Serious Game-based Development of Obesity Intervention Skills - PROJECT DESCRIPTION
Serious Game-based Development of Obesity Intervention Skills
Intended Impact: Medical students are not adequately prepared with the clinical skills they need to
intervene with overweight or obese patients in order to help curtail the epidemic of obesity in the
United States. The ObesityTxChallenge project addresses this practice and training gap via novel
tablet and web-based training of medical students. The project strives to improve the assessment and
intervention skills of medical students by modifying our unique Clinical Encounters 3D-Patient
Training Environment, developed for our Pain Tx Challenge product with to deliver an enhanced
serious game-based simulation. The curriculum will be based on a modification of our 10 hour obesity
training for practicing doctors, located at ImpactObesity.com.
To reach our goal of improving outcomes of patients with overweight or obesity, via Obesity Tx
Challenge, students will conduct interviews and examine virtual (e.g., computer-generated) patients
and receive differing simulated patient responses (e.g., acceptance, confusion, refusal, suspicious
behavior). Via the product's unique branched path learning and time pressure, students will make
choices and see the results later in the experience. Multiple paths (and outcomes) enhance realism,
enthusiasm, changes in attitude, and educational effect. Virtual preceptors identify students' incorrect
or less than optimal clinical choices and decisions and weak patient-provider interaction skills and
provide feedback. The complex biological basis of obesity medicine is taught via a Unity 3D-based
"breakout" learning experience to provide a basic science foundation for the clinical knowledge.
Learners select physical exam components to fully investigate weight status as well as select and
interpret diagnostic tests. Player students categorize overweight and obesity via standard measures
(weight, BMI, abdominal circumference) to establish a diagnosis of obesity or assess overweight.
They develop an evidence-based comprehensive treatment plan that includes lifestyle modification,
inter-professional collaboration, such as with dietitians, counselors, or weight loss programs,
appropriate use of medications and weight loss surgery, motivational interventions, follow-up
recommendations, and referral as necessary. Game points and visual rewards reinforce best practice
choices and enhance student engagement.
The game's deliberate practice efficiently provides a wide variety of clinical experiences over time
and an opportunity to develop useful skills as students work with the 2/3rds of adult patients who are
overweight or obese. The training offers an opportunity to establish lifelong practice patterns that will
assist in stemming the obesity epidemic.
Phase I will specifically demonstrate product feasibility and acceptability by completing: 1) needs
analyses and preference testing with target audience students and faculty; 2) a training framework
and game design document; 3) a semi-functional, interactive prototype of the planned training with
realistic computer-generated patients and explanatory biological animations, using Unity 3D which
can be delivered in 2D (standard monitors) and 3D contexts, such as Oculus VR; 4) assessments to
be used in the Phase II evaluative study of the product; and 5) alpha/usability testing of the prototype
with medical students and assessment of preference, acceptability and effectiveness of the animation
presentations.
Phase II will complete the ObesityTxChallenge product, produce the ObesityTxChallenge
Implementation Guide for faculty preceptors and training directors to implement the game, and
evaluate the game's effectiveness with a population of medical students. A robust evaluation of the
game will assess learner response to this novel approach in terms of acceptance, enthusiasm, and
impact on skills, confidence and attitude via a randomized, cross-over, wait list control, pre-test/post-
test design. It will compare change in target clinical skills and core competencies related to
overweight and obesity assessment and intervention. The robust assessment of ObesityTxChallenge
informs our own environment and provides guidance to other researchers and educators regarding
the ability of game-based training to instill clinical skills and behaviors in students.
