http://informahealthcare.com/jic ISSN: 1356-1820 (print), 1469-9567 (electronic) J Interprof Care, 2015; 29(3): 260–262 ! 2015 Informa UK Ltd. DOI: 10.3109/13561820.2014.942839
SHORT REPORT
Playing interprofessional games: reflections on using the Interprofessional Education Game (iPEG) Sundari Joseph1,2 and Lesley Diack3 1
Faculty of Health and Social Care, Robert Gordon University, Aberdeen, UK, 2Division of Medical and Dental Education, School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK, and 3School of Pharmacy and Life Sciences, Robert Gordon University, Aberdeen, UK
Abstract
Keywords
This report explores the relevance of gaming in IPE curriculum design with the use of the Interprofessional Education Game (iPEG) as an activity aimed to achieve positive interprofessional learning outcomes for students. It was designed to enable the understanding of professional roles and responsibilities in patient/client care settings. We provide a description of its implementation and evaluation with first year student cohorts (900+ per cohort) over a 3-year period within an established interprofessional education (IPE) programme. The game encapsulates fun and memorable learning styles to explore professional stereotypes and team approaches to care delivery. It can be a valuable teaching tool for those designing IPE curriculum. Evaluation data from students and staff were mainly positive. We discuss the use of the game and its potential to be adapted in flexible and creative ways to assist educators in consider incorporating gaming within their own IPE programmes.
Evaluation research, health and social care, interprofessional education, professional stereotypes, role clarity
Introduction Since 2003 there has been an interprofessional education (IPE) programme between the two universities in Aberdeen. This has involved large student cohorts (n ¼ 900+) from 17 courses and 10 professions. Evaluation data from the first 5 years of this programme (Diack, Gibson, Healey, Bond, & Mckenzie, 2008) identified the need to develop new ways of understanding professional roles. The Interprofessional Education Board Game (iPEG) was developed in response to this feedback. Academics from the two universities collaborated to develop new ways of understanding professional roles by students at an early stage of their undergraduate career. Loosely based around the premise of MonopolyÔ (HASBRO, Pawtucket, RI) (Figure 1), the iPEG uses ‘‘discussion’’ and ‘‘task’’ cards to engage students and explore professional roles. It comprises real-case scenarios with vignettes on each discussion card that build in complexity as the game progresses. The iPEG can be played in many different ways and is flexible to adapt to the contextual needs of players.
Playing the game The game is best played in mixed groups with different professions represented. It can be played with students from different educational backgrounds ranging from first year to final year undergraduates. The iPEG can be adapted to classroom or
Correspondence: Dr. Sundari Joseph, PhD, Faculty of Health and Social Care, Robert Gordon University, Garthdee Road, Aberdeen AB10 7QG, UK; Division of Medical and Dental Education, School of Medicine and Dentistry, University of Aberdeen, Medical School Building, Foresterhill, Aberdeen AB25 2ZD, UK. E-mail: [email protected]
History Received 27 January 2014 Revised 25 June 2014 Accepted 6 July 2014 Published online 7 August 2014
placement settings. We have now implemented the iPEG in undergraduate courses, in different countries and languages, in non-healthcare settings and as an ice breaker at conference workshop presentations with educators. The iPEG can be defined as a ‘‘serious’’ game because it serves the educational purpose of achieving learning outcomes related to the understanding of professional roles (Abt, 1970). The iPEG aims to simulate the interprofessional teamwork that occurs in ‘‘real’’ settings and is governed by rules that can be adapted. The dice is thrown and the counter moved to the relevant square. If the player landed on a ‘‘task card’’ square, the students picked up a task card and followed its instructions. Task cards provided the ‘‘fun’’ element to the game and encouraged students to mimic the role of different professional’s thereby stimulating discussion on stereotypical perceptions. Landing on a ‘‘discussion card’’ square the students were encouraged to discuss case scenarios in mixed groups. Playing in pairs ensures students contribute their answers to the case scenario and to the group. Different members of the group could embellish this answer adding their knowledge and experience of the scenario, thereby enhancing the learning of the entire interprofessional group. The iPEG’s goal was to complete the game and in the process engage with the instructions on the cards. When discussing the scenario or task with the rest of the players, immediate feedback on the answers given was provided by the group. Intrinsic motivation was demonstrated by the need to learn with, from and about other professionals concurring with the overall aim of the IPE session. There were no extrinsic motivators, for example a prize for the winner. Indeed, there were no winners as the iPEG relied on the team effort to complete the game. It was possible to instil some competitiveness between several teams in one room; however, when this was attempted it detracted from the discussion
DOI: 10.3109/13561820.2014.942839
Playing games with interprofessional learning
261
Figure 1. iPEG the board game.
