From Classroom to Clinic: Gamification Strategies in Podiatry & Healthcare

Key Takeaways

1. Gamification can enhance engagement and retention in healthcare education.
By incorporating elements like challenges, rewards, and interactive problem-solving, gamification may help learners absorb and retain complex clinical information more effectively than traditional didactic methods alone.
2. These strategies extend beyond education into patient care.
Gamified approaches can improve patient communication, trust, adherence, and shared decision-making by making health information more interactive and personalized.
3. Healthcare gamification is evolving rapidly across multiple settings.
From podiatry escape rooms and opioid prescribing workbooks to fitness apps and digital therapeutics, game-based learning concepts are increasingly shaping clinical training and patient engagement alike.

Transcript

Please note: This content is a direct transcript, capturing the authentic conversation without edits. Some language may reflect the flow of live discussion rather than polished text. 

Jennifer Spector, DPM:
Welcome to Podiatry Today Podcasts. I'm your host, Dr. Jennifer Spector, the Associate Editorial Director for Podiatry Today. Medical education is evolving, but the challenge remains the same. How do we make learning stick in high stakes clinical environments? From residency training to continuing education, clinicians are expected to absorb complex information quickly, retain it, and apply it in real time. One emerging approach that we're here to talk about today is gamification or the use of game-based principles like competition, feedback, and rewards to enhance learning and engagement. Joining us today is Dr. Robert Smith, who brings a unique perspective at the intersection of pharmacology, podiatry, and education among others. He's a consultant to the National Board of Podiatric Medical Examiners, and he's authored over 110 refereed journal articles. He's also the founder and president of STOP: Studying Opioid Harm, a nonprofit educational company to build and develop tools that educate and mitigate the harm from opioids.

Lastly, he's a senior fellow and chair of the Podiatric Academy for the National Academy of Practice from 2019 until the present. Welcome and let's get started. So Dr. Smith, what exactly is gamification?

Robert Smith, DPM:
Gamification can be defined as the application of the characteristics and benefits of games to real world processes or problems. I've loved game theory. It's fascinating because it differs from serious games in terms of the design intention and with gamification, interventions involving the application, which is the same as any game element with a utilitarian purpose and a serious games designed as a full-fledged games for a purpose other than just entertainment. There's potential in setting his or her own objectives or outcomes, personalization of the intervention, and of course, cost effectiveness.

Jennifer Spector, DPM:
So how might this translate in value in the clinical world?

Robert Smith, DPM:
Has the potential to provide learners with opportunities to be part of an active learning, solving clinical problems and gaining experience in risk-free surroundings without needing to involve patients. Learners may have an opportunity to develop analytical skills, strategic thinking, knowledge, multitasking, decision-making, communication, psychomotor skills, and a multi-player function allows for opportunities for collaborative learning.

Jennifer Spector, DPM:
It seems like for the right person or people, the motivational properties within gaming might be able to be something that's harnessed for educational purposes. What's the potential reach here? What kind of impact could this have?

Robert Smith, DPM:
Again, looking at the gamification, having the potential to reach global audience, and hence it's been identified as possible educational strategies that could contribute to transform health professional education as we know it.

Jennifer Spector, DPM:
Are there any particular subspecialties where this is already in use?

Robert Smith, DPM:
There are strategies for the emergency room, the operating room, interdisciplinary team approach to treating illnesses, and then also office practice, as well as role playing. Now, I won't bog you down with the two references, and there are many of them out there, but unfortunately they are low powered and they're not as robust as random controlled trials. But one article in 2014 found that compared with an online educational posting, serious gaming may improve knowledge. And then in 2019, Gentry et al., Reviewed many gaming texts as well as articles showing that serious gaming and gamification in pre and post-registration of health professionals education could result in increased knowledge, skills, and satisfaction when compared to traditional education and perhaps other modalities of digital education.

Jennifer Spector, DPM:
So what are some of the core concepts that surround this idea?

