Crossing the Chasm With Serious Games for Medical Education

Crossing the Chasm is a 1991 marketing book by Geoffrey A. Moore, revised in 1999, about selling high-tech products in their early years. It builds on Everett Rogers' diffusion of innovations and the technology adoption lifecycle, which has five segments: innovators, early adopters, early majority, late majority and laggards. Moore's claim is that the hardest step is the one from visionary early adopters to pragmatic early majority, and that this applies only to disruptive or discontinuous innovation.

The commentary suggested medical games could be among the first serious games to make that jump. Its support was partly anecdotal. It cited the positive attitudes medical students reported toward serious games, and Frederick W. Kron, a board-certified family physician, who said that media technologies from the video game industry could help educators meet academic leaders' call for new ways to teach medical concepts.

The central evidence was a paper by Graafland, Schraagen and Schijven, "Systematic review of serious games for medical education and surgical skills training", published in the British Journal of Surgery in 2012 (volume 99, pages 1322 to 1330). The authors searched five databases for studies up to April 2012 and found 25 articles describing 30 games. Seventeen were built for teaching, and 13 were commercial games useful for medical skills. Among the named educational games were 3DiTeams, HumanSim and CliniSpace.

Only six games had a validation process. Three trained teams in critical care and triage, and three were commercial games used to train laparoscopic psychomotor skills. None had completed full validation for its purpose. The authors concluded that blended, interactive learning with games can train technical and non-technical surgical skills, but that games need validation before they enter surgical curricula.

The commentary also drew out that games let several professionals train on one case at once, or one professional on many cases, which supports skills that reduce errors in operating rooms and emergency departments. It noted that development can cost millions, a price it argued patient safety could justify, with insurers as possible backers.

The review is cataloged under DOI 10.1002/bjs.8819, and that DOI now forwards to the paper's page on Oxford Academic. The Wiley address of the PDF used in 2012 forwards to a newer Wiley address. The abstract figures above come from the DOI registry record. Whether medical games have crossed the chasm is a judgment the review does not settle, because it found no fully validated game.