Imaging Informatics: Shall We Play a Game?
By Chuck Green
Radiology Today
Vol. 20 No. 12 P. 6

Thanks to a spate of technological advances, gaming is increasingly becoming a popular way for aspiring radiologists to supplement their preparation for the field. A review article in the August 2019 issue of Academic Radiology, “Making Learning Fun: Gaming in Radiology Education,” offers a comprehensive look at gaming in radiology education.

According to the paper, gamification has been tapped by other fields of medicine, such as surgery, to enhance learning. A recent study performed at AdventHealth Celebration Hospital in Celebration, Florida, demonstrated that physicians who played video games before simulated surgery committed 37% fewer errors and performed the procedures 27% faster.

But, to be clear, unlike games played purely for entertainment, games specifically applied to medical education are necessarily interactive and prompt users to make complex decisions, states the article’s lead author, Omer Awan, MD, an associate professor of radiology at the University of Maryland School of Medicine in Baltimore.

“Gaming incorporates a scoring mechanism, leading to competition among players, which further fosters engagement and interaction,” Awan says. Simulation-based games help prepare radiologists for tasks such as taking call, continues Awan, who explains that the paper was aimed at, among other things, evaluating gaming and its current status and theories.

Methodology and Findings
Coauthors of the paper included radiology residents and fellows, as well as faculty members throughout the country, Awan says. He was chairman of the group. They held monthly conference calls during which objectives of the initiative were discussed, followed by the development of an outline of potential topics.

Once the group identified topics to focus on, members divided the paper into different sections, with each assuming ownership of various sections, which they then drafted. “Everyone did their own research and put their thoughts together,” Awan says. He oversaw the process and made major edits to the paper, which he approved and sent to the journal.

Members focused on games that they found to be most prominent in radiology, based on factors such as their own experiences, Awan explains. He adds that the games strive to provide players/trainees with pertinent knowledge or skills that are key to their success. In the case of diagnostic radiology, for example, they gain skills that help them interpret radiology exams. Awan emphasizes that the effectiveness of games hinges mostly on their application.

The paper states that, due to gaming’s high degree of pervasiveness in the millennial culture, it is an innovative tool that allows students to learn radiology and interact with radiologists. “The way people grow up, it’s sort of a natural way to express themselves,” Awan says. That said, although some believe that the average age of gamers—based on software purchases—is 37, most frequent game purchasers are an average of 41 years old, the paper states. In addition, approximately 53% of people between the ages of 30 and 49 years and more than 30% of people older than 50 play video games.

Another myth is that time prohibits professionals from indulging in games. According to estimates, however, 61% of professionals play games during working hours. Also, gaming is not primarily a male pastime; around 47% of gamers are female.

Potential Obstacles
It is important, though, to realize that educational gaming faces potential obstacles that stand in the way of outright implementation, the paper notes. Another study described four barriers—lack of resources, students’ apathy, subject fit, and classroom dynamics—in adopting gamification within education. These factors reflect a significant barrier in segueing from the generally accepted method of lecture-based learning, Awan says.

Factors such as time, cost, and the dynamic between the student and the didactic teacher also affect the outcomes of video game–based training, Awan’s paper notes. Students’ interest and ability to relate to the gaming experience is paramount for successful evolution to hands-on gaming applications in education.

Another looming shortcoming of game-based learning is its cyclical content, which tends to address lower-level learning goals rather than higher levels, the paper shows. As a result, gaming may fail to capture the interest of students with more seniority, Awan points out.

Developing a system for correlating scores to evaluations for students has also proven difficult, according to the paper. Performance in gaming has failed to consistently correlate with better grades. One challenge it highlights revolves around providing an experience unique enough to minimize variable past gaming experience.

Future Possibilities
Possible stumbling blocks aside, Awan says, “I continue to see pervasiveness of gaming and more and more institutions and people going to gaming as an enthusiastic way to approach radiology.” Additionally, Awan predicts that gaming will be leveraged in AI. “People will be able to apply games tailored to overcome those weaknesses, to augment and enhance their own education experience,” he says.

Notably, due to a lack of available commercial gaming options, it is vital to share results developed at the institutional level through community interfaces such as blogs, journal articles, or conferences, the paper states.

Awan adds that he is “excited to see what games come out in future and how they can augment peoples’ way of thinking, learning, and interpretation of radiology.” As a greater number of residency programs search for ways to revamp their educational curriculum, he continues, gaming will provide a unique learning paradigm that offers enormous potential to learners in terms of shaping educational attitudes, behavior, and knowledge.

— Chuck Green is a freelance writer based in Chicago.