Robert Smith, DPM:
It revolves around the strategic application of a game design principle to enhance student engagement or patient engagement and improve learning outcomes. It involves integrating game-like elements such as points and badges, leaderboards, and challenges into traditional teaching methods. And I'm going to hone in on that and repeat that throughout our little podcast here. This approach aims to make learning more interactive, engaging and effective by encouraging active participation, as well as a deeper knowledge retention. Gamification leverages psychological principles of motivation, such as intrinsic and extrinsic reward to create a dynamic and participatory learning experience. It transforms lessons into interactive experiences, making students more likely to participate and fostering a sense of achievement. The flow state achieved through gamification can lead to increased student engagement, patient engagement, and improved learning outcomes, as well as patient outcomes, and are more inclusive educational environment than strictly didactic or lecturing or even small skillset reviews.

Jennifer Spector, DPM:
Are there any inherent roadblocks or challenges associated with this approach?

Robert Smith, DPM:
Overreliance on the extrinsic rewards. What's my reward? The student would say if I achieve this and the need for the teacher to be properly trained. Despite these challenges, gamification holds significant potential to reduce educational disparities and improve learning experiences globally. By emphasizing student-centered design and collaboration among stakeholders, educators can maximize the potential of gamification to foster inclusiveness, equitable outcomes, and inspiring education. And we can substitute the word patient in for student and still have the same outcome.

Jennifer Spector, DPM:
So you mentioned about this use of gamification when it comes to patient education as well. I'd be really curious to learn from you a little bit more about how gamification concepts might enhance the patient experience or perhaps even build trust between patients and clinicians.

Robert Smith, DPM:
Well, if you remember the old cartoons, as the physician starts lecturing the patient, they tune them out. Whereby if we engage the patient, we allow them the trust that we offer them as a foundation to improve engagement and outcomes and interactive educational tools like gamification can help support this relationship.

Jennifer Spector, DPM:
So what's happening here from a practical standpoint?

Robert Smith, DPM:
First, we're going to improve communication. We know that through studies that educational gamification can facilitate effective communication between clinicians and patients addressing the misunderstandings and fostering trust. We allow for patient-centered care. By incorporating gamification elements, healthcare providers can create a more patient-centered environment, which again, is essential in building trust. We use empathy and understanding, allowing patient to feel valued and respected, which is crucial for trust. It allows also for continuous learning. Gamification encourages ongoing learning and engagement from both patients and clinicians. Again, improving communication and thus addressing the misunderstandings by making learning experience more engaging, gamification can lead to behavioral changes that enhances trust and improve overall healthcare outcomes using their own autonomy, their choices, not being dictated to, not being scolded, but having the ability to make their choices. These strategies collectively contribute to a more trusting healthcare environment, leading to better patient satisfaction and health outcomes.

Jennifer Spector, DPM:
In your experience, could you share some examples of implementation of these concepts?

Robert Smith, DPM:
So historically, when I was a practicing pharmacist and clinical adjunct professor at the College of Pharmacy for the University of Florida, before going to podiatry school, I developed a word search of the top 100 dispense medications that was published in Pharmacy Times. In the summer of 1995, the Florida Pharmacy Association's Journal published my top 30 dispensed drugs crossword puzzle with little trivia questions to help spark knowledge and create creative learning. So then I decided to create and develop a podiatric pediatric activity book. It offers a variety of activities, mazes, connect the dots, spot the differences in colors, crossword puzzles and word searches, building jigsaws, little x-rays on blank, sturdy jigsaw puzzles, or some of these puzzles had photographs or drew directional paths of shoes walking or suggested foot hygiene, spelling out when the jigsaw puzzle was completed. Now, when 2017 came as a teaching tool, I developed for podiatry medical students and podiatry residents, the fundamentals of opioid prescribing and disposal workbook, following up with either crossword puzzles, word searches, names, mathematic, sudoku type, especially for morphine milligram equivalents.

