The role of gaming for information, education and communication of AMR: full review of online education resources

Abstract

Background: The first objective of the Global Action Plan on antimicrobial resistance (AMR) is to improve awareness and understanding of AMR through effective communication, education and training. Towards this several efforts have been made to create AMR awareness resources. The aim of these resources is to inform the public about responsible antibiotic use and drive positive behavioural change. Digital media and specifically games can serve as unique innovative platforms in public communication programmes.

Objectives: This study focuses on compiling and evaluating game-based AMR resources. Recognizing the engaging and creative potential of games as learning tools, the primary objective of this study was to identify games that can be used, individually or in combination depending on their unique focus and gameplay experience, for AMR awareness. Furthermore, games are evaluated on five objective criteria and recommendations are made towards further development of gaming resources towards AMR awareness.

Methods: Meticulous curation was performed to mine information, education and communication resources, with a primary focus on games for AMR awareness and evaluating them based on game design and gameplay, AMR content and learning, engagement and replay appeal, learning outcomes, and level of difficulty and challenges.

Results: In this study, we selected 12 AMR games. Our evaluations, spanning various gamification elements and interactive parameters, informed recommendations for future AMR resource development, including multilevel game design, varied graphics, simple-to-understand rules, sustained challenge and a sense of reward, among others.

Conclusions: This study generated the first-ever comprehensive catalogue of AMR games that may assist public communication programmes for AMR awareness. Evaluation of these games led to actionable design recommendations for future resources towards effective communication of AMR complexity, enhanced learning and awareness.

Figure 1.

Flowchart depicting the workflow of the systematic curation of game-based resources on AMR awareness. Two-stage screening process is involved in selecting AMR games, which were then evaluated on several game parameters. The evaluation is then assessed to make recommendations for future resources of AMR.

Figure 2.

Summary of the resources reviewed. Resource web links: Aporo: https://play.google.com/store/apps/details?id=com.gioelecasazza.Aporo&hl=en&gl=US, ArMoR: The Game is On!: https://sites.google.com/view/anshub/armor, Bacteria Combat Lite: https://play.google.com/store/apps/details?id=com.GameDr.bacteriacombat&hl=en_IN&gl=, Bash the Bacteria: https://bugsgames.github.io/bashthebacteria/, Battling the Bugs: https://bugsgames.github.io/battlingthebugs/, Dicing with Death: https://bugsgames.github.io/dicingwithdeath/, Dr Bug: Microbe Mayhem!: https://portfolio.global-initiative.com/oxford-pharmagenesis  https://apps.apple.com/us/app/dr-bug-microbe-mayhem/id1248291732, Fungal Invaders: https://www.sciencegamecenter.org/games/fungal-invaders, Micro-Combat: https://eu-jamrai.eu/micro-combat/, Private Penny: The Resistance: https://play.google.com/store/apps/details?id=com.Ateneo.PPTR&hl=en_IN&gl=US, Superbugs: The Game: https://amr.longitudeprize.org/superbugs-game/, Terebra: https://play.google.com/store/apps/details?id=com.biofaction.synpeptide&hl=en&gl=US. Source of resource: (i) governments, (ii) professional societies, (iii) universities/higher education institutes, (iv) healthcare facilities, (v) WHO, (vi) industry, (vii) insurance companies, (viii) NGOs. Focus of resource: (i) principles/practice of prudent prescribing, (ii) antimicrobial stewardship principles/practices, (iii) guidelines/policies/pathways for syndrome management of infections, (iv) infection prevention/control, (v) implementation/behaviour change, (vi) evaluation/measurement, (vii) evidence gathering. Target audience: (i) doctors, (ii) pharmacists, (iii) nurses/midwives, (iv) non-medical managers, (v) public health, (vii) laboratory, (viii) infection prevention practitioners. Setting of resource: 1. Pre-service (university, higher education institution), 2. Service (i) hospital, (ii) outpatient clinic, (iii) community/general practice, (iv) long-term care facility/nursing home, (v) hospital and ambulatory, (vii) other. HIC, high-income countries; HMI, high- and middle-income countries; IPC, infection prevention and control; LI, low-income countries; LMIC, low- and middle-income countries; N/A, not applicable.