title: Serious gaming for orthotopic liver transplant anesthesiology: A randomized control trial.
abstract: Anesthetic management of orthotopic liver transplantation (OLT) is complex. Given the unequal distributions of liver transplant surgeries performed at different centers, anesthesiology providers receive relatively uneven OLT training and exposure. One well-suited modality for OLT training is the "serious game," an interactive application created for the purpose of imparting knowledge or skills, while leveraging the self-motivating elements of video games. We therefore developed a serious game designed to teach best practices for the anesthetic management of a standard OLT and determined if the game would improve resident performance in a simulated OLT. Forty-four residents on the liver transplant rotation were randomized to either the gaming group (GG) or the control group (CG) prior to their introductory simulation. Both groups were given access to the same educational materials and literature during their rotation, but the GG also had access to the OLT Trainer. Performance on the simulations were recorded on a standardized grading rubric. Both groups experienced an increase in score relative to baseline that was statistically significant at every stage. The improvements in scores were greater for the GG participants than the CG participants. Overall score improvement between the GG and CG (mean [standard deviation]) was statistically significant (GG, 7.95 [3.65]; CG, 4.8 [4.48]; P = 0.02), as were scores for preoperative assessment (GG, 2.67 [2.09]; CG, 1.17 [1.43]; P = 0.01) and anhepatic phase (GG, 1.62 [1.01]; CG, 0.75 [1.28]; P = 0.02). Of the residents with game access, 81% were "very satisfied" or "satisfied" with the game overall. In conclusion, adding a serious game to an existing educational curriculum for liver transplant anesthesia resulted in significant learning gains for rotating anesthesia residents. The intervention was straightforward to implement and cost-effective. Liver Transplantation 23 430-439 2017 AASLD.
authors.affiliation: Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Daniel
authors.initials: D
authors.lastname: Katz
authors.affiliation: Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Jeron
authors.initials: J
authors.lastname: Zerillo
authors.affiliation: Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Sang
authors.initials: S
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Bryan
authors.initials: B
authors.lastname: Hill
authors.affiliation: Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Ryan
authors.initials: R
authors.lastname: Wang
authors.affiliation: Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Andrew
authors.initials: A
authors.lastname: Goldberg
authors.affiliation: Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Samuel
authors.initials: S
authors.lastname: DeMaria
mesh_terms: D000072080:Anesthesiologists / Q000193:education*; D000776:Anesthesiology / Q000193:education*; D003198:Computer Simulation; D003362:Cost-Benefit Analysis; D003697:Delphi Technique; D004521:Educational Measurement / Q000379:methods; D006801:Humans; D007396:Internship and Residency / Q000191:economics / Q000379:methods*; D016031:Liver Transplantation / Q000009:adverse effects*; D017410:Practice Guidelines as Topic; D018910:Video Games