The Benefits and Drawbacks of Video Games in the Classroom Peer Review

Klaudia Ćwiękała Lewis, Department of Nursing, York College of Pennsylvania, USA.

Introduction

The term video game generally means the interaction of games played utilizing a specialized electronic device or any other type of screen that it is programmed on (video game, n.d.). The term 'video game,' has been recorded in history as early as 1948 with the invention of the "Cathode-Ray Tube Amusement device" (Brookhaven National Library, northward.d.). This particular device utilized manual pictures placed on the screen as an overlay and the game was played under the overlay. In 1952 the first recorded, total-screen video game, without the motion-picture show overlay, was developed and titled "OXO" or a version of tic-tac-toe (Brookhaven National Library, n.d.) This device fully displayed the processed output of a game onto a screen. As the years and eventually decades progressed, video games take progressed from something that is played casually, to simulations, educational games, and full virtual reality types of games. Although in before times, video games had the stigma of existence for pure entertainment value just, the literature has conveyed the utilization of video games, specifically in nursing, equally early every bit the 1980'south [1]. This was preceded with the idea of multiple constraints with video games to use in nursing education. The main reasoning was deeply rooted in the nursing tradition from the founder Florence Nightingale of being educated in the classroom and supported that method of pedagogy for nursing [1]. Secondary reasoning for the resistance to the utilization of video games in education stemmed around the lack of knowledge and research surrounding them as being utilized every bit an educational tool for nursing students. That is the primary purpose of this paper, not to show that games tin can be utilized as a tool within the nursing education scheme, merely rather to illustrate specific advantages and disadvantages of utilizing video games as presented inside the articles based upon using gaming equally an adjunct in the educational activity of nursing students.

Methods

A literature search was conducted in two ways. First a systematic literature search was conducted using six popular health science databases. Secondly a Google Scholar (http://scholar.google.com/) search was conducted. The second search immune the researcher to explore more publications in a less structured manner. During the second search, abstracts were reviewed carefully, equally this database provides more low- quality material. The search was conducted to answer the research question: What advantages and disadvantages of using video games and simulations for designing learning experiences for the nursing student and educators are discussed in current literature? An electronic search was conducted of the published research studies examining the advantages and disadvantages of using video games and simulations for designing learning experiences for the nursing pupil and educators. Electronic databases included: PubMed, Cumulative Alphabetize to Nursing and Allied Health Literature (CINAHL), Web of Science, and Embase, from January, 2007 to December, 2019. Search terms included: "Video Games" or "Gaming Simulation" AND "Nursing Didactics". Articles were limited to English. The abstracts of all research studies were reviewed to decide the relevance to the presented topic.

Results

The search of 5 databases yielded 138 articles for screening for potential inclusion. After removing duplicate articles and those not related to the topic, a total of 34 studies were reviewed in depth for eligibility. The 34 manufactures were reviewed based on inclusion and/or exclusion criteria, yielding 18 articles included in this review (Figure 1). illustrates the report pick process. Fifteen articles were examined to create a listing of potential advantages and disadvantages of using games and simulations for designing learning experiences for nursing students and educators.

Advantages and Disadvantages

Advantages

The researched articles that were found revealed a vast amount of data pertaining to video game usage with the teaching of nursing students. Upon further examination, specifically looking for the advantages of using games, the following list was developed based upon the primary themes of the manufactures presented.

• Errors are not harmful to patients

• Simulated training leads to clinical improvement

• Video games let for specific designs and patient interactions specific to a specialized skillset

This author will delve further into the explanation of these advantages in relation to the enquiry that presented the concepts of utilizing video games in nursing education.

Errors are not harmful to patients: Medical errors are a very serious problem within the Usa of America's healthcare system. Overall medical errors that involve all types of errors including doctor, nurse and unlicensed professional errors account for over 130,000 patient deaths a year [2]. Specifically, pertaining to nursing, the majority of nursing errors are related to medication errors. It was deducted inside a enquiry study performed in 2009 that in upwards of 65% of nursing errors were related to medication errors [iii]. These errors range from the occurrence of pocket-sized issues such as increased discomfort to more serious consequences such as allergic reactions and increased length of stay. There is, estimated to be, over $70 million a year of increased healthcare costs associated with medication errors alone [3].