Jennifer Spector, DPM:
Well, it really seems like there's multiple potential benefits to gamifying this learning for both patients of all ages and for more professional learners. What are you working on now? Anything new?

Robert Smith, DPM:
What I'm working on right now is a podiatry themed mobile escape room. Did a lot of study on this. I love escape rooms. I've gone through many of them in my area here, studied them. And what I have developed is an escape room specific for podiatric medicine. Studies have shown that gamification, especially escape rooms, enhance learning attitudes and behaviors. I divide the group into teams, inform them what is needed for them to escape from the podiatry lounge, let's say, by successfully completing 10 stations. Genetic debriefing is undertook by the facilitators. The core skills explored here is history and physical of the podiatry patient, differential diagnosis, lower extremity anatomy, physiology, radiology, medical intervention, surgical, intervention, pharmacology and therapeutics and social services. Very excited about this. I will be beta testing it.

Jennifer Spector, DPM:
Well, I'm sure the results of that beta test will be very interesting. I'm curious to know, are there other areas maybe outside of podiatry that are using these gamification concepts, perhaps in ways that we might not have even realized?

Robert Smith, DPM:
There are four examples that I am well aware of and actually have worked with. Digital Therapeutics has gamification applications, guide for patients through personalized treatment pathways, making exercise, pain management, or rehabilitation more engaging while tracking improvements for the clinicians. If we're looking at fitness and lifestyle applications, the platforms like Fitbit or MyFitnessPal uses gamification to encourage physical activity, healthy eating and sleep tracking through milestones and rewards. Mental health applications such as HappyFi, employ interactive games to help manage stress, anxiety, and depression, promoting adherence to therapeutic exercises. And then our public health campaigns, gamification learning platforms can encourage vaccines, hand hygiene, and other preventative behaviors by making participation interactive and rewarding. Are

Jennifer Spector, DPM:
There any other potential benefits outside of the incentive reward structure?

Robert Smith, DPM:
We're addressing psychological needs. Gamification aligns with psychosocial needs such as competency and autonomy, making health behavior feel less like a chore and more like an exciting quest. Strengthening the healthcare system, successful gamification initiatives can enhance provider performance metrics and improve overall health outcomes, making healthcare more efficient and effective. These strategies collectively contribute to a more engaging and effective healthcare experience, ultimately leading to better outcomes.

Jennifer Spector, DPM:
Well, I know there's a lot more detail we could be digging into today, but what do you most hope that our listeners will take away from this episode today?

Robert Smith, DPM:
So in conclusion, and I want to thank you, Dr. Spector, for letting me talk about gamification. I'm excited about this. Using gamification in healthcare evolves from its infancy to now present. It requires a conservative collaboration among healthcare professionals, designers, and technologists, and researchers. This collective effort ensures that gamification not only engages and motivates patients, but also adheres to the highest standard of medical care and ethical practice. By embracing these principles, gamification can become a fundamental component of future healthcare delivery, offering innovative solutions that could revolutionize healthcare models and approaches across various population.

Jennifer Spector, DPM:
Well, thank you so much, Dr. Smith, for sharing this with us today. It certainly is a new lens through which to view how we educate patients, how we educate our peers and even ourselves. If you found this valuable, make sure that you tune into other episodes of Podiatry Today Podcasts. On your favorite podcast platforms, share us with your colleagues, leave us a review. It really will help people find our program more easily and help you connect to the foot and ankle medicine and surgery that you're looking for here. We hope you'll continue to tune in to Podiatry Today Podcasts, and thanks for joining us today.


Dr. Smith is a podiatrist, pharmacist, and pedorthist He is a contributing editor and reviewer to JAPMA in the area of Podiatric Clinical Pharmacology. He has authored over 110 refereed journal articles for the disciplines of Pharmacy, Podiatry, and Wound Care. He is the Founder and President of STOP-Studying Opioid Harm, Inc. Dr. Smith is a senior fellow and the chair of the Podiatric Academy for the National Academy of Practice from 2019 to present.