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Book Excerpt : Serious Games: Games That Educate, Train, and Inform - Games for Physical and Mental Health
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Book Excerpt : Serious Games: Games That Educate, Train, and Inform - Games for Physical and Mental Health

October 31, 2005 Article Start Page 1 of 2 Next

The following is an excerpt from Serious Games: Games That Educate, Train, and Inform (ISBN 1592006221) published by Thomson Course Technology.


Healthcare professionals are looking to utilize the educational benefits of video games. A number of serious games now exist that target healthcare and well-being, like the “exergaming” game, Yourself!Fitness, and the biofeedback game, The Wild Divine Project, which combines breathing techniques and meditation with biofeedback. These new genres are recent developments.

More importantly, there has been an increase in the amount of research done in this area. In some of the research, games are used to probe the nature of the patient's condition. In other studies, the games are used therapeutically. Studies based on outcome research have always found positive implications of using games.

Dr. Mark Wiederhold, co-founder of the Virtual Reality Medical Center , talked about the many uses of video games (which he equated with “virtual reality”) in modern medicine during his presentation, “The Potential of Games in Healthcare,” at the 2004 Serious Games Summit in Washington , D.C. Some examples he gave were

  • Using video games to distract patients during painful medical procedures.
  • Using simulations to improve rehabilitation.
  • Using virtual reality (VR) environments to improve motor skills.
  • Using video games for therapeutic interventions.

Dr. Wiederhold's presentation focused on the use of inexpensive, off-the-shelf software and equipment. Especially inexpensive. “If it's not inexpensive, it won't be used,” he stated. Some games are less suitable to healthcare purposes, but others have been surprisingly effective. He talked about using first-person shooter (FPS) games to treat fear spiders, since shooting seems effective in that case, but he added that he would like to move past that to gameplay mechanics that offered more depth.

Japanese game companies have paved the way for wider mainstream acceptance of serious games with healthcare benefits. Namco has created “rehabilitainment” products, also called “games for elders,” and in 1999, entered the nursing home business. Konami, which acquired a fitness club franchise in 2001, expanded its brand with Konami Sports Club and Self Fitness Club and has been instrumental in merging fitness with entertainment. Similarly, Taito is moving into “amusement training.” Unfortunately, in the U.S., healthcare games have largely been developed by independents, nonprofits, healthcare professionals, or concerned parents.

Hospitals and Medicine

Hospitals and larger clinics, often partnering with non-profit organizations and research facilities, have begun to experiment with alternatives to traditional treatments and therapies. Among their experiments have been a growing number that attempt to integrate video games into the treatment and recovery process. Video games have been used to distract patients during painful medical procedures as well as to improve motor skills in physical therapy and to speed recovery for certain operations and conditions.

On the other side of the treatment equation, doctors and other healthcare professionals are beginning to use video games as training tools. The advantages of being able to practice delicate surgery or dangerous procedures without having to actually perform the surgery or procedure on a living person are obvious.

Distraction Therapy

How much pain a person experiences often depends on how much conscious attention the person gives to the pain signals. Video games and virtual reality (VR), with their ability to immerse the individual in a computer-generated environment, have been shown to be effective in focusing a patient's attention away from their medical treatment and the pain they are experiencing. Immersed in the world of the game, they are not as consciously aware of what is going on around them, and they miss a proportion of the pain signals.

The Believe In Tomorrow Foundation, an organization founded in 1982 with the goal of improving the quality of life for critically ill children, has long been an advocate of the use of virtual reality or computer games for pain management. The foundation's Management and Distraction Technology program uses distraction as a pain management technique and has been employed in hospitals nationwide for almost two decades. Participating doctors and hospitals give children kaleidoscopes, squeeze balls, hand-held video games, and so on, before and after treatment. This teaches children an important key to enduring pain: Don't focus on the painful stimuli. The squeeze ball or the video game gives them something else to focus on and think about. Video games, particularly those with virtual reality (VR) immersion via headsets or similar technology, are a recent extension of that program.

The distraction is important before the treatment or procedure as well. Everyone is anxious before surgery and most other medical procedures. This is called anticipatory anxiety. Children seem to feel anticipatory anxiety more deeply than adults, to the extent that sometimes children need to be held down even for a simple injection with a hypodermic needle. The same distraction techniques can be used to alleviate anticipatory anxiety.

The Believe In Tomorrow Foundation found that developing games on its own, or contracting with experienced game developers, was cost-prohibitive. The immense budgets of modern games were beyond the foundation's nonprofit, donation-funded means. Thus the foundation sought partnerships, such as the one with BreakAway Games. BreakAway Games, intent on showcasing the effectiveness of its serious games products, donated its deep sea diving simulator for use by the foundation.

In the summer of 2005, the Believe In Tomorrow Foundation will be conducting a new study in the effectiveness of VR techniques. Specifically, the study will compare a patient's pain tolerance when playing a video game to that when interacting in a VR environment. The goal of the study is to show that immersive VR is even more effective than playing normal video games, either handheld or on a console with a TV.


A key element in the treatment of chronic diseases, such as asthma and diabetes, is self-management. It is imperative that the patients adjust their lifestyle and habits to deal with the disease. The consequences of ignoring chronic conditions could be increased health problems or even death.

In 2000, Patient Education & Counseling reported on Watch, Discover, Think, and Act, a computer game designed to enhance self-management skills and improve asthma outcomes in inner-city children with asthma. Children ages six to seventeen years old from four pediatric practices were selected and randomly assigned to either use the computer game or the usual asthma education and treatment. The game's protagonist's asthma condition was tailored to match those of the child's, and, at the child's choice, the main character in the game could also be made to match their own gender and ethnicity. The children played the computer game as part of their regular asthma visits. The study found that the treatment associated with the computer game resulted in “fewer hospitalizations, better symptom scores, increased functional status, greater knowledge of asthma management, and better child self-management behavior.”

In the same vein, Packie & Marlon, by ClickHealth, was designed to help children and teenagers with diabetes improve their diabetes self-management. The game, originally released for the Nintendo SNES and Windows 95, saw use at home, in hospitals, in clinic waiting rooms, and in diabetes summer camps. In a clinical study performed with the National Institutes of Health, ClickHealth found that children who played Packie & Marlon showed gains in self-efficacy, communication with parents, and diabetes self-care. They also had fewer urgent doctor visits for diabetes-related problems. More recently, in early 2005, Guidance Interactive Healthcare released Glucoboy, a glucose meter that can be connected to a Nintendo GameBoy. As a reward for maintaining good blood sugar control, Glucoboy downloads video game programs into the GameBoy.

Article Start Page 1 of 2 Next

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