Currently submitted to: JMIR Serious Games
Date Submitted: Jul 22, 2026
Open Peer Review Period: Jul 23, 2026 - Sep 17, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Designing a Serious Game to Foster Brokerage Behavior in Healthcare Networks: Development and Formative Evaluation Study
ABSTRACT
Background:
Inter-organizational collaboration has become crucial in healthcare as complex challenges require coordinated efforts across organizational boundaries. Individuals, acting as brokers, play a pivotal role in bridging organizational boundaries by coordinating, transferring and translating knowledge across organizations. However, these brokers are often unaware of the different broker roles they enact, limiting their ability to collaborate effectively.
Objective:
This study aimed to describe the design of a serious game on brokerage behavior and report initial insights from its use in practice.
Methods:
Learning objectives and a game were formulated based on multiple 'open triads' as network structure to encourage players to engage in different brokerage roles, described by Gould and Fernandez. The serious game's development was followed by a series of try-outs including reflection sessions in which players reflected on the experienced collaboration efforts and brokering behavior.
Results:
Gameplay lasted 15-25 minutes, during which players engaged in different forms of brokerage behavior. As the game progresses, players employed different brokering strategies to overcome barriers and work collaboratively towards common goals. As designed, several tensions emerged when players experienced conflicting goals or forms of (competitive) network dynamics. Subsequent reflection sessions deepened the understanding of how individual and collective goals shape brokering behavior and vice versa, and how this can influence inter-organizational collaboration.
Conclusions:
The application of the serious game demonstrated its potential to foster game-based learning on brokerage behavior and its influence on inter-organizational collaboration. During gameplay, players enacted different brokerage roles and were also engaged in broader network dynamics, such as boundary spanning. Through gameplay and reflection, players recognized boundary roles and overcame typical counterproductive network behavior, such as ‘siloing’.
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© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.