time as the focus became to complete the game with speed and win rather than learn about professional roles. The iPEG has altruistic rewards and focuses on achieving together, simulating the spirit of collaborative practice.
Translating playing into learning There are two main features of translating playing into learning: the student’s attitude towards engagement and the role of the facilitator. Students can perceive games simply as a playful exercise with no significant learning (Stephens, Abbott-Brailey, & Pearson, 2007). Learning was iterative as the outcomes of student discussions were continually aggregated from simple to complex healthcare scenarios, thus increasing in-depth learning on interprofessional competencies. Therefore as the game progressed, their understanding of professional roles grew. The achievement of different levels of learning is called ‘‘scaffolding’’ in game design (McClarty et al., 2012) and is vital for intrinsic motivation and continued engagement. The students are very much in control of iPEG with facilitator input emphasizing the creation of links between playing and learning. There is, however, no direct link between playing iPEG and the assessment of IPE and this can be considered a limitation of the game, as students in general value assessment-driven activities. Effective facilitation is also acknowledged to be a crucial part of successful IPE (Freeth, Hammick, Reeves, Koppel, & Barr, 2005). The key elements to the facilitation a ‘‘serious’’ game are briefing and debriefing. This separates the game from becoming a playful task and emphasizes the learning outcomes as essential. Facilitators therefore create a connection for students from learning in the game and their application of the skills learnt in other situations (McClarty et al., 2012). When playing the iPEG, the facilitators ‘‘framed’’ the game experience as education enabling students to focus on the interprofessional outcomes. Games with a clinical focus, however, can be ‘‘vectors’’ or teaching tools for learning to work together, enhancing IPE curriculum from the more traditional activities, for example case study or problem-based approaches (Oandasan & Reeves, 2005). When educators create innovative styles of learning, they provide learners with tools that will build their potential to manage the complexity encountered with IPE. The design features within the iPEG concur with the literature on serious game development
(McClarty et al., 2012). These include: clear goals, constructive and immediate feedback, and intrinsic motivation.
Evaluation overview Group student evaluation was completed at the end of the iPEG sessions using a survey tool designed by the authors with numeric and text-based elements. Data collected over three consecutive years indicated 90% agreement for outcome achievement (n ¼ 1400). Staff evaluation questionnaires were completed and reflective feedback on student perceptions was included in facilitator training sessions. Ninety percent of staff (n ¼ 55) evaluated the game positively. Analysis of the students’ text-based comments identified a minority who expressed a lack of understanding regarding the purpose of the game. Facilitators’ text-based comments were mixed with the majority agreeing that iPEG achieved the learning outcomes. There was consistency between the students’ comments and the facilitator perceptions on the student engagement. In order to improve the experience for all students and to instil relevance and inclusivity, the game design has been improved by providing greater variation to the scenario contexts and including more health and social care interactions. The rules of the game were also altered to allow further discussion and reflection time rather than focussing on speed of completion.
Discussion The students’ perceptions of gaming using iPEG indicated that the majority felt that their learning of other professional roles had improved. A small proportion (53%) indicated that playing games in higher education settings was not appropriate for academic learning. The facilitation experience for the students who responded in this way requires further exploration but was not feasible within the adopted evaluation process. Skilled facilitation directs the students towards the achievable learning outcomes, transforming playing into learning. The role of the facilitator is vital to developing a positive attitude towards interprofessionalism. The strengths of this study are that it was conducted over three consecutive years with responses from 10 different disciplines and two universities. Students and staff evaluations were consistent.
