You have heard many stories about serious games, but have they really been proven to work? Grendel Games has developed several serious games  over recent years. In this article, we share the scientific publications about the serious games Underground, Water Battle, Garfield’s Count Me In, Gryphon Rider and Reducept.

Underground

The serious game Underground was developed in collaboration with the University Medical Center Groningen (Netherlands). The game is intended to challenge surgeons to achieve their desired  training hours. More information about the game can be found on this page. Underground has been the subject of several scientific publications. We summarize the publications below.

Training in Basic Laparoscopic Surgical Skills: Residents’ Opinion of the New Nintendo Wii-U Laparoscopic Simulator

The study by Overtoom et al. (2017) evaluated surgeons’ experience with the laparoscopic serious game, Underground. Participants received an introduction and then had to complete levels 3 and 4 of Underground. Afterwards, they completed a questionnaire in which they gave their opinion on: realism, usability, suitability, haptic feedback (control via touch) and use for home training.

Conclusion

Most surgeons liked the serious game Underground. The participants gave Underground a high score on its usability and suitability as a training tool. However, the surgeons did ask for an improvement in the game, such as adding a proper leaderboard.

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Validation of a video game made for training laparoscopic skills

Scientific literature gives an indication of the benefits of gaming. In this study, Jalink (2014)  examined the effects of the serious game Underground on training laparoscopic surgeons… Surgeons were interviewed about the game and testing was done by having the surgeons play the game.

Conclusion

A total of 72 laparoscopic experts were asked to play the game and give their opinions. The results show, among other things, that the group of experts found the game’s hardware sufficient as a laparoscopic tool. Also, experts feel that Underground can be used for training basic laparoscopic skills. Furthermore, the study showed that experts in the field of laparoscopic surgery can actually benefit from a “pre-operative warm-up”. using Underground.

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Construct Validity of a Serious Game for Laparoscopic Skills Training: Validation Study

The aim of the study by Ijgosse et al. (2020) was to establish ‘construct validity’ for the laparoscopic serious game Underground. Serious gaming can increase the motivation of surgeons in training, but little is known about its effectiveness. In this study, all participants completed two levels of the serious game Underground.

Conclusion

Serious gaming can help develop laparoscopic skills. Experience with gaming and gender influenced performance in the game Underground. To realize the full potential of serious gaming for medical training, a more formal approach to developing performance measures is needed.

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Training basic laparoscopic skills using a custom-made video game

Games can be used to train basic laparoscopic skills of surgical students. Therefore, the serious game Underground, which uses Wii controllers, was created. In the study by Goris et al. (2014), the Underground serious game was validated through a traditional validation process, as described by the European Association of Endoscopic Surgeons.

Conclusion

In the validation process, it was found that the game has ‘face, construct and competitor validity compared to existing simulators. However, more research needs to be done on test and experimental validity before the game can be used for surgical training.

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Saving robots improves laparoscopic performance: transfer of skills from a serious game to a virtual reality simulator

Ijgosse et al. (2018) established construct validity for the laparoscopic serious game Underground in a study. They did this by comparing laparoscopic simulation performance of two groups. A total of 107 participants were divided between an Underground group and a control group. The Underground group played three sessions in the game Underground, followed by a transfer session on an FLS video trainer and LapSim VR simulator. The control group trained for four sessions on the FLS video trainer and LapSim. 

Conclusion

The study demonstrated skill transfer between a serious game and a validated laparoscopic simulator. Serious gaming can become a valuable, cost-effective addition to the skills lab if a the knowledge can be used in the operating room.

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Impact of Super Monkey Ball and Underground video games on basic and advanced laparoscopic skill training

The study by Rosser Jr. et al. (2016) describes the correlation between the game Super Monkey Ball (SMB) and the serious game Underground for the Nintendo Wii U. Sixty-eight participants, including 53 assistant surgeons and 15 attending surgeons, participated in the study.

Conclusion

The conclusion was that both games are effective for training laparoscopic skills, and are better used together than separately.

In the study, the game Super Monkey Ball had a significant correlation with intracorporeal suturing. Underground showed more of a correlation with basic surgical skills.

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Playing to your skills: a randomized controlled trial evaluating a dedicated video game for minimally invasive surgery

The purpose of the study by Harrington et al. (2018) was to evaluate skill development via the laparoscopic video game Underground. A randomized controlled trial was conducted with volunteer students who had a limited background in gaming.

Conclusion

The study demonstrated significant value in training using the laparoscopic video game Underground. The serious game may lay the groundwork for future surgical development on home game consoles.

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Garfield’s Count Me In

In collaboration with educational consultants, Wolter Danhof and Piet Bandstra, Grendel Games developed a maths game in which the world-famous cat Garfield plays the leading role: Garfield’s Count Me In. The game helps children from (special) primary education, at home and at school, to practice their maths. More information about the game can be found on this page.

Rather play games than do maths: practicing fact retrieval with the Garfield’s Count Me In game

Van Hoogmoed (2019) examined the effectiveness of the serious game ‘Garfield’s Count Me In’. At seven schools, students were asked to practice the game ‘Garfield’s Count Me In’ for 15 minutes four days a week for a month. Afterwards, they filled out a questionnaire with questions about the game.

Conclusion

Playing the ‘Garfield’s Count Me In’  has a positive effect on students learning math faster. Students enjoyed playing the game at school and at home. Further research should show whether children also spontaneously practice with the game at home, if it would be made available, and to what extent this contributes to a better transfer of knowledge.

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Gryphon Rider

The serious game Gryphon Rider is developed for children with non-congenital brain injury (NAH), who have to repeat many physical balance exercises. The game is developed at the request of, and in cooperation with rehabilitation professionals. More information about the game can be found on this page.

User experience of games for rehabilitation of children with a chronic condition

The purpose of this study (Donna, 2018) was to analyze the user experience of health games. The study focuses on games for the rehabilitation of children with a chronic condition. Two games were examined: Gryphon Rider (a game for children with balance problems due to a NAH) and AIRplayground (a game that encourages physical activity for children with asthma). After the children were asked to play the game appropriate to their situation, they were interviewed about their experience with the game.

Conclusion

The study proposes a new model of the user experience of health games. This model can be used to better evaluate health games, and to design new games. The model should be further developed in the future.

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Reducept

Reducept was created in collaboration with Margryt Fennema(health scientist and digital healthcare innovator), and Louis Zantema (medical psychologist). The serious game is specially designed for patients to help them cope with chronic pain. They are also taught where their pain comes from. More information about the game can be found on this page or in the whitepaper.


How barriers and facilitators of Virtual Reality E-health technology implementation can be used to conform a website to practitioners

Over the past 20 years, several e-health services have been developed. Yet, organizations implementing e-health services do not seem to be fully aware of the barriers and facilitators that affect the integration of these healthcare services. The purpose of this study (Doctor, 2019) is to provide a comprehensive list of relevant barriers and facilitators to help organizations plan and implement successful e-health services. Reducept, among others, was used to accomplish this research.

Conclusion

Addressing barriers early and leveraging facilitators during implementation can help create e-health services that better meet the needs of the target population and deliver greater benefits to patients and caregivers.

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