End-users' involvement in the development of serious games for healthcare professions education, a systematic descriptive review (Preprint)
BACKGROUND Based on ethical and methodological arguments, numerous calls have been made to increase end-user involvement in serious game (SG) development. Involving end-users is seen as a way to give them power and control over an educational software designed for them. It can also help identify areas for improvement in SG design and improve its efficacy on targeted learning outcomes. However, no recognized guidelines or framework exist to guide end-user involvement in SG development. OBJECTIVE To describe how end-users are involved in the development of SGs for healthcare professions education. METHODS We examined the literature presenting the development of 45 SGs that had reached the stage of efficacy evaluation in randomized trials. One author performed data extraction using an ad hoc form based on an SG design framework. Data were then coded and synthesized based on similarities. The coding scheme was refined iteratively with the involvement of a second author. Results are presented using frequencies and percentages. RESULTS End-user involvement was mentioned in the development of 21/45 SGs. The number of end-users involved ranged from 12 to 36. End-users were often involved to answer specific concerns that arose during the SG development (n = 6) or in the testing of a prototype (n = 12). In many cases, researchers solicited input from end-users regarding the goals to reach (n = 10) or the functional esthetics of the SGs (n = 7). Most researchers used self-reported questionnaires (n = 7). CONCLUSIONS Researchers mention end-user involvement, which is also poorly described, in the development of less than half of SGs identified. This represents significant limitations to the evaluation of the impact of their involvement on SG efficacy and in making recommendations.