Games for health professionals – a Cochrane review investigates

Having looked at whether a board game can help smokers, in Monday’s blog, I’m now turning my attention to educational games for health professionals – going to work has never been so much fun! This was the unlikely topic of a Cochrane systematic review which has now been updated. There are lots of reasons why educational games might help people improve their knowledge, skills and attitudes, such as the opportunity to practice problem-solving and decision-making in the safe context of the game, and through discussions with other players which the game promotes. Interactive learning in a stress-free and fun situation (no waiting to throw a six then, I presume) is also thought to aid retention of new knowledge. The use of games to help health professionals learn isn’t new (though the nearest we got to a game when I was a student nurse was blindfolding our colleagues and feeding them cornflakes – if you need anyone to do that then just give us a shout), but do they work?

The Cochrane team looked for evidence (from studies of various designs) on the effectiveness of educational games on health professionals’ performance (process of care) and on patient outcomes and, as secondary outcomes, on professionals’ knowledge, skills, attitude and satisfaction. Interventions involving role play or simulations were not included. The updated review contains just two studies, both randomised controlled trials, one newly added. One study, with 273 healthcare workers in a small community hospital in the US, used a game based on the television game show “Family Feud” as a reinforcement technique, focusing on infection control. The other, with 35 family physicians at a continuing medical education event in Canada, compared learning through a game modelled on the “Snakes and Ladders” board game with traditional case-based learning of stroke prevention and management. Here’s what they found:

  • Neither study assessed any patient or process of care outcome – these were the primary outcomes for the review
  • Infection control trial: the game group had statistically higher scores on the knowledge test (P = 0.02) but the educational significance of this is unclear
  • Stroke prevention and management trial: the effect on knowledge was not statistically different between the two groups immediately and 3 months after the intervention. The level of reported enjoyment was higher in the game-based group
  • The studies had small sample sizes and were at unclear risk of bias

The authors concluded:

The findings of this systematic review do not confirm nor refute the utility of games as a teaching strategy for health professionals. More and better evidence are needed to make practice recommendations. However those designing and implementing educational games should carefully consider their advantages and disadvantages.

What a shame there’s so little evidence about the usefulness of these approaches. An earlier Cochrane review exploring educational games for mental health professionals found only one trial with 34 people, who showed improved knowledge after playing an educational game. I wonder if any of you use educational games, or have participated in them, as part of health professional training?  I’m heading out into the woodland now, to see if anyone’s up for a game.


Akl  EA, Sackett  KM, Erdley  WS, Mustafa  RA, Fiander  M, Gabriel  C, Schünemann  H. Educational games for health professionals. Cochrane Database of Systematic Reviews  2013, Issue 1. Art. No.: CD006411. DOI: 10.1002/14651858.CD006411.pub3

Bhoopathi PS, Sheoran R. Educational games for mental health professionals. Cochrane Database of Systematic Reviews 2006, Issue 2. Art. No.: CD001471. DOI: 10.1002/14651858.CD001471.pub2.

The Lifestyle Elf: Can a board game help increase smokers’ knowledge and willingness to quit? Monday 18th February 2013.


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Sarah Chapman

My name is Sarah Chapman. I have worked on systematic reviews and other types of research in many areas of health for the past 17 years, for the Cochrane Collaboration and for several UK higher education institutions including the University of Oxford and the Royal College of Nursing Institute. I also have a background in nursing and in the study of the History of Medicine.

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