ep. 8 – Live. Die. Repeat. Gamification of simulation training


This month we turned our focus to simulation delivery formats, and in particular a novel approach described recently.

Sunga K, Sandefur B, Asirvatham U, et al. LIVE. DIE. REPEAT: a novel instructional method incorporating recursive objective-based gameplay in an emergency medicine simulation curriculum BMJ Simulation and Technology Enhanced Learning 2016;2:124-126.

We were fortunate to be joined by 2 authors of the paper

Kharmene Sunga (@Kharmene) is an emergency physician at Mayo Clinic in Rochester, Minnesota, where she is also lead for simulation in the ER residency. Daniel Cabrera (@CabreraERDR) is also an emergency physician at Mayo, a social media enthusiast and @smaccteam speaker.

Their paper, and original blog post,  challenges our traditional approach to simulation delivery – often ether a scenario followed by long(ish) debrief, or  ‘pause and discuss’ where the scenario is paused at intervals for discussion and then continues on.

Using gamification principles, and a fair bit of movie watching – Kharmene and Daniel have devised a sim format that involves ‘recursive objective based gameplay’ – where participants attempt to reach higher stages in the ‘game’ but have to repeat the level if they die. Seen from an educational theory perspective – this is deliberate practice in action. It’s a fast paced and engaging format, and provides a chance to practice again after a short and directive debrief.

Inspired by the idea of forgoing some of the long debrief after a scenario in favour of a chance for participants to practice, I’ve adapted the principle to our final year student sims, which have been similarly well received.

Comments and other ideas for adaption welcome.