title: A randomized controlled trial on teaching geriatric medical decision making and cost consciousness with the serious game GeriatriX.
abstract: OBJECTIVE
  Medical students often lack training in complex geriatric medical decision making. We therefore developed the serious game, GeriatriX, for training medical decision making with weighing patient preferences, and appropriateness and costs of medical care. We hypothesized that education with GeriatriX would improve the ability to deal with geriatric decision making and also increase cost consciousness.
  
  
  METHODS
  A randomized, controlled pre-post measurement design.
  
  
  METHODS
  Fifth-year medical students.
  
  
  METHODS
  Playing the serious game GeriatriX as an additive to usual geriatric education.
  
  
  METHODS
  We evaluated the effects of playing GeriatriX on self-perceived knowledge of geriatric themes and the self-perceived competence of weighing patient preferences, appropriateness, and costs of medical care in geriatric decision making. Cost consciousness was evaluated with a postmeasurement to estimate costs of different diagnostic tests.
  
  
  RESULTS
  There was a large positive increase in the self-perceived competence of weighing patient preferences, appropriateness, and costs of medical care in the intervention group (n = 71) (effect sizes of 0.7, 1.0, and 1.2, respectively), which was significantly better for the last 2 aspects than in the control group (n = 63). The intervention group performed better on cost consciousness. Although the self-perceived knowledge increased substantially on some geriatric topics, this improvement was not different between the intervention and control groups.
  
  
  CONCLUSIONS
  After playing the serious game, GeriatriX, medical students have a higher self-perceived competence in weighing patient preferences, appropriateness, and costs of medical care in complex geriatric medical decision making. Playing GeriatriX also resulted in better cost consciousness. We therefore encourage wider use of GeriatriX to teach geriatrics in medical curricula and its further research on educational and health care outcomes.
authors.affiliation: Department of Geriatric Medicine, Radboud University Medical Center, Nijmegen, The Netherlands. Electronic address: joep1_@hotmail.com.
authors.forename: Joep
authors.initials: J
authors.lastname: Lagro
authors.affiliation: Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Marjolein H J
authors.initials: MH
authors.lastname: van de Pol
authors.affiliation: Department of Geriatric Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Annalies
authors.initials: A
authors.lastname: Laan
authors.affiliation: Institute for (bio) Medical Education, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Fanny J
authors.initials: FJ
authors.lastname: Huijbregts-Verheyden
authors.affiliation: Institute for (bio) Medical Education, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Lia C R
authors.initials: LC
authors.lastname: Fluit
authors.affiliation: Department of Geriatric Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Marcel G M
authors.initials: MG
authors.lastname: Olde Rikkert
mesh_terms: D003194:Computer-Assisted Instruction; D065187:Controlled Before-After Studies; D003363:Cost Control; D003657:Decision Making; D004504:Education, Medical, Undergraduate / Q000379:methods*; D004521:Educational Measurement; D005853:Geriatrics / Q000191:economics* / Q000193:education*; D006801:Humans; D013663:Teaching / Q000379:methods*; D018910:Video Games
keywords: Medical decision making; geriatric medicine; medical education; serious games