Evaluation of affective learning in a gamified pharmacy simulation
Keywords:pharmacy education, gamification, simulation, affective learning, professional development, students
Introduction: Pharmacy students must achieve learning in the affective domain to attain the professional values that underpin patient-centred practice and self-directed, lifelong learning. An array of learning and teaching activities, including gaming and simulation, are used to achieve affective learning. The aim of this research was to evaluate affective learning in participants of an extended, immersive, gamified pharmacy simulation.
Methods: Student teams managed simulated pharmacies, assuming the role of autonomous pharmacists to complete regular, scaffolded, pharmacy-related tasks and safely provide medicines and counselling. The 3-week gamified simulation was designed to develop teamwork and collaborative skills, while enhancing students’ professional identity, confidence and competencies. Affective learning was assessed via analysis of student reflective journals. Final-year pharmacy students completed debriefing and reflection at specific timepoints during participation in the 3-week gamified simulation. The validated Griffith University Affective Learning Scale (GUALS) was used by trained external assessors to evaluate the highest levels of affective learning detected in student reflective journals. Quantitative analysis of GUALS scores was conducted using SPSS 25. Means were computed per student for each week, regardless of journalling frequency, and changes over time compared.
Results: From 2016 to 2018, 123 students participated in the simulation, generating 734 reflective journal entries for analysis. Overall, affective learning was evident, and its level increased over the course of the simulation. This was primarily associated with the improvements of female students.
Conclusion: An extended, immersive, gamified pharmacy simulation induced and enhanced affective learning in final-year pharmacy students.
Aburahma, M. H., & Mohamed, H. M. (2015). Educational games as a teaching tool in pharmacy curriculum. American Journal of Pharmaceutical Education, 79(4), Article 59. https://doi.org/10.5688/ajpe79459
Akl, E. A., Kairouz, V. F., Sackett, K. M., Erdley, W. S., Mustafa, R. A., Fiander, M., Gabriel, C., & Schünemann, H. (2013). Educational games for health professionals. Cochrane Database of Systematic Reviews, 2013(3), Article CD006411. https://doi.org/10.1002/14651858.CD006411.pub4
Andrusyszyn, M. A. (1989). Clinical evaluation of the affective domain. Nurse Education Today, 9(2), 75–81. https://doi.org/10.1016/0260-6917(89)90057-9
Baker, C., Pulling, C., McGraw, R., Dagnone, J. D., Hopkins-Rosseel, D., & Medves, J. (2008). Simulation in interprofessional education for patient-centred collaborative care. Journal of Advanced Nursing, 64(4), 372–379. https://doi.org/10.1111/j.1365-2648.2008.04798.x
Bhoopathi, P. S., & Sheoran, R. (2006). Educational games for mental health professionals. The Cochrane Library, 2006(2), Article CD001471. https://doi.org/10.1002/14651858.CD001471.pub2
Black, P. E., & Plowright, D. (2007). Exploring pharmacists' views about the contribution that reflective learning can make to the development of professional practice. International Journal of Pharmacy Practice, 15(2), 149–155. https://doi.org/10.1211/ijpp.15.2.0011
Bloom, B. S., Engelhart, M. D., Furst, E. J., Hill, W. H., & Krathwohl, D. R. (1956). Taxonomy of educational objectives, Handbook I: The cognitive domain (Vol. 19). David McKay Company. https://web.archive.org/web/20201212072520id_/https://www.uky.edu/~rsand1/china2018/texts/Bloom%20et%20al%20-Taxonomy%20of%20Educational%20Objectives.pdf
Brown, B., Holt-Macey, S., Martin, B., Skau, K., & Vogt, E. M. (2015). Developing the reflective practitioner: What, so what, now what. Currents in Pharmacy Teaching and Learning, 7(5), 705–715. https://doi.org/10.1016/j.cptl.2015.06.014
Brown, D. L., Ferrill, M. J., Hinton, A. B., & Shek, A. (2001). Self-directed professional development: The pursuit of affective learning. American Journal of Pharmaceutical Education, 65(3), 240–246.
