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Serious Games Reinforcing Safety Protocols In The Operating Room

Safety Surgery Trainer (SST), developed by Alion Science and Technology, in conjunction with Synensis, was also selected as a finalist in the 2015 Serious Games Showcase and Challenge in the Business Category.

SST is a patient-safety "Serious Game" for perioperative staff who work in the Operating Room (nurses, surgeons, anesthesia, and scrub tech). Perioperative refers to the three phases of surgery: preoperative, intraoperative, and postoperative. The goal of perioperative care is to provide better conditions for patients before operation, during operation, and after operation.

Preventable medical errors cause up to 98,000 deaths each year and the majority are due to breakdowns in communication, leading the World Health Organization (WHO) to mark “Communication” as the #1 healthcare research priority. 

In efforts to address the root causes of these mistakes – and save more lives – Alion Science and Technology, in partnership with the University of Central Florida, IDEAS and Synensis Health, developed the Safe Surgery Trainer (SST) for the Office of Naval Research (ONR).

As the Navy’s first patient safety training game for medical teams involved in surgery – before, during and after, SST was conceived to provide virtual training scenarios to reinforce safety protocols, enhance team performance and improve outcomes for patients -- SST had to be easy to use, require minimal time, and directly address WHO's #1 Healthcare Research problem.

Departing from an in-depth understanding of SST target audience (highlyeducated/extremely busy players), Alion and partners have developed a unique value proposition “To generate a significant change in behaviors in just 30 minutes.” They deliver on this promise via the game simple interface, highly visible feedback, and short gameplay that addresses the use of effective communication techniques that facilitate a psychologically-safe OR.

The game requires no training, and stays focused on the core learning objective. SST leverages techniques from entertainment games to create a fast, player-driven, engaging set of mechanics.

In the game, the player’s challenge is to use effective communication techniques to navigate perioperative scenarios and, in the process, gain a deeper understanding of the use of patient safety communication protocols.

SST runs on a variety of platforms; can be freely distributed within the military health system; and has been tested by hundreds of individuals with ZERO usability issues. Studies at Langley AF Hospital showed a 32% improvement in patient safety knowledge among EXPERT learners. In addition, medical staff who played the game showed a 300% greater use of appropriate safety language compared to the control group. Later studies at Portsmouth Naval Hospital replicated this result, demonstrating a 650% greater use of appropriate safety language.

The most impressive game design elements in my view are the use of situational judgment to measure players’ progress against the correct behaviors as well as the real-time feedback woven throughout the game. In conjunction, these two elements highly-contribute to the effectiveness and practicality of the experience with minimal time requirement.

Players are allowed to make a small number of mistakes on each level. Successful completion is based on the severity of errors, the number of times the content has been taught and how far the player has progressed within the game. Feedback measurement is provided immediately, as well as in collated scores for each perspective, and in total.

Summing up, Safe Surgery Trainer (SST) is most successful in training players to adopt an appropriate behavior that reinforces safety protocols in the Operating Room, providing hard evidence that Serious Games technology can be applied to the domain of patient safety.