The new way to train clinicians: video games and escape rooms

A video game that gives you points if you clear a blocked artery. An escape room competition inside a hospital.

This is not your usual way of training clinicians, keeping their skills fresh and allowing them to earn continuing medical education credits for free. But it may be the next big thing inside hospitals, as leaders reshape training, look for ways to better engage employees and get them out of lecture halls where they sit glassy-eyed, stealing glances at their phones.

Level Ex, a medical video game studio, has a team of biomedical engineers and physicians that develop free games for physicians. Several million medical professionals play the games, said company founder Sam Glassenberg.

“We also have a stable of several hundred physician advisors and contributors in just about every major specialty that are just bombarding us with the content they want and need,” he said. “There is no shortage of problems to solve.”

Dr. Atman Shah, interventional cardiologist at the University of Chicago Medicine, worked as a physician adviser to Level Ex as it developed Cardio Ex, a simulation game designed for cardiologist to practice treating coronary artery disease. Within the app, players take angiograms of the arteries, find a blockage and use different tools to try to open it.

“If it works, it’s great,” Shah said. “If it doesn’t, the game’s over. You lose points, but it’s a much safer way than actually [performing it] on a patient.”

Level Ex makes money through sponsorships. For instance, a web game sponsored by Moderna trains physicians on how to combat vaccine hesitancy by role-playing conversations with different patients.

“There are certain doctors that are really good at having that conversation with a patient and convincing them to take the shot and then there’s the majority of doctors that just aren’t as good at it,” Glassenberg said.

Physicians can earn continuing medical education credits by playing the games. Each state sets its own annual requirements for maintaining licensure, while hospitals have separate credit requirements to maintain clinical privileges.

It’s certainly a different way to earn credits than the traditional practice of attending lectures at conferences or by reading medical journal articles and answering questions.

Oncology clinicians can earn credits through the OncoBlast app, a game launched last month by Binaytara, a nonprofit organization that aims to improve healthcare in underserved communities and enhance cancer care through education. It features courses for every major cancer type, asks case-based questions and lets players see where they rank globally. 

To get paid, Binaytara seeks independent medical education grants from pharmaceutical companies. Some of the courses include information about the companies’ latest drugs and how to manage side effects. 

It can be expensive to earn continuing medical education credits. It could cost more than $2,000 to get five credits when you add up the cost to register and the cost of a flight and hotel stay, said Dr. Binay Shah, co-founder and president of Binaytara.

“Here you have these gaming apps, so you may be in a clinic, [and if] you don’t have patient for 10 minutes, you can actually play a game and get your continuing education credit whether you are in New York City or in a small town like Syracuse or Buffalo,” he said.

Escape rooms

Both Northeast Georgia Medical Center and Baltimore-based Mercy Medical Center use escape rooms for training — the former teaches physician residents about fall precautions and the latter teaches nurse residents things such as how to calculate the correct medication dosage.

Inside the Northeast Georgia Medical Center escape room, residents must find things that are out of place such as a patient mannequin secured to the bed with tape instead of the proper restraint. It cost the medical center $6,920 to develop the escape room and each event costs $960. 

The medical center also hosts an in-person game called sim wars for its emergency medicine residents. It is set up like the Olympics where each team is a different country and they practice emergency pediatric, obstetric and trauma scenarios.

For the pediatric scenario, a patient mannequin has a blood pressure, a pulse and can breathe and bleed, and actors play the role of parents. Players have to communicate effectively with the distressed parents while caring for the child while faculty grades them.

“For emergency medicine, they need to be able to do their critical skills and at the same time have what we call situational awareness — how do you manage a room and take care of your patient at the same time,” said Jim Rinehart, director of clinical skills and simulation with Northeast Georgia Medical Center.

Working with software company Brinkbit, Mercy Medical Center spent hundreds of thousands of dollars to develop World of Salus. The online game has nurses travel to six different islands to test their knowledge on topics such as pain management, fall prevention and procedures for infection control and pressure injury prevention.

Mercy made the investment because it determined traditional learning approaches failed to capture the residents’ attention, said Stacey Brull, vice president of patient care services and chief nursing officer for Mercy Medical Center. 

“We were watching people in orientation and in some of our lectures, and they sort of just had a glossed-over look or they were on their phones,” she said.

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