A Serious Game Series for Learning NICU Care

Abstract

Opportunities for medical and nursing students to experience neonatal intensive care unit (NICU) environments are limited by patient safety concerns and the complexity of neonatal care. Narrative-based serious games offer a route to vicarious clinical experience, yet the reasons why narrative should support learning in this particular setting are rarely made explicit, and educational content covering the transition from hospital to home remains scarce. This paper reports a two-phase, learner-driven design study conducted in Japan. In Phase 1 we developed and released “First Steps in the NICU: Discovery Edition” (First NICU), a six-chapter narrative visual novel; its development and its acceptance among the first 160 players have been reported previously. Here we present a previously unreported needs analysis drawn from the same voluntary post-game survey, now extended to 180 respondents (82 healthcare professionals or students, 98 members of the general public). Asked which topics future serious games should address, 105 of 180 respondents (58.3%) selected home support for children with medical complexity and 87 of 180 (48.3%) selected discharge support from the NICU, with school attendance for such children selected by 88 of 180 (48.9%); 144 of 180 (80.0%) selected discharge or home support, or both. Asked which scenes were most memorable, 82 of 180 (45.6%) named the brief discharge-support episode set in the general care unit, although it is one chapter of six and contains no acute clinical event. These learner-identified priorities directly informed Phase 2, the ongoing development of “First Steps in the NICU 2: Discharge Support Edition”, which simulates multidisciplinary discharge planning, parent education for home medical care and coordination with community services, and which introduces interactive mini-games for procedural tasks. We set out how each Phase 2 design decision was derived from Phase 1 findings and from narrative learning theory, and discuss what this sequence suggests for designing narrative serious games that span a care continuum. Because no objective assessment of learning was undertaken, the evidence reported here concerns acceptance and learner-expressed priorities rather than educational effectiveness.