Gamification of Critical Care Medical Education: ICUlympics

Background: Gamification in graduate medical education (GME) has been shown to enhance clinical training, and trainees positively perceive it, yet the evidence is limited in critical care medicine education. Objectives: To assess the educational impact on residents of the ICUlympics, a critical care medicine-based competition-style medical game series set with an initial classificatory phase (three days of one-hour critical care medicine-based games: Day 1: Kahoot!; Day 2: Kahoot! Reloaded; and Day 3: Under Pressure) and the follow-up "finals" (a final competition day among the top three performers: Day 4: Jeopardy!). Methods: We designed a single-center prospective pilot study. We first anonymously surveyed a cohort of residents who rotate in our intensive care unit and obtained a baseline critical care medicine knowledge score through a cognitive test composed of 20 multiple-choice questions (maximum score, 20) and a baseline of residents' perceptions and satisfaction toward medical education games using a five-point Likert eight-item survey (baseline survey). We then deployed the ICUlympics competition in May 2022. Thirty days later, we surveyed the cohort (postintervention survey). We assessed residents' changes in clinical knowledge scores, perceptions, and satisfaction scores toward medical education games according to their participation in the ICUlympics and baseline cohort scores. Results: Sixty-eight residents (73.9% of eligible trainees) participated in the baseline survey, and 48 (52.2%) completed the postintervention survey. Nineteen residents (20.6%) participated in all three days of the ICUlympics classificatory phase, and 25 (27.2%) did not participate in any day. The clinical knowledge score measured was higher in residents who participated in the ICUlympics compared with nonparticipating residents (14.2 ± 2.1 vs. 9.8 ± 2.9; P < 0.001) and residents' baseline clinical knowledge (14.2 ± 2.1 vs. 10.7 ± 2.4; P < 0.001). Residents who participated in the ICUlympics, compared with those who did not, had more favorable perceptions of and satisfaction with games in medical education. Conclusions: The ICUlympics, a competition-style series of educational games for critical care medicine, increases residents' critical care clinical knowledge while promoting positive perceptions of and higher satisfaction with gamification in medical education.