanism and exact complication were voluntary.
Figure 4
Figure 4
Interprofessional evaluation of the initially specified suspected diagnosis by suspected exact complication across all serious gaming cases. Specification of the organ system was mandatory, while specification of complication mechanism and exact complication were voluntary.
Figure 5
Figure 5
Case-specific evaluation of therapy escalation. In order to analyze the appropriateness of management, 1 therapeutic measure was defined as crucial for each serious gaming case based on valid guidelines. POPF: postoperative pancreatic fistula.
Figure 6
Figure 6
Results of the noncomparative validity and usefulness analysis. After completing a serious gaming case, participants were asked to rate it across several dimensions using a 5-point scale.
See this image and copyright information in PMC

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