User Assessment of "InsuOnLine," a Game to Fight Clinical Inertia in Diabetes: A Pilot Study.
OBJECTIVE
We performed a pilot study to assess usability and playability of "InsuOnLine," a serious game for education of primary care physicians on insulin therapy for diabetes mellitus.


METHODS
A multidisciplinary team has designed and developed "InsuOnLine," using Andragogy and Problem-Based Learning principles, with game elements to improve players' motivation. The prototype was tested by four medical doctors and two medical students, using the System Usability Scale (SUS) and a questionnaire to assess playability. These results were used to guide corrections, after which the beta version was retested by 14 medical students and 6 residents.


RESULTS
Out of a maximum score of 100 on the SUS, the "InsuOnLine" prototype was rated 88, and some areas for improvement were identified (game instructions, controls). After corrections, the beta version was rated 92.5 on the SUS. Users have found the beta version to be fun, engaging, challenging, relevant, and realistic. Users said that the game has increased their knowledge on diabetes and insulin, that it has made them feel more confident for prescribing insulin, and that it would have impact on how they treated patients with diabetes. Most users said they have learned more from the game than they would have from a lecture. Lessons learned were the need of early piloting, preferably by users with very little or very much gaming experience, on their own computers and free patterns of use.


CONCLUSIONS
"InsuOnLine" was rated by users as easy to play, fun, and useful for learning. Further studies will assess its educational effectiveness. "InsuOnLine" is a promising tool for large-scale continuing medical education on insulin, helping to fight clinical inertia in diabetes.
1 Londrina State University , Londrina, Paraná, Brazil .|2 Little Prince Complex, Curitiba, Paraná, Brazil .
Leandro Arthur
LA
Diehl
3 Oniria Software Ltd. , Londrina, Paraná, Brazil .
Rodrigo Martins
RM
de Souza
1 Londrina State University , Londrina, Paraná, Brazil .
Pedro Alejandro
PA
Gordan
4 Maringá State University , Maringá, Paraná, Brazil .
Roberto Zonato
RZ
Esteves
2 Little Prince Complex, Curitiba, Paraná, Brazil .
Izabel Cristina Meister
IC
Coelho
D000328:Adult; D003920:Diabetes Mellitus / Q000628:therapy*; D019468:Disease Management; D004502:Education, Medical, Continuing / Q000379:methods*; D004521:Educational Measurement / Q000379:methods; D005260:Female; D005717:Games, Experimental; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D013337:Students, Medical; D011795:Surveys and Questionnaires; D014584:User-Computer Interface; D018910:Video Games