Reply to Surapaneni: Why are educational games useful in health professional education?

Letter to the EditorReply to Surapaneni: Why are educational games useful in health professional education?Fernanda Klein Marcondes, Maria Antonia Ramos de Azevedo, and Luís Henrique MontrezorFernanda Klein MarcondesDepartment of Biosciences, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, BrazilStudy and Research Group in University Pedagogy, Department of Education, Institute of Biosciences, State University of São Paulo (UNESP), Rio Claro, Brazil, Maria Antonia Ramos de AzevedoStudy and Research Group in University Pedagogy, Department of Education, Institute of Biosciences, State University of São Paulo (UNESP), Rio Claro, Brazil, and Luís Henrique MontrezorStudy and Research Group in University Pedagogy, Department of Education, Institute of Biosciences, State University of São Paulo (UNESP), Rio Claro, BrazilDepartment of Biological Science and Health—Medicine, University of Araraquara (UNIARA), Araraquara, BrazilPublished Online:28 Sep 2023https://doi.org/10.1152/advan.00167.2023MoreSectionsPDF (214 KB)Download PDF ToolsExport citationAdd to favoritesGet permissionsTrack citations ShareShare onFacebookTwitterLinkedInWeChat After reading the Letter to the Editor of Dr. Surapaneni (1) considering our article [Pessoa et al. (2)] and game-based learning, we would like to thank and endorse their observations about the design of educational games as useful strategies to promote effective learning. The cited game has been developed to help students understand the concepts of tonicity and osmolarity and apply them to knowledge about the effect of intravenous solutions on cell volume and function. The definition of these clear learning objectives was crucial for the game design, organization of the activity to use it in class, and positive perception by students.The first point we used to develop this educational game was the real difficulties of students in understanding tonicity, osmolarity and osmosis concepts, observed over years in physiology classes. The observations of such difficulties helped us to identify “hard” key themes, guiding us in the game development. This also occurred when we developed educational games about the cardiac cycle (3–5), action potential (6), and integration of synapse-muscle contraction-autonomic nervous system physiology (7). Briefly, these games have a phase in which tables have to be filled with specific cards as puzzles and another phase with questions.Besides having clear learning objectives, the students have to apply previous knowledge, developing the skill to relate and integrate information, to solve the educational games. The process of reviewing the topic led to stronger association of new information with existing neural networks of knowledge, favoring subsequent memory and associative memory (8, 9).In addition, it is important that the teaching-learning process should occur under conditions in which the students feel at ease and able to make mistakes and voice doubts, because learning depends on the nature of stimuli, environmental conditions, and emotional factors (10). Such a favorable environmental condition is provided in group activities with educational games because students may learn together with their colleagues, feeling more at ease in voicing their doubts, exchanging ideas, and assisting each other. Also, during these processes the other key characteristic expected in game-based learning is present: immediate feedback and formative assessments. Activities with educational games allow the students to identify what they do not know, so that they can learn during the activity. At the same time, professors may evaluate themselves, allowing them to improve their teaching, making necessary changes in following classes and activities to increase learning. These are premises of active learning methodologies, which should enable the theoretical-methodological action of students and professors, enabling them to perform a critical and contextual analysis of students’ progress resulting from the strategies and resources used, not only at the end of the process but especially during its progress (11, 12). In this way, learning arises from the students themselves, who, when confronted with their doubts, questions, and reflections, are able to perceive their active and critical roles in the lived experiences.Moreover, the activities with educational games we use in our classes are done in groups of five or six students, and after conclusion of each phase a professor or monitor evaluates the group answer (the table completely filled or answers to questions). The time used to finish each phase is not evaluated. Each group may finish in their own time. Therefore, there is no competition. In our experience, this seems to be important because different students