Gaming in health

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Last Update

  • Updated.jpg 6 May 2016


See also Avatars | Gamification | Massive open online courses (MOOCs)‎ | Massively-Multiplayer Online Role-Playing Games (MMORPGs) | Media literacy | Minecraft | Wearable computers

Gaming refers to a range of structured activities that require a game surface (online or offline), a number of players that engage with each other (and often compete in some way) and rules that govern how any game will be played and judged or refereed. It should be considered part of the gamification trends that involves winning, scoring and obtaining badges. According to Wikipedia, "...Canada has the third largest video game industry in terms of employment numbers right behind the USA and Japan with 16,000 employees, 348 companies, and a direct annual economic impact of nearly $2 billion. Gaming is an activity that implies participation, and within various gamer subcultures, gaming refers to a range of diverse activities that are not solely electronic such as:

  • Role-play where players assume fictional roles, characters and even sometimes avatars
  • Video games where electronic games have a video interface
  • Tabletop games where they are played on flat surfaces such as board or card games
  • To look at the many interactive games used in health and medicine, see the Health games research (database)
  • Several empirical studies show that there are positive health effects associated with digital videogame play among adults. With current advancements in technology, including advanced motion sensing, digital game platforms have a lot of potential to improve the health of older populations. In 2012, Hall et al published a systematic review of the effects on health outcomes associated with digital videogame play among older adults.
  • Twitch is a live streaming video platform owned by Inc.

Health benefits

Could gaming be good for your health?

  • DeSmet et al (2014) presents a meta-analysis of 54 digital serious game studies for health promotion; it examines the effects on behavior, determinants and clinical outcomes which were small but significant. What was interesting that the games were effective regardless of respondents' age or gender. No effect differences were found between stand-alone and multi-component games.
  • Primack et al (2012) The goal of this study was to determine whether video games may be useful in improving health outcomes. The authors found that video games have potential to improve health outcomes, particularly in psychological therapy and physical therapy.
  • Schott and Hodgetts (2006) describe some of the positive health benefits associated with the use of game technologies in relation to surgical training and therapeutic interventions, physical exercise, health education and community participation. Games can provide shared spaces that promote social interaction through which a sense of belonging and participation can be fostered.

The emerging research seems to suggest that people engaging in online communities with high levels of social capital and mutual support tend to be healthier. The cultivation of shared identities, trust, mutual support, shared interests and public narratives are central to fostering participation in health promotion practices. When it comes to developing ways of working with young people to further enhance their health, we should carefully consider youth sub-cultural practices and work with communities of practice within such populations, rather than just engineer traditional support groups or online communities. In this respect, gaming may become a tool for health research and interventions aimed at understanding and promoting organic forms of civic participation and improving population health.

Game studies

The focus on "game studies" in academic circles is a return to critiques of video games from the 1980s. The negative impact games have on the lives of players continues to be a source of some scientific debate. With video games usage in libraries, librarians are required to evaluate games from the point of view of collaboration, sportsmanship and learning. Academic librarians whose instructional and information literacy goals include games are few and far between but there are early adopters. The popularity of gaming on university campuses in North America has created new potential for librarians hoping to tap into using games. One aspect of the gaming community is the inclination to share knowledge and collaborate over transnational boundaries. Games are used as educational tools for students, pilots, soldiers and surgeons, schools from k-12 (and beyond) and even businesses. Gaming should be taken seriously; it requires players who construct hypotheses, solve problems, develop strategies and learn the rules of "in-game worlds". Gamers also learn how to juggle tasks, evaluate risks and make decisions. Gameplay is a form of preparation for the 21st century as some forward-thinking firms are already starting to realize.

Gaming in libraries

As new media are assimilated into scholarly processes, the flow of information in the digital age is changing how research is conducted. For example, some academics have taken on virtual identities, or conduct their research in world. One area identified as specific to the online world is the development of virtual economies where fictional items are bought and sold on eBay (Steinkuehler, 2005). Virtual currencies are at work in our real world; this alone seems to indicate the importance of paying attention to the influence of video games in society. The power of video to teach is well-established; scholars say that peripheral and accidental learning behind the scenes engages learners with interactive media. But caution is needed; educators who espouse the potential of edutainment, for example, should remember that it is not a panacea. Given the idea to use games is not new, why go down this road again? One reason is that new generations are using technology differently (Prensky, 2001); they are born gaming and educated with a preference for active engagement. They have become intolerant to traditional teaching. The potential for building a video game to incorporate information is appealing to educators. Librarians with an interest in promoting learning in training modules will find the idea of library instruction in a video game compelling. It's one way to get beyond the boredom that students often associate with library instruction. In the past, educational video games struggled to prove their effectiveness. There are reasons why the first wave of excitement about using video games failed to produce results. Companies could not sustain the hype and compete with large gaming companies. As the complexity of video games grows, there is interest in analyzing the learning that results from game play. The success in the commercial gaming market encourages the educational community to re-examine the ways that technology can be used in teaching to reach learners in innovative ways.

