title: Septris: a novel, mobile, online, simulation game that improves sepsis recognition and management.
abstract: OBJECTIVE
  Annually affecting over 18 million people worldwide, sepsis is common, deadly, and costly. Despite significant effort by the Surviving Sepsis Campaign and other initiatives, sepsis remains underrecognized and undertreated.
  
  
  METHODS
  Research indicates that educating providers may improve sepsis diagnosis and treatment; thus, the Stanford School of Medicine has developed a mobile-accessible, case-based, online game entitled Septris (http://med.stanford.edu/septris/). Septris, launched online worldwide in December 2011, takes an innovative approach to teaching early sepsis identification and evidence-based management. The free gaming platform leverages the massive expansion over the past decade of smartphones and the popularity of noneducational gaming.The authors sought to assess the game's dissemination and its impact on learners' sepsis-related knowledge, skills, and attitudes. In 2012, the authors trained Stanford pregraduate (clerkship) and postgraduate (resident) medical learners (n = 156) in sepsis diagnosis and evidence-based practices via 20 minutes of self-directed game play with Septris. The authors administered pre- and posttests.
  
  
  RESULTS
  By October 2014, Septris garnered over 61,000 visits worldwide. After playing Septris, both pre- and postgraduate groups improved their knowledge on written testing in recognizing and managing sepsis (P < .001). Retrospective self-reporting on their ability to identify and manage sepsis also improved (P < .001). Over 85% of learners reported that they would or would maybe recommend Septris.
  
  
  CONCLUSIONS
  Future evaluation of Septris should assess its effectiveness among different providers, resource settings, and cultures; generate information about how different learners make clinical decisions; and evaluate the correlation of game scores with sepsis knowledge.
authors.affiliation: Mrs. Evans is program officer of quality and organizational improvement, Department of Medicine, School of Medicine, Stanford University, Stanford, California. Dr. Daines is clinical assistant professor, Department of Medicine, School of Medicine, Stanford University, Stanford, California. Mr. Tsui is instructional technologist in online curriculum, Information Resources and Technology, School of Medicine, Stanford University, Stanford, California. Dr. Strehlow is clinical associate professor, Department of Surgery and Department of Emergency Medicine, School of Medicine, Stanford University, Stanford, California. Dr. Maggio is assistant professor, Department of Surgery, School of Medicine, Stanford University, Stanford, California. Dr. Shieh is clinical associate professor and medical director for quality, Department of Medicine, School of Medicine, Stanford University, Stanford, California.
authors.forename: Kambria H
authors.initials: KH
authors.lastname: Evans
authors.forename: William
authors.initials: W
authors.lastname: Daines
authors.forename: Jamie
authors.initials: J
authors.lastname: Tsui
authors.forename: Matthew
authors.initials: M
authors.lastname: Strehlow
authors.forename: Paul
authors.initials: P
authors.lastname: Maggio
authors.forename: Lisa
authors.initials: L
authors.lastname: Shieh
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003258:Consumer Behavior; D003661:Decision Support Techniques; D006801:Humans; D063731:Mobile Applications; D009862:Online Systems; D018794:Problem-Based Learning; D018805:Sepsis / Q000175:diagnosis* / Q000628:therapy*; D018910:Video Games