262
S. Joseph & L. Diack
A limitation of the study was that there was minimal attempt to triangulate the results. In summary, this article has introduced the relevance of gaming in IPE curriculum design. It discussed the value of good game design in achieving IPE learning outcomes. As reported above, students felt the iPEG achieved a deeper understanding of other professional roles but were not unanimous in appreciating the learning approach. IPE literature recommends the use of creative and innovative learning approaches to encourage student engagement with complex and diverse information. Further research is required to ascertain perceptions for engagement with gaming and IPE. It is aimed that a transcultural study which employed the iPEG will report findings in the near future.
Declaration of interest The authors report no conflicts of interest. The authors are responsible for the writing and content of this paper.
J Interprof Care, 2015; 29(3): 260–262
References Abt, C. (1970). Serious games. New York: The Viking Press. Diack, H.L., Gibson, M., Healey, T., Bond, C., & Mckenzie, H. (2008). The Aberdeen interprofessional health and social care education initiative: Final report. Retrieved from http://www.ipe.org.uk. Freeth, D., Hammick, M., Reeves, S., Koppel, I., & Barr, H. (2005). Effective interprofessional education: Development, delivery, evaluation. Oxford: Blackwell. McClarty, K.L., Orr, A., Frey, P.M., Dolan, R.P., Vassileva, V., & McVay, A. (2012, June). A literature review of gaming in education. Research report. Gaming in education. Retrieved from http://www.pearsonassessments.com/hai/Images/tmrs/Lit_Review_of_Gaming_in_ Education.pdf. Oandasan, I. & Reeves, S. (2005). Key elements of interprofessional education. Part 1: The learner, the educator and the learning context. Journal of Interprofessional Care, 19, 21–38. Stephens, J., Abbott-Brailey, H., & Pearson, P. (2007). ‘‘It’s a funny old game’’. Football as an educational metaphor within induction to practice-based interprofessional learning. Journal of Interprofessional Care, 21, 375–385.
Copyright of Journal of Interprofessional Care is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
SHORT REPORT
Playing interprofessional games: reflections on using the Interprofessional Education Game (iPEG) Sundari Joseph1,2 and Lesley Diack3 1
Faculty of Health and Social Care, Robert Gordon University, Aberdeen, UK, 2Division of Medical and Dental Education, School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK, and 3School of Pharmacy and Life Sciences, Robert Gordon University, Aberdeen, UK
Abstract
Keywords
This report explores the relevance of gaming in IPE curriculum design with the use of the Interprofessional Education Game (iPEG) as an activity aimed to achieve positive interprofessional learning outcomes for students. It was designed to enable the understanding of professional roles and responsibilities in patient/client care settings. We provide a description of its implementation and evaluation with first year student cohorts (900+ per cohort) over a 3-year period within an established interprofessional education (IPE) programme. The game encapsulates fun and memorable learning styles to explore professional stereotypes and team approaches to care delivery. It can be a valuable teaching tool for those designing IPE curriculum. Evaluation data from students and staff were mainly positive. We discuss the use of the game and its potential to be adapted in flexible and creative ways to assist educators in consider incorporating gaming within their own IPE programmes.
Evaluation research, health and social care, interprofessional education, professional stereotypes, role clarity
Introduction Since 2003 there has been an interprofessional education (IPE) programme between the two universities in Aberdeen. This has involved large student cohorts (n ¼ 900+) from 17 courses and 10 professions. Evaluation data from the first 5 years of this programme (Diack, Gibson, Healey, Bond, & Mckenzie, 2008) identified the need to develop new ways of understanding professional roles. The Interprofessional Education Board Game (iPEG) was developed in response to this feedback. Academics from the two universities collaborated to develop new ways of understanding professional roles by students at an early stage of their undergraduate career. Loosely based around the premise of MonopolyÔ (HASBRO, Pawtucket, RI) (Figure 1), the iPEG uses ‘‘discussion’’ and ‘‘task’’ cards to engage students and explore professional roles. It comprises real-case scenarios with vignettes on each discussion card that build in complexity as the game progresses. The iPEG can be played in many different ways and is flexible to adapt to the contextual needs of players.
