JMIR Publications

ABSTRACT

Background:

This study explores gamification in the design of virtual patients to enhance the training of Swedish military medics within trauma. The challenges related to prehospital trauma care faced on the battlefield require tailored educational tools that support military medics’ education and training.

Objective:

The aim of the study is to investigate how to design virtual patients with game elements for Swedish military medics to support learning in military trauma care.

Methods:

The study involved 14 Swedish military medics of the Home Security Guard participating in a tactical combat care course. Participants interacted with three different virtual patient cases designed to simulate military trauma scenarios. Data were collected through think-aloud sessions and semi-structured interviews. The data were analyzed using interaction analysis, structured by the uPEA framework, and reflexive thematic analysis, to explore participants' reasoning processes and perceptions, and identify possible game elements to inform the virtual patient design.

Results:

Mapping the military medics’ reasoning to the uPEA framework revealed that study participants became more creative after making a mistake followed by feedback, and after receiving a prompt to make a new decision. The thematic analysis revealed six themes: Motivation: “keep on trying”; Agency in interaction with VPs; Realistic tactical experience; Confidence: “I know that the knowledge I have works”; Social influence on motivation; and Personalized learning. Participants suggested that game elements such as: scoring, badges, virtual goods, progress bars, performance tables, content unlocking, hints, challenge, control, imposed choice, narrative, avatars, sensation, randomness, difficulty adaptation, competition, leaderboards, social pressure, progression and renovation, can promote engagement, motivation, and support confidence in decision-making.

Conclusions:

The insights gained by the study may encourage designing virtual patients with game elements, as well as including possibly wrong decisions, their consequences, and relevant feedback, that may support military medics’ reflections and decision-making. Military medics may benefit from scenarios that require not only medical knowledge application but also tactical decision-making, reflecting the complexity of trauma care on the battlefield. Integrating challenges that may induce error can be beneficial, as wrong decision-making followed by feedback can promote creativity and reflection. Gamification in the design of virtual patients represents a promising approach to military medical training, offering a platform for medics to practice medical and tactical decision-making in a risk-free environment.