need different amounts of time to think, to understand a topic, and to elaborate a question to present their doubts. In this way we can focus on the learning of each group, and each student in the group, more properly.In conclusion, if educational games have well-defined learning objectives, provide immediate feedback, and are used in groups developing collaborative learning, the environment becomes pleasant, safe, and even funny.GRANTSThe authors have received grants for research projects for development and evaluation of effects of educational games provided by the American Physiological Society (Teaching Career Enhancement Award 2016), Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP grants 2019/06430-3 and fellowships 2022/12433-8, 2022/14201-7), and Fundo de Apoio ao Ensino, Pesquisa e Extensão da UNICAMP (FAEPEX, grants 2288/20 and 2424/22).DISCLOSURESNo conflicts of interest, financial or otherwise, are declared by the authors.AUTHOR CONTRIBUTIONSF.K.M. drafted manuscript; F.K.M., M.A.R.d., and L.H.M. edited and revised manuscript; F.K.M., M.A.R.d., and L.H.M. approved final version of manuscript.REFERENCES1. Surapaneni KM. The building blocks of effective academic games in health professions education. Adv Physiol Educ. In Press. doi:10.1152/advan.00146.2023.Link | Google Scholar2. Pessoa PT, Palanch AC, Casale KR, Montrezor LH, Taxini CL, Azevedo MA, Marcondes FK. An educational game for teaching osmolarity and tonicity: opinions of dental and medical students. Adv Physiol Educ 47: 557–561, 2023. doi:10.1152/advan.00228.2022. Link | ISI | Google Scholar3. Cardozo LT, Miranda AS, Moura MJ, Marcondes FK. Effect of a puzzle on the process of students’ learning about cardiac physiology. Adv Physiol Educ 40: 425–431, 2016. doi:10.1152/advan.00043.2016. Link | ISI | Google Scholar4. Cardozo LT, Lima PO, Carvalho MS, Casale KR, Bettioli AL, Azevedo MA, Marcondes FK. Active learning methodology, associated to formative assessment, improved cardiac physiology knowledge and decreased pre-test stress and anxiety. Front Physiol 14: 1261199, 2023. doi:10.3389/fphys.2023.1261199.Crossref | Google Scholar5. Marcondes FK, Moura MJ, Sanches A, Costa R, de Lima PO, Groppo FC, Amaral ME, Zeni P, Gaviao KC, Montrezor LH. A puzzle used to teach the cardiac cycle. Adv Physiol Educ 39: 27–31, 2015. doi:10.1152/advan.00116.2014. Link | ISI | Google Scholar6. Luchi KC, Montrezor LH, Marcondes FK. Effect of an educational game on university students' learning about action potentials. Adv Physiol Educ 41: 222–230, 2017. doi:10.1152/advan.00146.2016. Link | ISI | Google Scholar7. Cardozo LT, Azevedo MA, Carvalho MS, Costa R, de Lima PO, Marcondes FK. Effect of an active learning methodology combined with formative assessments on performance, test anxiety, and stress of university students. Adv Physiol Educ 44: 744–751, 2020. doi:10.1152/advan.00075.2020. Link | ISI | Google Scholar8. Ruiter DJ, van Kesteren MT, Fernandez G. How to achieve synergy between medical education and cognitive neuroscience? An exercise on prior knowledge in understanding. Adv Health Sci Educ Theory Pract 17: 225–240, 2012. doi:10.1007/s10459-010-9244-5. Crossref | PubMed | ISI | Google Scholar9. van Kesteren MT, Krabbendam L, Meeter M. Integrating educational knowledge: reactivation of prior knowledge during educational learning enhances memory integration. NPJ Sci Learn 3: 11, 2018. doi:10.1038/s41539-018-0027-8. Crossref | PubMed | Google Scholar10. Chidambaram SB, Rathipriya AG, Bolla SR, Bhat A, Ray B, Mahalakshmi AM, Manivasagam T, Thenmozhi AJ, Essa MM, Guillemin GJ, Chandra R, Sakharkar MK. Dendritic spines: revisiting the physiological role. Prog Neuropsychopharmacol Biol Psychiatry 92: 161–193, 2019. doi:10.1016/j.pnpbp.2019.01.005. Crossref | PubMed | ISI | Google Scholar11. Hoffmann J. Avaliação Mediadora. Porto Alegre-RS, Brazil: Meditora Ediação, 2019.Google Scholar12. Marcondes FK, Cardozo LT, Pessoa PT, Casale KR, Azevedo MA. Contribuição de jogos educacionais para aprendizagem colaborativa, no ensino superior em saúde. In: Metodologias Ativas: Gamificação, edited by Yanaze L, Corregio S. Diadema, Brazil: V&V Ed., 2022, p. 110–125.Crossref | Google ScholarAUTHOR NOTESCorrespondence: F. K. Marcondes (ferklein@unicamp.br). Download PDF Previous Back to Top FiguresReferencesRelatedInformation Related ArticlesThe building blocks of effective academic games in health professions education 28 Sep 2023Advances in Physiology Education More from this issue > Volume 47Issue 4December 2023Pages 821-822 Crossmark Copyright & PermissionsCopyright © 2023 the American Physiological Society.https://doi.org/10.1152/advan.00167.2023PubMed37769063History Received 21 August 2023 Accepted 21 August 2023 Published online 28 September 2023 Published in print 1 December 2023 Keywordsformative assessmentgameficationlearningteaching Metrics