Buissink-Smith, N., Mann, S., & Shephard, K. (2011). How do we measure affective learning in higher education? Journal of Education for Sustainable Development, 5(1), 101–114. https://doi.org/10.1177/097340821000500113
Deterding, S., Dixon, D., Khaled, R., & Nacke, L. (2011, September). From game design elements to gamefulness: Defining "gamification". In Proceedings of the 15th International Academic MindTrek Conference: Envisioning Future Media Environments (pp. 9–15). Association for Computing Machinery. https://doi.org/10.1145/2181037.2181040
Donlan, P. (2018). Developing affective domain learning in health professions education. Journal of Allied Health, 47(4), 289–295.
Dyment, J. E., & O'Connell, T. S. (2011). Assessing the quality of reflection in student journals: A review of the research. Teaching in Higher Education, 16(1), 81–97. https://doi.org/10.1080/13562517.2010.507308
Fens, T., Dantuma-Wering, C. M., & Taxis, K. (2020). The pharmacy game—GIMMICS®: A simulation game for competency-based education. Pharmacy, 8(4), Article 198. https://doi.org/10.3390/pharmacy8040198
Fens, T., Hope, D. L., Crawshaw, S., Tommelein, E., Dantuma-Wering, C., Verdel, B. M., Trečiokienė, I., Solanki, V., van Puijenbroek, E. P., & Taxis, K. (2021). The international pharmacy game: A comparison of implementation in seven universities world-wide. Pharmacy, 9(3), Article 125. https://doi.org/10.3390/pharmacy9030125
Glennon, W., Hart, A., & Foley, J. T. (2015). Developing effective affective assessment practices. Journal of Physical Education, Recreation & Dance, 86(6), 40–44. https://doi.org/10.1080/07303084.2015.1053635
Hirsch, A. C., & Parihar, H. S. (2014). A capstone course with a comprehensive and integrated review of the pharmacy curriculum and student assessment as a preparation for advanced pharmacy practice experiences. American Journal of Pharmaceutical Education, 78(10), Article 192. https://doi.org/10.5688/ajpe7810192
Hope, D. L., Grant, G. D., Rogers, G. D., & King, M. A. (2021). Integration of an extended, immersive, gamified pharmacy simulation as a capstone event. Pharmacy Education, 21(1), 656–669. https://doi.org/10.46542/pe.2021.211.656669
Hope, D. L., Rogers, G. D., Grant, G. D., & King, M. A. (2021). Experiential learning in a gamified pharmacy simulation: A qualitative exploration guided by semantic analysis. Pharmacy, 9(2), Article 81. https://doi.org/10.3390/pharmacy9020081
Kim, B. (2015). Understanding gamification. Library Technology Reports, 51(2). American Library Association. https://journals.ala.org/index.php/ltr/issue/download/502/252
Kolb, D. A. (1984). Experiential learning: Experience as the source of learning and development. Prentice-Hall.
Kolbe, M., Eppich, W., Rudolph, J., Meguerdichian, M., Catena, H., Cripps, A., Grant V., & Cheng, A. (2020). Managing psychological safety in debriefings: A dynamic balancing act. BMJ Simulation and Technology Enhanced Learning, 6(3), 164–171. https://doi.org/10.1136/bmjstel-2019-000470
Koster, A., Schalekamp, T., & Meijerman, I. (2017). Implementation of competency-based pharmacy education (CBPE). Pharmacy, 5(1), Article 10. https://doi.org/10.3390/pharmacy5010010
Krathwohl, D. R., Bloom, B. S., & Masia, B. B. (1964). Taxonomy of educational objectives, Handbook II: Affective domain. David McKay Company.