The advantage of utilizing gaming in relation to errors is that gaming is not using real-life subjects. This alone is benign due to the fact that if a video game grapheme has a medication fault, a human being is not harmed by that fault. Robyn and Simon (2009), inside their review, showed that 50% of their reviewed research studies pertaining to simulation had a significant effect on a nursing student's confidence with their skills and critical thinking. Utilizing simulation for education assistance with nursing education tin boost the nursing pupil's confidence and critical thinking which can lead to fewer errors. One result with clinical scenarios that may occur, according to Sleeper and Thompson[4], is that students may have a fear of performing skills or even communicating on how to perform skills due to the fear of causing harm to patients, even when in a supervised environs. Gaming and simulations can help quell those fears by providing an surround of no fear of damage to the patient. Multiple enquiry articles specifically mention the importance of the creation of that type of environment of not harming a patient [ane,5-12]. [5,ix] continue to printing that issue of errors non affecting humans and that simulations create a supervised session that allows the students to practice, feel and try new skills in different ways to help them learn how to perform those skills in a controlled style. That can assist decrease the anxiety related to trying new procedures and increase the comfort level of the students to endeavour to learn more easily.

Imitation training leads to clinical improvement: Simulation and teaching are synonymous with each other to provide a new method of training outside of the traditional classroom method of education. This type of training helps expand the situation and cognition that is being transferred to the student to allow for placement of the knowledge in a more realistic context [12,13]. The benefits to the simulation-type of education can be attributed to the idea that the students can retain more cognition utilizing simulation versus the traditional classroom-type of way. In a classical piece of work by Edgar Dale, he developed a 'Cone of Experience' that outlined the hypothetical amount of knowledge retained during an educational session. To simplify the cone, it lists the hypothetical per centum of knowledge retained with the various types of learning experiences kickoff with (a) x% of knowledge remembered with reading, (b) 20% of knowledge with what they hear, (c) xxx% of noesis remembered with what they see, (c) 50% of knowledge remembered with what they meet and hear, (d) 70% of knowledge remembered of what they say and write, (eastward) xc% of knowledge remembered of what they do as they perform the task [fourteen].

The simulation utilizes the knowledge learned and applies that direct towards a state of affairs where the pupil can perform the action on a training dummy while 'educating' the instructor [15]. This method of learning and knowledge retentiveness is up in the highest per centum, co-ordinate to the cone of experience, which can translate into increased clinical competence [16]. This improvement in the clinical competency of the students has been researched fairly extensively over the years. In a Systemic Review of simply 12 research studies surrounding the usage of simulationbased learning, Deceit and Cooper [16] found that all 12 of the studies, consisting of a total sample size of 1533 study participants showed a significant improvement in the clinical competency of the research participants. In another study researching undergraduate nursing pupil'southward experiences, they connected the trend of the increased cognition and increased feeling of having better cognition towards being able to perform their clinical functions within their skills [x].

Video games allow for specific designs and patient interactions specific to a specialized skillset: One of the swell concepts surrounding video games is that they are a game. Games tin can be fabricated to prove anything that they are programmed to testify. The just limitations to this would exist the hardware limitations on what can be processed for the graphics and the limitations pertaining to the method of commitment [12]. This relates to the simulation equipment and the capabilities of these to procedure and fairly simulate what needs to exist simulated [xv]. Video games and simulations can exist made to club depending on the topic that is being educated, the specialty that needs to be learned and the imagination of the developer [15]. Specialists within the individual fields will need to be present during the programming of the game or simulation to ensure that the data existence presented is sound and the research is based upon that specialty.

