Abstract
Purpose
Engaging surgical residents and faculty with workplace-based assessment (WBA) are challenging. Gamification has helped engage trainees with simulation and online curricula but has not been used to encourage engagement with assessment. We explore the impact of gamification on engagement with WBA using the Society for Improving Medical Professional Learning (SIMPL) app.
Methods
General surgery residency programs were divided into two intervention cohorts and a control cohort. The first intervention group received a weekly leaderboard of the most active residents and faculty engaged with SIMPL, while the second intervention group received leaderboards every other week. The control group did not undergo an intervention. For each cohort, resident and faculty engagement with SIMPL was measured, defined as the average number of evaluations submitted per day. Negative binomial mixed models were used to explore the mean number of evaluations completed by residents and faculty in each cohort while adjusting for program-specific factors.
Results
Nine programs were included in the weekly intervention, nine programs in the biweekly intervention, and nineteen programs in the control group. Programs receiving a weekly leaderboard increased their average daily evaluations from 5.8 to 8.0 over the course of the intervention (p < 0.01). Average daily evaluations failed to increase for the biweekly intervention (8.2 to 7.3/day, p = 0.14) and control groups (2.7 to 2.5/day, p = 0.48).
Conclusions
Sending a weekly leaderboard of resident and faculty activity in SIMPL had a positive impact on engagement with WBA compared to biweekly or no leaderboard interventions. Strategically applying gamification may improve engagement with WBA tools.
Similar content being viewed by others
References
George BC, Bohnen JD, Williams RG, Meyerson SL, Schuller MC, Clark MJ, et al. Readiness of US general surgery residents for independent practice. Ann Surg. 2017;266:582–94.
Mattar SG, Alseidi AA, Jones DB, Jeyarajah DR, Swanstrom LL, Aye RW, et al. General surgery residency inadequately prepares trainees for fellowship: results of a survey of fellowship program directors. Ann Surg. 2013;258:440–9.
Napolitano LM, Savarise M, Paramo JC, Soot LC, Todd SR, Gregory J, et al. Are general surgery residents ready to practice? A survey of the American college of surgeons board of governors and young fellows association. J Am Coll Surg. 2014;218:1063-1072.e31.
Anderson TN, Payne DH, Dent DL, Kearse LE, Schmiederer IS, Korndorffer JR. Defining the deficit in us surgical training: the trainee’s perspective. J Am Coll Surg. 2020. https://doi.org/10.1016/j.jamcollsurg.2020.11.029.
Holmboe ES, Sherbino J, Long DM, Swing SR, Frank JR, for the International CBME Collaborators. The role of assessment in competency-based medical education. Med Teach. 2010;32:676–82.
Rutledge C, Walsh CM, Swinger N, Auerbach M, Castro D, Dewan M, et al. Gamification in action: theoretical and practical considerations for medical educators. Acad Med. 2018;93:1014–20.
McCoy L, Lewis JH, Dalton D. Gamification and multimedia for medical education: a landscape review. J Am Osteopath Assoc. 2016;116:22–34.
Kerfoot BP, Kissane N. The use of gamification to boost residents’ engagement in simulation training. JAMA Surg. 2014;149:1208.
Petrucci AM, Kaneva P, Lebedeva E, Feldman LS, Fried GM, Vassiliou MC. You have a message! Social networking as a motivator for FLS training. J Surg Educ. 2015;72:542–8.
El-Beheiry M, McCreery G, Schlachta CM. A serious game skills competition increases voluntary usage and proficiency of a virtual reality laparoscopic simulator during first-year surgical residents’ simulation curriculum. Surg Endosc. 2017;31:1643–50.
Mokadam NA, Lee R, Vaporciyan AA, Walker JD, Cerfolio RJ, Hermsen JL, et al. Gamification in thoracic surgical education: using competition to fuel performance. J Thorac Cardiovasc Surg. 2015;150:1052–8.
Nevin CR, Westfall AO, Rodriguez JM, Dempsey DM, Cherrington A, Roy B, et al. Gamification as a tool for enhancing graduate medical education. Postgrad Med J. 2014;90:685–93.
van Gaalen AEJ, Brouwer J, Schönrock-Adema J, Bouwkamp-Timmer T, Jaarsma ADC, Georgiadis JR. Gamification of health professions education: a systematic review. Adv in Health Sci Educ. 2021;26:683–711.
George BC, Bohnen JD, Schuller MC, Fryer JP. Using smartphones for trainee performance assessment: A SIMPL case study. Surgery. 2020;167:903–6.
George BC, Teitelbaum EN, Meyerson SL, Schuller MC, DaRosa DA, Petrusa ER, et al. Reliability, validity, and feasibility of the Zwisch scale for the assessment of intraoperative performance. J Surg Educ. 2014;71:90–6.
Bohnen JD, George BC, Williams RG, Schuller MC, DaRosa DA, Torbeck L, et al. The feasibility of real-time intraoperative performance assessment with SIMPL (System for Improving and Measuring Procedural Learning): early experience from a multi-institutional trial. J Surg Educ. 2016;73:e118–30.
Bates D, Mächler M, Bolker B, Walker S. Fitting linear mixed-effects models using lme4. J Stat Softw. 2015;67:1–48.
Deci EL, Ryan RM. Self-determination theory: a macrotheory of human motivation, development, and health. Can Psychol. 2008;49:182–5.
Schumacher DJ, Englander R, Carraccio C. Developing the master learner: applying learning theory to the learner, the teacher, and the learning environment. Acad Med. 2013;88:1635–45.
ten Cate OTJ, Kusurkar RA, Williams GC. How self-determination theory can assist our understanding of the teaching and learning processes in medical education AMEE guide No. 59. Med Teach. 2011;33:961–73.
Hattie J, Timperley H. The power of feedback. Rev Educ Res. 2007;77:81–112.
Luckoski J, Jean D, Thelen A, Mazer L, George B, Kendrick DE. How do programs measure resident performance? A multi-institutional inventory of general surgery assessments. J Surg Educ. 2021. https://doi.org/10.1016/j.jsurg.2021.08.024.
Kamine TH, Sabe AA, Nath B, Barnes K, Kent TS. Use of learning teams to improve the educational environment of general surgery residency. J Surg Educ. 2018;75:e17-22.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
No authors report financial or non-financial interests that are related directly or indirectly to this work. On behalf of all authors, the corresponding author states that there is no conflict of interest.
Supplementary Information
Below is the link to the electronic supplementary material.
Rights and permissions
Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Thelen, A.E., Nepomnayshy, Z., Qureshi, A. et al. Impact of gamification techniques on surgical trainee engagement with workplace-based assessment. Global Surg Educ 1, 51 (2022). https://doi.org/10.1007/s44186-022-00056-7
Received:
Revised:
Accepted:
Published:
DOI: https://doi.org/10.1007/s44186-022-00056-7