Joep Lagro1, Marjolein H J van de Pol2, Annalies Laan3, Fanny J Huijbregts-Verheyden4, Lia C R Fluit4, Marcel G M Olde Rikkert3. 1. Department of Geriatric Medicine, Radboud University Medical Center, Nijmegen, The Netherlands. Electronic address: joep1_@hotmail.com. 2. Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands. 3. Department of Geriatric Medicine, Radboud University Medical Center, Nijmegen, The Netherlands. 4. Institute for (bio) Medical Education, Radboud University Medical Center, Nijmegen, The Netherlands.
Abstract
OBJECTIVE: Medical students often lack training in complex geriatric medical decision making. We therefore developed the serious game, GeriatriX, for training medical decision making with weighing patient preferences, and appropriateness and costs of medical care. We hypothesized that education with GeriatriX would improve the ability to deal with geriatric decision making and also increase cost consciousness. DESIGN: A randomized, controlled pre-post measurement design. PARTICIPANTS: Fifth-year medical students. INTERVENTION: Playing the serious game GeriatriX as an additive to usual geriatric education. MEASUREMENTS: We evaluated the effects of playing GeriatriX on self-perceived knowledge of geriatric themes and the self-perceived competence of weighing patient preferences, appropriateness, and costs of medical care in geriatric decision making. Cost consciousness was evaluated with a postmeasurement to estimate costs of different diagnostic tests. RESULTS: There was a large positive increase in the self-perceived competence of weighing patient preferences, appropriateness, and costs of medical care in the intervention group (n = 71) (effect sizes of 0.7, 1.0, and 1.2, respectively), which was significantly better for the last 2 aspects than in the control group (n = 63). The intervention group performed better on cost consciousness. Although the self-perceived knowledge increased substantially on some geriatric topics, this improvement was not different between the intervention and control groups. CONCLUSIONS: After playing the serious game, GeriatriX, medical students have a higher self-perceived competence in weighing patient preferences, appropriateness, and costs of medical care in complex geriatric medical decision making. Playing GeriatriX also resulted in better cost consciousness. We therefore encourage wider use of GeriatriX to teach geriatrics in medical curricula and its further research on educational and health care outcomes.
RCT Entities:
OBJECTIVE: Medical students often lack training in complex geriatric medical decision making. We therefore developed the serious game, GeriatriX, for training medical decision making with weighing patient preferences, and appropriateness and costs of medical care. We hypothesized that education with GeriatriX would improve the ability to deal with geriatric decision making and also increase cost consciousness. DESIGN: A randomized, controlled pre-post measurement design. PARTICIPANTS: Fifth-year medical students. INTERVENTION: Playing the serious game GeriatriX as an additive to usual geriatric education. MEASUREMENTS: We evaluated the effects of playing GeriatriX on self-perceived knowledge of geriatric themes and the self-perceived competence of weighing patient preferences, appropriateness, and costs of medical care in geriatric decision making. Cost consciousness was evaluated with a postmeasurement to estimate costs of different diagnostic tests. RESULTS: There was a large positive increase in the self-perceived competence of weighing patient preferences, appropriateness, and costs of medical care in the intervention group (n = 71) (effect sizes of 0.7, 1.0, and 1.2, respectively), which was significantly better for the last 2 aspects than in the control group (n = 63). The intervention group performed better on cost consciousness. Although the self-perceived knowledge increased substantially on some geriatric topics, this improvement was not different between the intervention and control groups. CONCLUSIONS: After playing the serious game, GeriatriX, medical students have a higher self-perceived competence in weighing patient preferences, appropriateness, and costs of medical care in complex geriatric medical decision making. Playing GeriatriX also resulted in better cost consciousness. We therefore encourage wider use of GeriatriX to teach geriatrics in medical curricula and its further research on educational and health care outcomes.
Authors: Sarah Victoria Gentry; Andrea Gauthier; Beatrice L'Estrade Ehrstrom; David Wortley; Anneliese Lilienthal; Lorainne Tudor Car; Shoko Dauwels-Okutsu; Charoula K Nikolaou; Nabil Zary; James Campbell; Josip Car Journal: J Med Internet Res Date: 2019-03-28 Impact factor: 5.428