Serious gaming: the future of healthcare training



Healthcare has made great advancements, but at the same time is facing new challenges. High training costs, the increasing requirement for speed and the lack of time and availability of trainers and trainees. Serious gaming is one of the key technologies currently considered in most health care training centers. We asked our clients why.

As a society, we aspire to invent and reinvent systems and methodologies simply with the goal of making our lives better. This article explores serious gaming juxtaposing it with the future of healthcare training. This piece draws attention to the potential of serious gaming in the health sector and challenges healthcare trainers to examine the merits of adopting serious gaming in their curriculum.

First, let us briefly define serious games. They are games that have other purposes besides entertainment. Serious gaming can also be described as the methodology or tool for training, skills acquisition, behavioral change, and awareness creation. Serious games have been around for decades and have been applied to various sectors including healthcare.

The healthcare sector is definitely one that has made progress over the centuries. Despite the advancements in the sector, there is still plenty of room for improvement.

Medical procedures have advanced. For example, neurosurgery has developed to the stage where neurosurgeons perform procedures described as ‘Awake Brain Surgery’. This fascinating procedure helps improve the quality of life of patients after brain surgery. In other words, the procedure makes sure that the patient does not lose core abilities after brain surgery. Exceptional right? Don’t get too excited yet because even though the health sector has experienced enormous evolution and growth, there are still challenges.

Some of the challenges can be observed in healthcare training. The setbacks in healthcare training include:

High training cost

The cost of medical education has been skyrocketing for some time now. Some studies have observed that the cost of medical education for the past 50 years has increased at an outrageous rate that is unsurpassed in history. This situation has plunged many graduates into debt.

One of the reasons for the high training cost is an investment in new technologies and machines. Admittedly, some of these investments are costly and these health facilities would have to gets returns on their investments, hence, an increase in training fees.

Another factor for the high training costs is demand and supply. So, in most under-developed countries, for instance, the demand for health professionals is higher than the supply of infrastructure and human resource capacity. This situation would naturally cause a hike in the cost of training.

Speed of delivery

In the current age of connectedness, speed has become a requirement. This also applies to the health industry. There are high demands for medical professionals.

Medical practitioners are expected to deliver their services at lightning speed with precision. Generally, this situation is understandable because of the increase in workloads. It also implies that trainees are expected to acquire new skills quickly and always stay sharp. This situation puts both medical trainers and trainees under pressure.

Time and availability of trainers and trainees

In terms of the actual medical training, trainers and trainees are under immense pressure. Whilst the trainers struggle to give classes due to time constraints, students have to deal with the pressure of acquiring new skills and updating their knowledge to stay relevant.

Now that we have highlighted bottlenecks in the healthcare sector. Here are some proposed and existing solutions to the challenges:

Government subsidies

Various government schemes are introduced to lessen the burden of training costs on medical facilities. These schemes include different types of grants and scholarships.

Incentives for health trainers

The scarcity of health trainers in certain jurisdictions means these professionals are usually over-worked. Governments are then forced to keep them motivated. These motivations reflect in juicy working conditions and packages. All these extra incentives to health trainers are costs eventually borne by the ordinary taxpayer.

Innovation and technology

The constraints in healthcare training have warranted investments in technologies. The educational goals of adopting new technologies in health care training include the facilitation of skills acquisition, improve decision making, and enhance perceptual and psychomotor skills. Some of the technologies we see today are; mobile apps, virtual reality, and integrated simulators.

Serious gaming is one of the key technologies currently considered in most health care training centers. It’s important to understand why this is the case. From our communication with clients, there are 2 main reasons


Earlier in this article, we expressed the unsustainable rise in health care training costs. Serious gaming looks like a long-term solution to this ordeal.

It has been reported that a medical education cost the average taxpayer in Germany 200,000 euros, and 450,000 swiss francs in Switzerland. The question then is, can the cost be reduced? The cost of medical training can definitely be reduced with serious gaming.

For example, the cost of a laparoscopic training simulator is between €50,000 and €100,000, while the serious game, Underground, costs only €270.  This serious game was developed for laparoscopic trainees to enhance their hand motor skills and has been proven to work. This is a clear example of how serious gaming can be harnessed to cut down health care training costs.

Fun in skills acquisition

Serious games are not the same as simulators. For more information on the differences, read this paper. Health care training is rigorous and highly demanding. Trainees sometimes find pedagogical sessions mundane. This is not good news.

According to DEA (2014), Germany recorded 19,000 casualties in the hospital, linked to negligence and malpractice. The cure for this problem is to ensure the health personnel stays sharp. This implicitly means health trainees need to be fully engaged in their training. Serious gaming helps with this. The solution does not just give results but also does it in a fun way.


So the question we ask ourselves then is, in which areas can serious gaming be used in the health sector? In principle, serious gaming should be applicable in all areas. The only condition for this is, industry experts must be open to serious gaming solutions to engage with serious game developers. This is how the unique combination of entertainment and science is realized.

Grendel Games collaborated with surgeons from the University Medical Center Groningen to develop a product, Underground, for laparoscopic surgical trainees. See the factsheet for this product below:

Underground Fact Sheet

Product Background and Goal

  • The product is called Underground. The development of the product started in 2010 and was completed in 2013.
  • Trainee surgeons are usually expected to dedicate at least 200 hours per year to motor skills development. The problem has always been that the traditional system used (simulators) are considered unattractive and boring for trainees. Underground aims to train the motor skills of laparoscopy trainees in a fun way.

Product Description

  • Underground can be played on a Wii U GamePad but Grendel Games developed a tailor-made laparoscopic controller for the trainee surgeons.
  • The game is about a brave girl who goes on a rescue mission to free a friend stuck in a cave. The only way the mission can be successful is for the girl to build bridges and break down blockages in the cave. The intricacies of building and breaking are how trainee surgeons acquire the necessary motor skills.
  • The game can be completed in 4 to 12 hours depending on the intensity of play and the skill level of the player.

Product Validity

  • Underground is currently used by 209 health centers in over 11 countries across the globe.
  • 2031 trainee surgeons are using the product.
  • Underground has been tested and proven to be efficient in 3 scientific research groups from the Netherlands and Belgium. These works have also been peer-reviewed and published (check reference list).

Other facts

  • Underground is a 2-time winner of the Dutch Game Awards as the best serious game product.
  • The product has also been featured in BBC and Netflix documentaries.

Concluding remarks

So, laparoscopic surgery is an example of a health sector where serious games are being used. We also foresee huge potential in robotic surgery. Here, serious gaming will assist the training of the surgeons in the use and operation of surgical robots. Additionally, the skills of robotic surgeons can be sharpened with serious gaming.

The days of wondering whether serious gaming works are over. The discussion has shifted to how they can be maximally applied for desired results. There are countless sources of evidence on the efficacy of serious games.

Let us not deprive our health care trainees of fun education and training.

If you already have some ideas or questions, let’s continue the conversation, contact Tim Laning via email / tel: +31681565635 / Linkedin


  1. Using technology to meet the challenges of medical education
  2. Serious games in medical education
  3. The role of GME funding in addressing the physician shortage
  4. Information technology and medical education
  5. Saving robots improves laparoscopic performance: transfer of skills from a serious game to a virtual reality simulator
  6. A serious game skills competition increases voluntary usage and proficiency of a virtual reality laparoscopic simulator during first-year surgical residents’ simulation curriculum
  7. Comparing Video Games and Laparoscopic Simulators in the Development of Laparoscopic Skills in Surgical Residents

Tim Laning

Business developer

Do you want to know more about the possibilities of serious games? Let’s discuss what serious games can do for you.


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