In one study performed past Boctor [17], she utilized a Jeopardytype of game, as a full general review specialty for her form information, to assistance students reinforce the nursing knowledge that was taught to them. After the study was completed, a statistically significant number of students reported enjoying the game and requested to encounter more. This was likewise found in a study performed past Cremonini [xviii] that nursing students' satisfaction was loftier with the usage of video games in education. Multiple other studies also concur with the flexibility and adaptability of video games and simulation towards any specific specialty [5,vi]. Two studies were performed specifically with the pediatric nurse specialty and gaming. The beginning study performed by Verkuyl, Atack, Masatrilli and Romaniuk [19] studied virtual gaming to develop pediatric nursing skills and was successful in showing increased knowledge retention towards pediatric information and caring for pediatric patients. The second study performed by Verkuyl, Romaniuk, Atack and Mastrilli [20] researched the usage of virtual serious games and the clinical competency of nursing students within the pediatric population. They found that the knowledge gained by utilizing virtual serious games proved to exist a statistically significant gain in knowledge and expertise. This illustrates that even specialized nursing can benefit from video games and simulation.

Disadvantages

Despite the advantages of utilizing video games and simulation for the education of nursing students, in that location are still disadvantages that exist. These must be weighed when attempting to make up one's mind whether to comprise this tool into nursing education. The principal disadvantages that were found during the research includes:

• Costs

• User Interface Problems

• Real-life patient care is irreplaceable

This author volition now talk over the disadvantages associated with utilizing video games and simulation within nursing education based upon the listing higher up.

Costs: Costs of everything have to be accounted into anything that is being washed, whether in real life or inside concern. Budgeting, toll, profits and more must be advisedly considered when needing or wanting to practise just almost anything in life. Video games are no exception to cost. Typical costs include the equipment to be able to program the software, manpower to perform the programming, manpower to test the software also equally the marketing for the products and have costs associated with them. Those associated costs are and then passed onto the purchaser to keep the developer and publishing company in business organisation. Costs are associated with a large barrier to the adoption of video games and simulation applied science integration into a nursing program also [13]. Typical costs associated with pure video games can range from a few dollars to millions of dollars. For instance, the video game "Grand Theft Auto V" which was produced and released in 2013 ultimately cost $137.5 million dollars to produce (Sinclair, 2013) for a high visibility and very popular video game. This puts into perspective the potential costs of video games from the cheapest to i of the virtually expensive games to appointment. The actual cost of an education video game will depend on the simulation type, graphics, and interface [15]. There is the quality result pertaining to ensuring that the video game or simulation contains the advisable information and presents the quality and expectations of the nursing programme and nursing in general. This is where nursing regulation would have to step in to make sure that the data is sound and that regulations are produced and existence followed when utilizing video games. Some of the concepts that are needed for advisable development of games for nursing education, as provided by Lemermeyer [21]

• Method of learning is to exist engaging and valid

• Nurses should be involved in the evolution

Some of the regulatory components, associated with the content that would need to be considered also include, as provided by Lemermeyer [21]

• Governance

• Requirements for registration and practice permit renewal

• Scope of nursing practice

• Practice standards and ideals

• Continuing competence

• Professional Behave

All of these concepts would need to be included within the development of the video game and simulation and would need to exist accounted for inside the budget due to the time constraints needed for someone to clinch that these are followed to ensure that the highest standards and quality is met with the video game.

Another issue to note when considering toll is if the video game or simulation is associated with the usage of a existent simulation mannequin. This is another cost that would take to be accounted for inside the total toll for the video game or simulation. This would depend on the complexity of the simulation. For case, a half body, CPR simply mannequin would cost $1580.00 whereas a full body mannequin would cost $2061.00. [22]. In a product called "Sim Homo 3G" produced by Laerdal, this mannequin is very complex assuasive it to be used for CPR preparation, seizures, neurological examination, secretions, 4 placement, Medication assistants, trauma and more. This, very advanced, mannequin can cost up to $sixty,000 [23]. These prices practice not include the boosted equipment that is necessary to maintain and utilize information technology for multiple students every bit well. Ane last very important issue associated with price is the equipment, rooms to firm the equipment, costs for training the trainers, maintaining the equipment and the costs associated with paying the employees to train on the equipment. All of these things tin add upwardly.

