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Gamification in Critical Care Education and Practi ...
Gamification in Critical Care Education and Practice - 1
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All right, so my piece is to get you through the neurocognitive foundations of how gamification works. And when we talk about it, and Dr. Kaplan said, motivation is key. So what drives us? What motivates us? And we actually start at that bottom circle of behaviorist learning, where behavior will drive our learning, depending on our interaction with the environment. And that depends on how our interest is engaged, the emotion that it also evokes, the traits we have. I'll come back to cognitive, but also the self-determination. You saw that avatar, that need for competence, autonomy, and also social relatedness. So you saw this already from Dr. Kaplan, that when you look, and this is small, but when you go into the future, you're using active learning. And when you look at all the game design elements, that you need to show competence, so you want to have some feedback as well, that's happening here. And then the fact that we have that virtual ability gives you immediate feedback that you need to show competence. Also we need to show that continuous, sustained feedback, cumulative feedback that comes from the performance graphs you see, the badges, the leaderboards that are there. We've already talked about the autonomy, that we need to make those choices as that avatar. You have to have volitional engagement. That's what engages our brain the most. And then finally, that social relatedness, that we want to be able to see our teammates have some shared goals and meaningful stories. And so that's how we're going to engage people with this. And then so last, I want to talk a little bit about cognitive, the event-related brain potentials. How is the brain doing all this? So there's something, science is really interesting, something with the behavior, there's errors, and there's this rapid error correction that we make within 50 to 100 milliseconds, where there's a spontaneous error correction that we're making. But there's a more prolonged, and prolonged being 100 to 200 milliseconds, of feedback-related behavior change. So a behavior occurs, and if there's an error, you're going to have a compensatory behavior. And if a reward occurs, that's going to reinforce that behavior and strengthen it. So where does this come from? In the 1990s, they've done some really interesting work, but we found that it's mostly in the anterior cingulate gyrus that this is occurring, as well as the striatum. And what's driving this, that most of us know about, is dopamine. It comes from the nucleus accumbens, as well as the striatum negra, and the nucleus accumbens is in the basal, or the ventral forebrain. So this is what's driving that reward. So if you look back then, that error-related negativity that's happening very quickly, 50 to 100 milliseconds, that error commission happens, and spontaneously there's changes. But that feedback, as I mentioned before, takes a little longer, but our brain has encoded a reward prediction. And what happens next if there's an error? The dopamine-related phasic changes that occur in the striatum, and then amplitude modulation that occurs in the anterior cingulate gyrus is going to be key. So this is a little complicated, just going through it rapidly, is that, again, for time, 50 to 100 milliseconds, a response occurs, and that error-related negativity happens. What happens is that if there's an error trial, something's wrong, there actually is a decrease in the dopamine. And if you look here on the ordinate, this is actually negative. This is going more positive. There's a higher amplitude of this event-related negativity, which is going to have a fast response. And in that trial, that amplitude is dampened, whereas that feedback-related negativity that happens, and that's a little bit further out, as we talked in the 200 to 300 milliseconds that occurs, that when there's positive feedback, again, there's the increased dopamine, but actually has a positive or less high amplitude of a negative reaction that happens with negative feedback. So putting this into graphically or pictorially, the striatum has a prediction error that's encoded sitting in there, and then there's a reward or loss. And depending on whether there's a positive predictive error or a negative prediction error, there's going to be phasic changes in your dopamine, changes what's happening in the anterior cingulate gyrus, and then there's going to be a change in the amplitude that occurs, which is going to revise our predictions for the next time we do something, and we'll change our behavior based on that. So just so the essentials for you to be aware that these feedback-related negativities encodes this quantitative reward prediction, it's evoked by outcomes and stimuli that's going to predict the outcomes, and then the experience that we have with that gamification is going to shape both that feedback-related negativity and our behavior. And then the most important is that autonomy or volitional action is what maximally drives the system. So when we looked at animals, they were sort of forced to do something versus something they were doing more volitionally, it really changed the amplitude. So it's the fact that we have that autonomy. So anything in small doses may be fine, but as we know, things in large doses are not so good. The internet gaming disorder or behavioral addiction has been recognized. The DSM-5 text revision, textbook revision here in September of 2023 has described this as well as the World Health Organization, the ICD-11, that you become preoccupied, you can lose interest in other activities if you take away that gaming potential, that people actually have sadness, they're irritable, anxious. And then they have a tolerance as well that they have to gain more and more to be able to get the same positive reaction. So they can't curb that activity, they're using it to also solve their negative moods and they're continuing despite problems, they'll deceive family and friends and job and relations become jeopardy. So it's important to also recognize this. I'm going to turn it over for Dr.
Video Summary
The video discusses the neurocognitive foundation of gamification, highlighting how it influences motivation through behaviorist learning, emotional engagement, and self-determination (competence, autonomy, and social relatedness). It explains the brain's response to errors and rewards, emphasizing the role of dopamine in modifying behavior based on feedback. Key regions involved include the anterior cingulate gyrus and striatum. Autonomy maximizes engagement, but excessive gaming can lead to addiction issues recognized by DSM-5 and ICD-11, such as preoccupation, tolerance, and disrupted personal relationships.
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45-Minute Session | Beyond the Basics: A Comprehensive Session on Heat Management and Gamified Learning in Critical Care
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Year
2024
Keywords
gamification
neurocognitive
dopamine
addiction
self-determination
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