Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Nov 2, 2020
Date Accepted: May 7, 2021
Evaluating Quality, Usability, Evidence-based Content and Gamification Features in Mobile Learning Applications Designed to Teach Children Basic Life Support: A Systematic Review of Commercial Apps
ABSTRACT
Background:
Sudden cardiac death causes 8 million deaths per year globally. Following the World Health Organisation endorsement of the 'Kids save lives' initiative, basic life support (BLS) training for school-age children has been widespread. Mobile phone application (apps), combined with gamification represent an opportunity for including mobile learning (m-learning) for teaching schoolchildren BLS; however, a review of mHealth apps is needed to evaluate quality and BLS content.
Objective:
The aim of this study was to systematically evaluate the quality, usability, gamification features and evidence-based content of m-learning apps for teaching guideline-directed BLS knowledge and skills to school-aged children.
Methods:
We searched Google Play Store and Apple iOS App Store using multiple terms (e.g., “cardiopulmonary resuscitation (CPR)”, “BLS”, etc.). Apps meeting inclusion criteria were evaluated using the Mobile App Rating Scale User Version (uMARS) and System Usability Scale (SUS) by fifteen emergency healthcare professionals. We modified a “Five-finger” mnemonic for teaching school children BLS and reviewed the apps' BLS content by standardized criteria based on the three CPR guidelines. Gamification features in the apps were evaluated using gamification taxonomy.
Results:
Of the 1,207 potentially relevant apps, only 6 met inclusion criteria. Most apps were excluded because the content was not related to teaching school children BLS. The mean total score for uMARS and SUS score was 3.5/5 (SD=0.2; 95% CI=3.2-3.7) and 47.1/100 (SD=4.78; 95% CI=42.1-52.1) points, respectively. Half of the apps taught hands-only CPR, whereas the other half also included ventilation. All the apps indicated when to start chest compressions, and only one app taught BLS using an automated external defibrillator. Gamification was well integrated into the m-learning apps for teaching school children BLS, whereas gamification groups based on personality/fictionally, education or performance represent the majority of gamification features.
Conclusions:
Improving the usability and quality of BLS content in the apps and combining them with gamification features can offer educators novel m-learning tools to teach school children BLS skills.
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