User interface problems: This type of software event tin be broken down into two chief categories. The first existence bodily user interface issues surrounding the user themselves and the second being the platform for distribution.

user issues: This includes barriers with the language, ease of use of the software, usage of the software, understanding how to navigate inside the software as well as the visual presentation of the software [xv]. The software would have to exist easy enough to pick up and utilize with some instructions, but circuitous enough to maintain involvement in the game to keep attention for acceptable learning and knowledge memory. From the complexity point-of-view, if a game is besides complex in that location is a possibility for students to lose interest and risk not learning anything. If a game is besides uncomplicated, there is the possibility for students to become bored and take a chance non learning anything. Granic, Lobel and Engels [24] mention virtually complexity in video games, indicating that the ameliorate games tend to be dynamic on the complication of the game and adapted to the power of the player while increasing in difficulty and other aspects of the game. Other ideas to be included inside the game are the feedback mechanisms for both positive and negative choices made within the game. Reinforcement for positive choices, when performed in a correct way, has been establish to exist the most successful in adapting and learning new behaviors [24] Another issue is the accessibility of the game. Accessibility of software must accommodate students with special needs, and culling languages also every bit students with learning difficulties. This is extremely important to contain into the software as it allows for more students to utilise the game and still acquire the same data as anybody else. Some of the problems that surround accessibility include alternative methods for obtaining the information, such as alternative text, additional tutor or screens for caption, text-to-spoken communication, visual enhancements as well as the ability for the game to have different spellings for those times the students volition need to type in an answer [25].

Platform for distribution: This issue revolves around the upshot surrounding the number of different operating systems that are available. Currently for computers, three of the well-nigh popular operating systems are Windows, Macintosh and Linux. For gaming systems that are popular, there is the Microsoft Xbox, Sony PlayStation, and Nintendo Wii and Switch. For the mobile platform, the most popular are Android and Apple tree IOS. This list is far from being comprehensive as in that location are over 50 different 'operating' systems throughout the globe with dissimilar and specific functions that they were designed for. This issue revolves around the decision on how the delivery of the game or simulation will occur. That ultimately would be upwards to the establishment utilizing the software.

Real-life patient care is irreplaceable: It is condom to say that absolutely nothing tin completely replace a real-life person sitting, standing or lying in front of the nursing pupil, who has that ability to utilize all five senses on that patient [26].Patients have different personalities likewise as different ways to nowadays signs and symptoms. Video games and simulated patients can only utilize the data that has been programmed into them. It would exist impossible to plan every single type of skin color, every condition or every symptom that someone can have [12,26] Rex-Henderson, 2018). In add-on to those issues, students can enquire real-life patients whatever blazon of questions and receive answers to those questions. With virtual or fake patients, students can only inquire questions that were pre-programmed for the game to answer [12,xv,26-thirty]. Multiple research studies have mentioned that simulated patients are no replacement for existent-life patients and that video games and simulations should be kept as a supplement to the teaching on and with existent-life patients [1,9,10,12]. Simulations and video games tin only testify so much, with the educational content, up until the point the educatee is in a real-life state of affairs and the patient is complaining, talking, coughing, gagging and becoming unstable in front of them and the pupil has to make a determination on how to care for them on the spot.

Discussion

Information technology was presumed, by this writer, that video games and simulation would be a truly welcome addition to the nursing curriculum as an boosted tool for the education of nursing students. Based upon the listed advantages, the biggest advantage of the no gamble of harm to real humans, while beingness able to practise, can help significantly decrease nursing student's anxiety that could be generating a fear of trying new things out to learn. As nursing programs are trying to acquire and maintain clinical sites to help the students flourish and come across as much as they can while they are in the prophylactic net of their nursing plan, non all types of patients and treatments are available during the clinical and schooling years of nursing students. This is where video games and simulations can help to introduce the students to new concepts and ideas with the ability to specialize and target specific patient populations or skills that students may not see very often and allow them to have some experience with the more specialized patient populations.

