Currently submitted to: JMIR Serious Games
Date Submitted: Feb 16, 2026
Open Peer Review Period: Feb 19, 2026 - Apr 16, 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Warning: This is an author submission that is not peer-reviewed or edited.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.
Proof of Concept for a Virtual Serious Game for the Training of Doctors and Nurses: Design and Development of the GEMAS Project
ABSTRACT
Background:
Traditional lecture-based education has shown limitations in engagement, knowledge retention, and skill transfer in healthcare training. Serious games and virtual simulations offer accessible and scalable solutions to enhance emergency medicine (EM) education. The GEMAS project (Gamificación en Enfermería y Medicina para el Aprendizaje por Simulación) was developed as a narrative-driven serious game integrating clinical reasoning, diagnostic decision-making, and evidence-based emergency management.
Objective:
This study aimed to describe its development and evaluate its usability, satisfaction, and educational impact.
Methods:
A pre–post single-center pilot study was conducted among physicians and nurses from a university hospital with no prior experience in serious games or high-fidelity simulation. Participants completed a 2–3-hour GEMAS gameplay session. Educational outcomes were assessed using Levels I and II of the Kirkpatrick model: (1) satisfaction and usability through a 10-item Likert questionnaire and the System Usability Scale (SUS); and (2) knowledge acquisition via an expert-validated pre- and post-intervention test covering key emergency scenarios. Statistical analyses included paired t-tests and Pearson correlations between knowledge improvement and age or professional experience. The level of statistical significance considered was 5%.
Results:
22 healthcare professionals participated (31.8% physicians, 68.2% nurses; mean age 31 ± 7 years; 59% female). Satisfaction was high across all items (means >9/10), with no differences between professional categories. Median SUS was 87.25 overall (90 for physicians, 84.5 for nurses), with 77.3% giving grade A (>78.9, excellent usability). Knowledge scores improved significantly from pre- to post-intervention. Physicians improved from 48.5 ± 13.3 to 80.3 ± 15.2, and nurses from 23.5 ± 8.3 to 43.5 ± 15 (p < 0.001). No significant correlation was found between improvement and age (r = –0.08) or years of experience (r = –0.41).
Conclusions:
GEMAS demonstrated excellent usability, very high user satisfaction, and significant knowledge improvement among active healthcare professionals. Its design effectively enhances clinical reasoning and evidence-based decision-making, providing a scalable, low-cost complement to traditional simulation. Future multicenter studies will explore long-term learning transfer. Clinical Trial: NCT06516250
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