THE DEVELOPMENT OF GRAPHIC: A SERIOUS GAME FOR DENTAL PUBLIC HEALTH EDUCATION

Abstract

GRAPHIC, a serious game for dental public health (DPH) education, stands for Games Research Applied to Public Health with Innovative Collaboration. The aim of this paper is to provide an overview of the development and refinement of GRAPHIC. According to the game concept, students firstly are provided with information of a population (a learning scenario), and then they are required to select the best five options of oral health promotion programme using contemporary evidence to improve the oral health of their population. This game has been used since academic year 2011/12. Feedback on the use of GRAPHIC was provided by staff and students annually, such that four versions of the game have been developed.

Methods: GRAPHIC was evaluated using data from pre- and post-knowledge tests, direct observation, indirect observation using log data of game activities, and feedback provided by students and tutors from feedback questionnaires, personal interviews, and focus group interviews.

Results: The first version [GRAPHIC-I] was developed and used for final year dental students at Kings College London in academic year 2011/12 and 2012/13. Students, tutors, and a game developer were interviewed in academic year 2012/13, demonstrating that the game was useful although improvements of the usability and entertainment were required. This led to the development of GRAPHIC-II, in which the usability was significantly improved; however, the entertainment aspect was not much improved although the game was more colourful. Since GRAPHIC-II seemed very helpful, it was considered to be used as an international learning tool, so the game was piloted in Mahidol University, Thailand. Using feedback from Mahidol students, GRAPHIC-III was developed in English and Thai versions to be used in academic year 2014/15. After game completion, as part of their DPH education, students from both institutions were assessed by pre- and post-knowledge tests, without any major problem of the usability, but they reported that the game could be more engaging. Log data showed the variation in attempts. Therefore, GRAPHIC-IV included an interactive feature to the learning scenario part, using Adobe Flash, where students could control a cartoon character walking around a town to find relevant information. Also, in this version students had limited attempts to submit answers (n=20). Together they enhanced the visual experience of the programme and encouraged students to provide considered responses. DPH knowledge was improved in both institutions, and this version rated as more engaging.

Conclusion: Serious games seem to be practical learning tool for DPH education, as they engage students to address the oral health needs of a population.