Landers, R. N., Auer, E. M., Collmus, A. B., & Armstrong, M. B. (2018). Gamification science, its history and future: Definitions and a research agenda. Simulation & Gaming, 49(3), 315–337. https://doi.org/10.1177/1046878118774385
Lean, J., Moizer, J., Towler, M., & Abbey, C. (2006). Simulations and games: Use and barriers in higher education. Active Learning in Higher Education, 7(3), 227–242. https://doi.org/10.1177/1469787406069056
Lewis, D. J., Saydak, S. J., Mierzwa, I. P., & Robinson, J. A. (1989). Gaming: A teaching strategy for adult learners. The Journal of Continuing Education in Nursing, 20(2), 80–84. https://doi.org/10.3928/0022-0124-19890301-09
Ma, X., & Cartwright, F. (2003). A longitudinal analysis of gender differences in affective outcomes in mathematics during middle and high school. School Effectiveness and School Improvement, 14(4), 413–439. https://doi.org/10.1076/sesi.14.4.413.17155
Mantzourani, E., Desselle, S., Le, J., Lonie, J. M., & Lucas, C. (2019). The role of reflective practice in healthcare professions: Next steps for pharmacy education and practice. Research in Social and Administrative Pharmacy, 15(12), 1476–1479. https://doi.org/10.1016/j.sapharm.2019.03.011
Matulewicz, A. T., Hammond, V., Patterson, J. A., Frankart, L. M., & Donohoe, K. L. (2020). Utilizing widely available podcasts to create a reflection activity for pharmacy students. Currents in Pharmacy Teaching and Learning, 12(10), 1215–1223. https://doi.org/10.1016/j.cptl.2020.05.003
McKauge, L., Stupans, I., Owen, S. M., Ryan, G., & Woulfe, J. (2011). Building critical reflection skills for lifelong learning in the emergent landscape of a national registration and accreditation scheme. Journal of Pharmacy Practice, 24(2), 235–240. https://doi.org/10.1177/0897190010397373
Miller, M. (2005). Teaching and learning in affective domain. In M. Orey (Ed.), Emerging perspectives on learning, teaching and technology (pp. 93–103). The Global Text Project. https://www.e-booksdirectory.com/details.php?ebook=10151
Mylrea, M. F., Sen Gupta, T., & Glass, B. D. (2017). Developing professional identity in undergraduate pharmacy students: A role for self-determination theory. Pharmacy, 5(2), Article 16. https://doi.org/10.3390/pharmacy5020016
Mylrea, M. F., Sen Gupta, T., & Glass, B. D. (2019). Design and evaluation of a professional identity development program for pharmacy students. American Journal of Pharmaceutical Education, 83(6), Article 6842. https://doi.org/10.5688/ajpe6842
Ogrinc, G., Armstrong, G. E., Dolansky, M. A., Singh, M. K., & Davies, L. (2019). SQUIRE-EDU (Standards for quality improvement reporting excellence in education): Publication guidelines for educational improvement. Academic Medicine, 94(10), 1461–1470. https://doi.org/10.1097/ACM.0000000000002750
Phillips, B. B., Newsome, A. S., Bland, C. M., Palmer, R., Smith, K., DeRemer, D. L., & Phan, S. V. (2019). Pharmacy student performance in a capstone course utilizing the pharmacists’ patient care process. American Journal of Pharmaceutical Education, 83(8), Article 7357. https://doi.org/10.5688/ajpe7357
Prensky, M. (2001). Fun, play and games: What makes games engaging. In Digital game-based learning (pp. 105–144). McGraw-Hill. https://marcprensky.com/writing/Prensky%20-%20Digital%20Game-Based%20Learning-Ch5.pdf
Reber, R., & Flammer, A. (2002). The development of gender differences in affective expression and in the relationship between mood and achievement-related self-judgments. European Journal of Psychology of Education, 17(4), Article 377. https://doi.org/10.1007/BF03173592