Digital games in health

Games have a number of applications in healthcare such as:

  • Patients suffering from chronic diseases such as diabetes, asthma, heart disease and cancer can use games (such as Re-Mission to deal with cancer)
  • Games can be adopted in virtual and real physical therapy (e.g. Wii-Habilitation)
  • Games with build in health education offer an alternative to traditional learning methods and can significantly improve health knowledge. Professional medical training games such as Burn Center™ can also be used in clinical practice
  • Wellness promotion games promote healthy lifestyle and behavioral change and can be classified into four main categories. Exercise games, or exergaming (e.g. Wii Fit Plus and MayaFit) involve physical activity, healthy eating games improve eating habits and knowledge on nutrition and weight management, mental health games (e.g. Fit Brains) are designed to improve cognitive abilities and smoking cessation games help smokers quit in an entertaining way
  • Games have the potential to reach consumers in a non-invasive way; and can be used in a social context to inspire behavioural changes

Gaming to supplement or replace forms of medical treatment

  • For pain relief and distraction
  • Rehabilitation
  • Surgery skill increase
  • Diabetes awareness
  • Easing carpal tunnel syndrome
  • Mental health and sharpness (Brain Train!)
  • Acting out domestic and social situations
  • Social and communication development

Library researcher: the game

Several variations on the following been done as small, in-house projects:

  • navigational, adventure/discovery game
  • knowledge quest: find and assemble knowledge from library resources
  • acquire practice and skill of library researcher
  • resident librarians as game masters/mentors
  • open source game engine, content development, and community participation

There is, apparently, no large-scale version of this available yet (Walt Scacchi, UCgamelab).

Learning theories and gaming

Wasted efforts will be the greatest fear of educators and librarians involved in game development. In all likelihood, the pedagogy of the game itself will not be the major flaw in a failed game - it will be an inability to find an intrinsic fun factor or ingredient that motivates learners to play. Users need to find games fun or addicting in order for them to be successful. Creating a successful game is the most difficult task for educational game developers. Given that game studies programs are becoming very popular, they will help to direct well-trained gamers on campuses in their gaming explorations. The next wave of commercial game development is moving into player design where players actually build the games they want to play (Borland, 2006). This will build in usability testing as gamers become articulate about why they find certain games to be useful. Another benefit of games as learning tools is that players can go at their own pace. Games can be built to adapt to varying skill levels to make them interactive. As gaming becomes more popular, players begin to move into the building mode. Librarians can eventually tap into these skills and encourage participation in any library game building. Involving student gamers in game development is important. However, developers need to be passionate about teaching and reaching students at different levels not necessarily measurable in traditional ways. Finding ways to measure game design will be the next difficult task for educators. Understanding common learning patterns will be important. For instance, learners do not try out new games by reading manuals. Most prefer to learn basic moves and begin exploration on their own. The learning is completely interactive and immersive. The unknown and the discovery factor in learning and playing games are a big part of their appeal. Being thrown into a new environment and learning to survive is half the fun. If students viewed learning how to use the library in the same light as they do learning how to navigate around a new world in a video game - we might be able to teach the skills of information literacy more efficiently. If librarians can borrow techniques from video games, we might be able to teach more than we realize.

What's happening cognitively?

  • Socially & materially distributed cognition.
  • Collaborative problem solving, multiple problem spaces.
  • Coordination of people, (virtual) tools, artifacts, & text.
  • Constellation of literacy practices across multimedia, multimodal attentional spaces (Lemke).
  • Empirical model building (exploits, mods).
  • Negotiation of meaning & values within community.
  • Authoring of identities within & beyond the community.

See "The Gaming Generation & Libraries: Intersections" by Constance A. Steinkuehler.


Gaming has become extremely sophisticated, moving well beyond simple notions of "destroy the aliens" or "beat the opponent". Now gaming involves players in interactive environments in which cooperating, building, and interacting take place in virtual worlds. One of the first complex interactive games was SimCity. The goal of the game is to build and operate a city populated by Sims, as the little virtual people are called. Players must deal with zoning, utilities, budget, water, power, land values, tourism, crime, disasters, pollution, and other issues involved in running a city. They need to set up industrial, commercial, and residential zones with various density levels and then supply transportation, power, and water. The city must be a good place where people want to reside. When this goal is accomplished, the Sims will flock to the city to build houses, businesses, factories, airports, and so on.

Tax revenues must be collected, and money must be carefully spent. Every imaginable factor, no matter how small, can cause Sims to be happy or sad. The city can be a shining citadel or a run-down slum, depending on the Sims. The popularity of interactive games has led to the creation of many types of simulated games, which have evolved into multiplayer online environments. Hundreds and even thousands of people from around the world pay a monthly fee to log on and maneuver their way through virtual social worlds. They choose a character (avatar) to become; design the character's appearance, personality, and skills and guide the character's life, relationships, and career in this simulated environment.

Characters encountered in the multiplayer version are created and controlled by real people who are also online and playing the game. Finally, interacting online has also taken on new meaning with wireless games that use cell phones as the medium of interaction. A multiplayer chase game called Can You See Me Now? is played simultaneously online (by the public) and in the streets (by assigned participants). Navigating through a virtual city as well as through real cities, participants mix reality with the virtual in an interesting way. A chat interface allows real-world and online participants to send each other text messages.