The disadvantages, however, are stiff with the usage of video games and simulations. The cost is well-nigh probable the biggest barrier to many healthcare institutions and schools. The premise that video games tin cost a few dollars to millions of dollars can exist a threat to the advancement of video games into nursing education. This cost does include the development costs associated with programming, voice-overs, and music also every bit testing. This, however, does not include hardware that the simulation may control such as the Sim Man 3G, which has the upward costs of over $lx,000, depending on the features required for your institution [23]. There are methods to exist able to afford the costs of software and hardware through grants that are offered through the federal government and other entities that offering money for technologies. The cost also doesn't include the equipment storage, maintenance, rooms to educate and utilize the equipment equally well as the cost for the education of the employees and students to do good.

The other disadvantages such as the interface issues can easily exist resolved with the educational facility or healthcare entity choosing one specific operating arrangement to utilize the software besides as limiting the software to in-house usage only. The terminal disadvantage to gaming is that real patients are not able to be substituted. Although this is a disadvantage, gaming and simulations are not healthcare. Healthcare is the caring of humans that are sick and ill. Humans are not a video game, and thus, video games are not humans. Although video games are programmed by humans, it is nigh impossible to account for every sign and symptom that patients may feel with a disease state. This leads to the mention that video games and simulations are an additional tool in the toolbox for the education of students and nurses. Information technology is non made to replace, but rather to assistance in the education of nursing to help create a rubber surround for the successful learning of new skills and increase the confidence of those learning. This leads us to the ultimate question, are video games and simulations worth it to utilize for the teaching of nursing students? Do the advantages outweigh the disadvantages? The entreatment of the current research showing positive adjustments in the clinical behaviors and conviction with skills at the bedside is a slap-up start at showing that video games and simulations are a great concept to help with nursing education. The other aspect is the ability to tailor the content of the video games to whatsoever specialty that you desire it to cover. Nursing is a diverse chore with an well-nigh limitless application both inside and outside of the hospital to see any types of injury, disease and fifty-fifty those people that are healthy. However, the price is i of the barriers to the full adoption of the video game and simulation tool. Looking at information technology from the patient perspective, with the cost of avoidable medical errors being $xix.5 billion, even preventing one percent of that equates to a $195 million dollar savings to the healthcare arrangement, more than enough to pay for even the well-nigh expensive $137.v million dollar Thou Theft Auto video game and have some money left to pay for the marketing of the video game. With that figure in mind, depending on how the nursing school or infirmary utilizes the video game and equipment, it will make upwards the price of the video game within a year or two, hypothetically with the prevention of common errors.

Conclusion

Video games and Simulations are a valuable tool to both nursing schools and hospitals to aid with the instruction of not merely nurses, but anyone inside the healthcare field. They offer many advantages to utilizing these modalities of education including no harm to a patient for performing an error, a possible increase in clinical improvement for the student utilizing the game and simulation, as well as the opportunity to tailor video games to multiple different types of specialties. However, despite the advantages, there are too disadvantages including cost, interface issues and the fact that a real-life patient is irreplaceable. The cost is the largest bulwark to the adoption of these technologies due to information technology potentially costing over a million dollars. All the same, with medical errors, potentially, costing upwards of hundreds of millions to over a billion dollars a year for the The states healthcare system, the utilization of video games and simulations tin can aid decrease the preventable errors and, in the long run, pay for the video game and simulation only from those savings. Healthcare is present to have intendance of people, whether they are ill or healthy and having that power to prevent errors from happening should be on the elevation of the priority listing for the healthcare arrangement. The personal experience of this author with simulation type of instruction has been a positive one and this author would like to come across the expansion of those technologies and tools for education of all students and experienced professionals.

Acknowledgement

Conflict of Interest

No conflict of interest.

meekinsimed1954.blogspot.com

Source: https://irispublishers.com/ijnc/fulltext/advantages-and-disadvantages-of-using-video-games-and-simulations-for-designing-learning.ID.000555.php

Share this post