Rogers, G. D., McConnell, H. W., de Rooy, N. J., Ellem, F., & Lombard, M. (2014). A randomised controlled trial of extended immersion in multi-method continuing simulation to prepare senior medical students for practice as junior doctors. BMC Medical Education, 14, Article 90. https://doi.org/10.1186/1472-6920-14-90
Rogers, G. D., Mey, A., & Chan, P. C. (2017). Development of a phenomenologically derived method to assess affective learning in student journals following impactive educational experiences. Medical Teacher, 39(12), 1250–1260. https://doi.org/10.1080/0142159X.2017.1372566
Rogers, G. D., Mey, A., Chan, P. C., Lombard, M., & Miller, F. (2018). Development and validation of the Griffith University Affective Learning Scale (GUALS): A tool for assessing affective learning in health professional students’ reflective journals [Version 1]. MedEdPublish, 7(1). https://doi.org/10.15694/mep.2018.000002.1
Rose, T. M., & Unni, E. J. (2018). Using drawings to probe the affective experience of pharmacy students on rotation: A pilot study. Currents in Pharmacy Teaching and Learning, 10(8), 1033–1040. https://doi.org/10.1016/j.cptl.2018.05.011
Schoenly, L. (1994). Teaching in the affective domain. Journal of Continuing Education in Nursing, 25(5), 209–212. https://doi.org/10.3928/0022-0124-19940901-06
Schwabe, G., & Göth, C. (2005). Mobile learning with a mobile game: Design and motivational effects. Journal of Computer Assisted Learning, 21(3), 204–216. https://doi.org/10.1111/j.1365-2729.2005.00128.x
Severiens, S. E., & Ten Dam, G. T. M. (1994). Gender differences in learning styles: A narrative review and quantitative meta-analysis. Higher Education, 27(4), 487–501. https://doi.org/10.1007/BF01384906
Stephens, M., & Ormandy, P. (2019). An evidence-based approach to measuring affective domain development. Journal of Professional Nursing, 35(3), 216–223. https://doi.org/10.1016/j.profnurs.2018.12.004
Tomkins, L., & Ulus, E. (2015). "Oh, was that 'experiential learning'?!" Spaces, synergies and surprises with Kolb’s learning cycle. Management Learning, 47(2), 158–178. https://doi.org/10.1177/1350507615587451
van der Werf, J. J., Dekens-Konter, J., & Brouwers, J. R. B. J. (2004). A new model for teaching pharmaceutical care services management. Pharmacy Education, 4(4), 165–169. https://pharmacyeducation.fip.org/pharmacyeducation/article/view/74
Van Rossem, I., Devroey, D., De Paepe, K., Puttemans, F., Petit, P., Schol, S., Deridder, S., & Vandevoorde, J. (2019). A training game for students considering family medicine: An educational project report. Journal of Medicine and Life, 12(4), 411–418. https://doi.org/10.25122/jml-2019-0056
Vesa, M., & Harviainen, J. T. (2019). Gamification: Concepts, consequences, and critiques. Journal of Management Inquiry, 28(2), 128–130. https://doi.org/10.1177/1056492618790911
Weigel, F. K., & Bonica, M. (2014). An active learning approach to Bloom's taxonomy: 2 games, 2 classrooms, 2 methods. US Army Medical Department Journal, 2014(January–March), 21–29. https://link.gale.com/apps/doc/A361848302/AONE?u=griffith&sid=googleScholar&xid=015aed06
How to Cite
Copyright (c) 2023 Focus on Health Professional Education: A Multi-Professional Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
On acceptance for publication in FoHPE the copyright of the manuscript is signed over to ANZAHPE, the publisher of FoHPE.
Any reproduction of material published in FoHPE must have the express permission of the publisher.
Articles published in Focus on Health Professional Education (FoHPE) are available under Creative Commons Attribution Non-Commercial No Derivatives Licence (CC BY-NC-ND 4.0).