  • web 2.0 includes gaming, both using the Internet as platform as well as across locally-mounted software; games test our problem-solving skills; create community; facilitate learning; develop identities; willingness to learn new things, and experiment;
  • gaming and virtual realities (Second life) are participatory; can enhance social engagement;
  • some health professionals do not want to learn library skills, no matter how much they need them; can gaming become part of information literacy training to entice med students to learn? in lieu of online tutorials?
  • improves self-efficacy; visuospatial abilities; operating room performance (Enochsson);
  • advanced simulation shortens the learning curve for trainees; psychomotor improvements;
  • digitization frees up space for creative service provision that supports the training of medical professionals;
  • research shows that gaming is a common experience among college students, with almost every single one of them having at least played a video game of some kind at least once; undergrads do not mind bringing equipment and are willing to help, provide advice, and troubleshoot equipment problems.
  • gaming offers academic librarians the chance to be leaders within their communities and partner with a wide variety of collaborators; an opportunity for academic libraries to build relationships with students and change their perceptions of the library.
  • library schools need to begin incorporating discussions about gaming and gaming services into classes;
  • collaborative rehabilitation environments encourage long-distance collaborative "play" using two robot-mediated environments; tele-rehab increases motivation on able-bodied persons, applicable to impaired persons, to engage, sustain play and relate during shared tasks; clear positive trend in favour of the robot-mediated game environments; environment more valuable and more interesting and enjoyable; willing to spend more time at a task?
  • gaming can double as physical workout; aid in physiotherapeutic interventions;
  • computers have potential in therapeutic environments; appropriate software (programs) needs to be developed for therapy
  • specially designed programs are needed in medicine;
  • the same graphics engine in a video game-ISG Technologies' 3DFX workstation-has been put in a medical diagnostic imaging tool dubbed `3DMV', which reconstructs 3D images from 2D CAT scans, magnetic resonance images, and angiograms and allows physicians to rotate and fly through these reconstructions in real time;
  • interactive multimedia in biomedical educational software with simulation games; models, created using the simulation development tool - Simulink by MathWorks, are decomposed to interconnected simulation chips suitable for interdisciplinary cooperation between physiologists and programmers during design-time.
  • seven degree-of-freedom (DOF) haptic devices are developed with applications towards robot-assisted minimally invasive surgery; consists of four degrees of force feedback (three spatial and one grasping/parting) capability and seven degrees of freedom for positioning capability; developed with applications towards robot-assisted minimally invasive surgery, used in rehabilitation for finger, hand, or forearm injuries;
  • computer-based management game MOSHI (management of small hospitals) was developed in Tanzania to enhance professional management training programme for African hospital administrators; players are in charge of a virtual hospital and make strategic and tactical decisions.

Gaming thrills

Future video games could routinely monitor players' vital signs and emotional state to ensure a truly exhilarating experience. This includes an accelerometer that measures the G-force their body is subjected to and an ECG monitor that keeps track of their heart rate. In addition, a helmet-mounted camera will film their facial expressions as they ride the machine. Information will be beamed in real time to a computer via a wireless link. As each volunteer is hurled around the rides their measurements will be reproduced on several public displays. Physiologists and psychologists will also discuss how thrill, anticipation and fear are affecting them.

Booster was developed from apparatus originally created to train fighter pilots and astronauts. Despite being wrenched around at 60 kilometres per hour, and pulling up to 3 g in acceleration, this correspondent's heart rate hardly changed: it went from 66 beats per minute (at rest) to 72 bpm at the end. But I could certainly feel a hormonal buzz, probably adrenalin, after disembarking from the ride. Booster - to measure the physiology of excitement and thrill; a ghost train, to measure fear and anticipation; and a ride called Miami Trip, a gentler ride designed to explore pleasure.

'Ere Be Dragons - a player is hooked up to a heart sensor and a GPS device, and walks through the real world while exploring one created on a pocket PC. The twist is that their experiences of the PC world (such as the discovery of treasure or encountering monsters) is influenced by the player's physiological state.


  • Digital games are increasingly being used in education
  • Many people play them
  • Across many demographics
  • Mainstream form of entertainment
  • Instant response to trial and error (implications for teaching and learning)
  • Cognitive and neural changes and development
  • Encourages online exploration
  • Library researcher: the game
  • Interface design
  • Accelerated online multi- tasking
  • Huge real-time social networking

Web Resources

  • offers the ability to build two games - Save Skelly! and GameShow - that can be generated as an html file or Flash swf
  • UBC has a site-wide license for this game generator which uses quiz questions in Respondus format, i.e., format questions are in in Vista or Connect. You’ll see a tab for some examples at the link above
  • generates 16 games and links to inexpensive stand-alone version of generator that creates 20 different game types
  • free program that allows you to build interactive mazes with text, images, sound and movies; links to external websites and documents that learners refer to as they make their way through decisions. Incorrect choices are ‘fatal’, i.e., students return to the beginning or ‘set back’; prizes are awarded for correct choices and lost for incorrect ones.
  • best example of a Quandary output is
  • User Name: demostudent | Password: P@ssw0rd1


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