Game-Based Learning for Integrated Care Implementation

Abstract

Innovative organisational models are increasingly recognised as key to improving integrated care pathways and managing chronic disease, yet their success depends as much on professionals’ ability to adopt new organisational behaviours as on the quality of their design. Serious games and Game-Based Learning (GBL) have been extensively studied for clinical and interprofessional competencies (Maheu-Cadotte et al., 2021; Gentry et al., 2019), but little attention has been paid to how organisational innovations can be systematically translated into learning processes that support their implementation. This paper addresses this gap by taking the DARE Health project and its seven-pillar model for cardiovascular-kidney-metabolic (CKM) care (Gravili et al., 2026) as an illustrative organisational context. It asks how GBL can be designed to support the implementation of integrated care models in healthcare. The paper develops a conceptual framework and demonstrates its analytical and design implications through an illustrative application. Drawing on Normalisation Process Theory (NPT; May and Finch, 2009), Organisational Learning (Argyris and Schön, 1978), and the serious-game-mechanics literature (Arnab et al., 2015), it develops a conceptual framework that treats GBL as an implementation-oriented learning strategy rather than merely an instructional method. The framework uses the four NPT mechanisms of coherence, cognitive participation, collective action and reflexive monitoring as an organising logic for game design, without treating them as rigid sequential stages. Consequently, four design principles are derived, each mapped onto one NPT mechanism. The framework is illustrated by tracing a single DARE pillar across all four mechanisms and by analytically linking all seven pillars to the mechanism in which their principal normalisation challenge is located. The paper contributes three conceptual outputs: an implementation-oriented logic for GBL design, four theory-derived design principles, and a criterion-based mapping of the DARE pillars to their principal normalisation challenges. These outputs provide a theoretically grounded basis for subsequent game development and empirical evaluation.