title: Evaluation of a 3D serious game for advanced life support retraining.
abstract: OBJECTIVE
  Advanced life support (ALS) knowledge and skills decrease in as little as three months, but only a few ALS providers actually attend retraining courses. We assess the effectiveness of a 3D serious game as a new tool for frequent ALS retraining.
  
  
  METHODS
  We developed a 3D serious game for scenario-based ALS retraining. The serious game, called EMSAVE, was designed to promote self-correction while playing. We organized a retraining course in which 40 ALS providers played two cardiac arrest scenarios with EMSAVE and took a test with 38 multiple-choice questions before and after playing. We administered the same test again 3 months later to evaluate retention. Participants also rated EMSAVE and the overall retraining experience.
  
  
  RESULTS
  After using EMSAVE, the number of correct answers per participant increased by 4.8 (95%CI +3.4, +6.2, p<0.001) and all but one participant improved. After 3 months, despite an expected decrease in ALS knowledge and skills (-1.9 correct answers, 95%CI -0.6, -3.3, p<0.01), there was a significant retention benefit (+2.9 correct answers per participant, 95%CI +1.5, +4.2, p<0.001). Moreover, all but one participant regarded EMSAVE as a valuable tool to refresh ALS knowledge and skills, and 85% of participants were also willing to devote 1h/month to retrain with the serious game.
  
  
  CONCLUSIONS
  A 3D serious game for scenario-based retraining proved effective to retrain in ALS and supported retention of acquired knowledge and skills at 3 months. EMSAVE also positively engaged and motivated participants.
authors.affiliation: Human-Computer Interaction Lab, Department of Mathematics and Computer Science, University of Udine, Italy. fabio.buttussi@uniud.it
authors.forename: Fabio
authors.initials: F
authors.lastname: Buttussi
authors.forename: Tommaso
authors.initials: T
authors.lastname: Pellis
authors.forename: Alberto
authors.initials: A
authors.lastname: Cabas Vidani
authors.forename: Daniele
authors.initials: D
authors.lastname: Pausler
authors.forename: Elio
authors.initials: E
authors.lastname: Carchietti
authors.forename: Luca
authors.initials: L
authors.lastname: Chittaro
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003194:Computer-Assisted Instruction; D004502:Education, Medical, Continuing; D005260:Female; D006801:Humans; D008020:Life Support Care / Q000592:standards*; D008297:Male; D008875:Middle Aged; D012153:Retention, Psychology; D013663:Teaching; D018910:Video Games; D055815:Young Adult
keywords: Advanced cardiac life support; Computer simulation; Education; Evaluation studies; Retraining; Serious gaming