Playing the game The game is best played in mixed groups with different professions represented. It can be played with students from different educational backgrounds ranging from first year to final year undergraduates. The iPEG can be adapted to classroom or
Correspondence: Dr. Sundari Joseph, PhD, Faculty of Health and Social Care, Robert Gordon University, Garthdee Road, Aberdeen AB10 7QG, UK; Division of Medical and Dental Education, School of Medicine and Dentistry, University of Aberdeen, Medical School Building, Foresterhill, Aberdeen AB25 2ZD, UK. E-mail: [email protected]
History Received 27 January 2014 Revised 25 June 2014 Accepted 6 July 2014 Published online 7 August 2014
placement settings. We have now implemented the iPEG in undergraduate courses, in different countries and languages, in non-healthcare settings and as an ice breaker at conference workshop presentations with educators. The iPEG can be defined as a ‘‘serious’’ game because it serves the educational purpose of achieving learning outcomes related to the understanding of professional roles (Abt, 1970). The iPEG aims to simulate the interprofessional teamwork that occurs in ‘‘real’’ settings and is governed by rules that can be adapted. The dice is thrown and the counter moved to the relevant square. If the player landed on a ‘‘task card’’ square, the students picked up a task card and followed its instructions. Task cards provided the ‘‘fun’’ element to the game and encouraged students to mimic the role of different professional’s thereby stimulating discussion on stereotypical perceptions. Landing on a ‘‘discussion card’’ square the students were encouraged to discuss case scenarios in mixed groups. Playing in pairs ensures students contribute their answers to the case scenario and to the group. Different members of the group could embellish this answer adding their knowledge and experience of the scenario, thereby enhancing the learning of the entire interprofessional group. The iPEG’s goal was to complete the game and in the process engage with the instructions on the cards. When discussing the scenario or task with the rest of the players, immediate feedback on the answers given was provided by the group. Intrinsic motivation was demonstrated by the need to learn with, from and about other professionals concurring with the overall aim of the IPE session. There were no extrinsic motivators, for example a prize for the winner. Indeed, there were no winners as the iPEG relied on the team effort to complete the game. It was possible to instil some competitiveness between several teams in one room; however, when this was attempted it detracted from the discussion
DOI: 10.3109/13561820.2014.942839
Playing games with interprofessional learning
261
Figure 1. iPEG the board game.
time as the focus became to complete the game with speed and win rather than learn about professional roles. The iPEG has altruistic rewards and focuses on achieving together, simulating the spirit of collaborative practice.
Translating playing into learning There are two main features of translating playing into learning: the student’s attitude towards engagement and the role of the facilitator. Students can perceive games simply as a playful exercise with no significant learning (Stephens, Abbott-Brailey, & Pearson, 2007). Learning was iterative as the outcomes of student discussions were continually aggregated from simple to complex healthcare scenarios, thus increasing in-depth learning on interprofessional competencies. Therefore as the game progressed, their understanding of professional roles grew. The achievement of different levels of learning is called ‘‘scaffolding’’ in game design (McClarty et al., 2012) and is vital for intrinsic motivation and continued engagement. The students are very much in control of iPEG with facilitator input emphasizing the creation of links between playing and learning. There is, however, no direct link between playing iPEG and the assessment of IPE and this can be considered a limitation of the game, as students in general value assessment-driven activities. Effective facilitation is also acknowledged to be a crucial part of successful IPE (Freeth, Hammick, Reeves, Koppel, & Barr, 2005). The key elements to the facilitation a ‘‘serious’’ game are briefing and debriefing. This separates the game from becoming a playful task and emphasizes the learning outcomes as essential. Facilitators therefore create a connection for students from learning in the game and their application of the skills learnt in other situations (McClarty et al., 2012). When playing the iPEG, the facilitators ‘‘framed’’ the game experience as education enabling students to focus on the interprofessional outcomes. Games with a clinical focus, however, can be ‘‘vectors’’ or teaching tools for learning to work together, enhancing IPE curriculum from the more traditional activities, for example case study or problem-based approaches (Oandasan & Reeves, 2005). When educators create innovative styles of learning, they provide learners with tools that will build their potential to manage the complexity encountered with IPE. The design features within the iPEG concur with the literature on serious game development
(McClarty et al., 2012). These include: clear goals, constructive and immediate feedback, and intrinsic motivation.
