Boston Researchers Show Improved Health Outcomes in Patients Educated Through an Online Game Format (1)

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21 August 2017

In a Diabetes Care article titled “A Team-Based Online Game Improves Blood Glucose Control in Veterans With Type 2 Diabetes: A Randomized, Controlled Trial” published by the American Diabetes Association online on Aug 8 2017, researchers showed that ‘diabetes self-management education (DSME) game patients had significantly greater HbA1c reductions over 12 months than civics game patients (28 mmol/mol [95% CI 210 to 27] and 25 mmol/mol [95% CI27 to23], respectively; P = 0.048).’


The study aimed to investigate ‘whether an online team-based game delivering diabetes self-management education (DSME) to patients via e-mail or mobile app could generate longer-term improvements in hemoglobin A1c (HbA1c).’


The article explains that the use of ‘a novel form of online education (termed spaced education[SE]) based on two robust psychological phenomena (the spacing and testing effects) can improve long-term retention of learning and generate meaningful behavior change.’


‘Delivered via e-mail or mobile application, SE presents clinical case scenarios accompanied by multiple-choice questions. Participants are asked to submit answers and are then immediately presented with the correct answer(s) and an explanation of the topic. The material is represented in a cycled pattern to reinforce the content over weeks and months. [Previous] randomized trials involving health care providers have shown that the SE methodology improves knowledge acquisition, boosts learning retention for up to 2 years, and durably improves clinical performance.


Incorporated game mechanics [such as] competition among participants and adaptive content delivery that is modified based on a participants past performance [are also integrated]. Team based competition within SE games generates significantly stronger engagement among participants, and an SE game delivered to clinicians led to significantly improved health measures of their patients.’


*Please note the original article is referenced below and has been directly quoted.


If you’d like to learn more about this educational instructional design method and how liV could support its use for one of your current educational initiatives, please contact Namita Vashi by email at



(1) B. Price Kerfoot, David R. Gagnon, Graham T. McMahon, Jay D. Orlander, Katherine E. Kurgansky and Paul R. Conlin. A Team-Based Online Game Improves Blood Glucose Control in Veterans With Type 2 Diabetes: A Randomized, Controlled Trial; Diabetes Care 2017 Jul; dc170310.


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