Primary care providers who engaged in an online game to solve clinical cases about hypertension management ended up improving the blood pressure of their patients faster than non-gamers, according to a new study by researchers at Brigham and Women’s Hospital (BWH) and the Veterans Affairs Boston Healthcare System.
The study, published in Circulation: Cardiovascular Quality and Outcomes, was a two-arm, randomized trial conducted over a year among primary care clinicians at eight Veterans Affairs hospitals.
According to the study:
Clinicians were randomized to either a group that received educational content about lowering blood pressure in the form of an online game vs. a group who received identical content via a static online posting. One hundred eleven clinicians enrolled in the study. Of those enrolled, 48 completed the trivia game while 47 completed the readings of the online posting.
“This study is the first to show that an online educational game among medical professionals can improve the health measures of their patients,” said Alexander Turchin, director of Informatics Research of the BWH Division of Endocrinology and the study’s co-lead author.
This works because of something called “spaced education,” which is a learning concept where students “may significantly increase knowledge retention if information is presented and reinforced over spaced intervals of time.” The online spaced-education game used in this study was developed by B. Price Kerfoot, a staff surgeon at the Veterans Affairs Boston Healthcare System and the study’s lead author.
According to the researchers, anyone can enroll in the spaced-education game for free at Qstream, a startup company launched by Harvard to develop and disseminate the spaced-education methodology outside of its firewalls.
This is how the game works:
The educational content consisted of 32 validated clinical cases followed by multiple-choice questions with explanations on hypertension management. Those in the online game group were e-mailed one question every three days. Questions were re-sent in 12 or 24 days if answered incorrectly or correctly, respectively. A question was retired when clinicians answered it correctly twice consecutively. The game would post clinician scores to foster competition.
Primary outcome measured was time to reach blood pressure target (less than 140/90 mm Hg). In multivariable analysis of 17,866 hypertensive periods among 14,336 patients, the researchers observed a modest decrease in the time to achieve target blood pressure values in patients treated by clinicians in the online game group.
The number of clinicians who had to participate in the game to achieve target blood pressure in one more patient was 0.43 (i.e., for every four clinicians who participated in the game, approximately 10 more patients achieved target blood pressure).
The researchers found that patients of clinicians who were playing the game lowered their blood pressure to their target level in 142 days compared to 148 days for those whose clinicians read an online posting.
“Based on our findings, educational games may be effective tools to engage health professionals, boost learning, optimize practice patterns, and improve patient outcomes,” Turchin says. “We hope that future studies continue to focus on figuring out how to most effectively integrate games into the education of health professionals for the benefit of their patients.”
Source URL: https://www.bostonmagazine.com/health/2014/05/27/docs-played-video-games-helped-patients-better-study-says/
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