Evaluation overview Group student evaluation was completed at the end of the iPEG sessions using a survey tool designed by the authors with numeric and text-based elements. Data collected over three consecutive years indicated 90% agreement for outcome achievement (n ¼ 1400). Staff evaluation questionnaires were completed and reflective feedback on student perceptions was included in facilitator training sessions. Ninety percent of staff (n ¼ 55) evaluated the game positively. Analysis of the students’ text-based comments identified a minority who expressed a lack of understanding regarding the purpose of the game. Facilitators’ text-based comments were mixed with the majority agreeing that iPEG achieved the learning outcomes. There was consistency between the students’ comments and the facilitator perceptions on the student engagement. In order to improve the experience for all students and to instil relevance and inclusivity, the game design has been improved by providing greater variation to the scenario contexts and including more health and social care interactions. The rules of the game were also altered to allow further discussion and reflection time rather than focussing on speed of completion.
Discussion The students’ perceptions of gaming using iPEG indicated that the majority felt that their learning of other professional roles had improved. A small proportion (53%) indicated that playing games in higher education settings was not appropriate for academic learning. The facilitation experience for the students who responded in this way requires further exploration but was not feasible within the adopted evaluation process. Skilled facilitation directs the students towards the achievable learning outcomes, transforming playing into learning. The role of the facilitator is vital to developing a positive attitude towards interprofessionalism. The strengths of this study are that it was conducted over three consecutive years with responses from 10 different disciplines and two universities. Students and staff evaluations were consistent.
262
S. Joseph & L. Diack
A limitation of the study was that there was minimal attempt to triangulate the results. In summary, this article has introduced the relevance of gaming in IPE curriculum design. It discussed the value of good game design in achieving IPE learning outcomes. As reported above, students felt the iPEG achieved a deeper understanding of other professional roles but were not unanimous in appreciating the learning approach. IPE literature recommends the use of creative and innovative learning approaches to encourage student engagement with complex and diverse information. Further research is required to ascertain perceptions for engagement with gaming and IPE. It is aimed that a transcultural study which employed the iPEG will report findings in the near future.
Declaration of interest The authors report no conflicts of interest. The authors are responsible for the writing and content of this paper.
J Interprof Care, 2015; 29(3): 260–262
References Abt, C. (1970). Serious games. New York: The Viking Press. Diack, H.L., Gibson, M., Healey, T., Bond, C., & Mckenzie, H. (2008). The Aberdeen interprofessional health and social care education initiative: Final report. Retrieved from http://www.ipe.org.uk. Freeth, D., Hammick, M., Reeves, S., Koppel, I., & Barr, H. (2005). Effective interprofessional education: Development, delivery, evaluation. Oxford: Blackwell. McClarty, K.L., Orr, A., Frey, P.M., Dolan, R.P., Vassileva, V., & McVay, A. (2012, June). A literature review of gaming in education. Research report. Gaming in education. Retrieved from http://www.pearsonassessments.com/hai/Images/tmrs/Lit_Review_of_Gaming_in_ Education.pdf. Oandasan, I. & Reeves, S. (2005). Key elements of interprofessional education. Part 1: The learner, the educator and the learning context. Journal of Interprofessional Care, 19, 21–38. Stephens, J., Abbott-Brailey, H., & Pearson, P. (2007). ‘‘It’s a funny old game’’. Football as an educational metaphor within induction to practice-based interprofessional learning. Journal of Interprofessional Care, 21, 375–385.
Copyright of Journal of Interprofessional Care is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
