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Title: Hidden Identity Simulation (HID SIM): a gamified approach to mass gathering medicine simulation
Authors
Anthony Seto
Connor Hass
Melissa Monaghan
Leo Ochieng
Liam Montgomery
Jan Rossiter
Ali Bayrouti
Candace Chan
Nicole Ertl
Ella Krane
Introduction
Gamification integrates game elements into non-game contexts to improve engagement. We created and evaluated Hidden Identity Simulation (HID SIM), a gamified simulation (SIM) designed to address team dynamics that may arise in multidisciplinary teams at mass gathering events (e.g., electronic dance music festivals).
HID SIM blends secret identity games (e.g., Werewolf) with healthcare SIM. In HID SIM, participants navigate a SIM while playing secret roles (e.g., “The Know-It-All”). Participants can practice effective teamwork skills to overcome challenging personalities.
Objective
The objective was to design, implement, and evaluate the HID SIM curriculum. HID SIM is a gamified simulation designed to apply teamwork skills while learning medicine.
Methods
We piloted HID SIM in a SIM theatre with 29 participants (multidisciplinary event medical crew). After drawing a hidden identity card, teams of 4-6 progressed through a case of cocaine toxicity, associated with seizure and cardiac arrest, while roleplaying their character. In the debrief, learners revealed their roles and discussed strategies for managing difficult team dynamics.
Results
Of 29 participants, 28 (97%) completed a post-SIM program evaluation survey. Among respondents (n=28), HID SIM received a mean rating of 4.75/5 (median 5/5). Respondents reported a mean agreement of 4.43/5 (median 5/5) that HID SIM was engaging. The mean agreement that HID SIM was less stressful than anticipated was 3.54/5 (median 4/5). Among participants with prior SIM experience (n=19), the mean rating for agreement that HID SIM was less stressful than other SIMs was 3.68/5 (median 4/5).
Participants rated their pre-/post-SIM self-efficacy on identifying barriers to effective team dynamics, optimizing team dynamics, comfort in managing challenging team dynamics, using closed-loop communication, communicating professionally, sharing a mental model, discussing clinical presentation signs/symptoms, and suggesting a treatment plan. All competencies showed significant increase (p<0.001) post-SIM.
Conclusions
HID SIM is a well-received and engaging gamified SIM designed to practice handling difficult team dynamics in high-acuity scenarios, with the benefit of being perceived as less stressful than anticipated and when compared to other SIMs. HID SIM helps improve participants’ self-efficacy in both teamwork and medical domains and can be integrated into other SIMs to add focus on team dynamics.
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