Gamification: Revolutionising Healthcare Training for Leaders and Professionals

Gamification in healthcare is an effective tool for developing skills, engaging professionals and promoting a culture of excellence. Combining storytelling, practical experiences and cooperative environments, it enhances learning and well-being. Careful planning, alignment with organisational goals and continuous evaluation ensure strategic results, transforming training into opportunities for growth and improved performance.

Key Points

Gamification enhances skill development and engagement in healthcare training.

1. Interactive learning fosters a culture of excellence and well-being in organisations.
2. Storytelling and practical experiences improve knowledge retention and teamwork.
3. Effective planning ensures alignment with organisational goals and training success.
4. Continuous evaluation enhances learning impact and strategic healthcare improvements.

Introduction

Developing individuals is a constant challenge in every area of society. In today’s world, there is a growing demand for specific skills required for various positions and organisations. The complexity of the healthcare sector is amplified by the diversity of professions and the expected results in managing and delivering healthcare services. In the realm of healthcare leadership, there is a need for competencies and skills that transcend any technical training, demanding continuous updates and improvements to keep up with the rapid changes in the sector.

In 2023, the International Hospital Federation (IHF) developed a leadership model that presents the main competencies required for healthcare leaders. This model, which includes values, self-development, execution, relations and transformation, categorises more than 30 competencies into two main areas: action domains and enabling domains (IHF 2023). In this context, healthcare organisations are increasingly facing challenges in effectively training their leaders and teams to remain current and capable in their roles.

In the meantime, it is important not only to develop skills in teams but also to provide an environment in which learning is free from the pressure of achieving results. This approach views training as a way to strengthen a culture focused on excellence while also ensuring that these practices align with ideals of well-being and quality of life. Gamification appears to meet this need for training that engages leaders and professionals; this method focuses on developing specific skills through play, enhancing the results by integrating practical experiences.

Historically, from childhood through adolescence, we learn new skills and abilities through games. Board or digital games are traditionally used at home or even in formal education to develop logical reasoning, strategic thinking and other skills. Initially applied in education (Damaševičius et al. 2023), gamification arrives in healthcare area to bring new perspectives of training.

Playing has a powerful impact on the formation and development of human beings. It offers simulated, fictitious or real scenarios that allow individuals to experiment and obtain preliminary experience in a controlled, risk-free environment. This opportunity enables each professional and leader to maximise their potential. In fact, there are numerous publications on the application of gamification in healthcare, detailing the various methods employed (Al-Rayes et al. 2022; Muangsrinoon et al. 2018).

When a healthcare organisation fully aligns gamification with its purpose of developing the institution's leaders and professionals, significant results can be achieved:

• Knowledge Fixation. Using multiple human senses during the game enhances the retention of knowledge implicit in gamification. By incorporating elements that solidify concepts, theories and discussions, each professional can better grasp the material presented.
• Cooperation Environment. Even if some games involve competitions, they need to be designed to promote a healthy atmosphere with a specific focus on delivering value and results to the organisation. Therefore, it is essential to strengthen cooperative gamification within the same group, fostering better communication among participants.
• Organisational Climate and Well-being. Gamification practices also contribute to a better organisational climate. Unlike traditional training and meetings, gamification allows for a deeper connection between players and aligns it with the purposes of the healthcare organisation. Introducing play into the workspace also has the potential to increase the well-being of professionals and leaders, explicitly presenting innovative care and training approaches.
• Connection of Routine Issues with the Game. By participating in meetings as well as in planning new projects and processes, the team will make conceptual connections and draw on experiences related to the gamification process. This facilitates a better understanding of various situations and even offers an alternative way of managing conflicts, referencing aspects perceived during the games.

How to Plan Gamification in Healthcare

To effectively structure a gamification approach for training and developing healthcare leaders and professionals, we propose a series of steps that can help in this journey. There are different paths to take, all of which can lead the organisation to achieve its desired results.

The steps presented below reflect one approach to achieving effective gamification in healthcare. However, they can also be adapted for gamification aimed at patients and other stakeholders within the health service.

1. Planning

The first step is planning. During this phase, we will make decisions that will impact all the subsequent stages of building this gamification. It is recommended to dedicate the most time and effort to this stage, as it tends to make the entire process more effective by avoiding rework and communication issues between teams.

At this stage, we need to reflect on some essential questions and find answers that will guide us in the next steps:

• Is gamification the best strategy for sharing this knowledge? Do we have the time and resources to make it possible?
• What is the subject we want to work on and what results do we aim for with this gamification?
• Which professional category and hierarchical level will take part in this gamification? In other words: who is the public participating in gamification? What are their ways of learning, their professional desires and their main references?
• What resources will be needed and how can we make them effective?
• Which areas will need to contribute to and approve this gamification project?
• Can we conduct any benchmarking to evaluate the gamification we want to build?
• Is this an ongoing activity, a programme in the organisation, or a specific project with a clear beginning, middle and end?
• What story would we like to tell with this game and what meanings do we want to convey to those who play? What are the sensations and learnings that should be the criterion of the game?
• Will this training be linked to people development, quality management or another area? What skills do we want to develop? How is this gamification strategy aligned with the organisation's training plan?
• Can we clearly define the rules of this game? What will be the rewards for those who achieve better results? How are we going to motivate professionals to take part?

These questions need to be carefully evaluated, as your answers will help define each of the following steps.

2. Purpose and Objective

After making all the necessary decisions and clarifications during the Planning stage, we can define the purpose and goal of our gamification. It is particularly important that the game is well-aligned with the organisational strategy, so it requires establishing the proper connection between the gamification initiative and the strategic planning of the healthcare service.

To do this, wecan evaluate the strategic objectives outlined for each perspective of the organisation's balanced scorecard, as well as their relation to the result we aim to achieve through gamification. Moreover, since this initiative serves as a training strategy, it is important to ensure that the gamification aligns with the annual training and development plan for leaders and healthcare professionals.

In addition, this new game needs to be developed with a focus on communication and marketing within the healthcare service. It is crucial that the storytelling and the messages we want to convey have a direct and positive impact on the organisation's image. This analysis is necessary for the entire aesthetic of the game based on the story we aim to tell. The goal of this game is to reinforce the brand ideals, the institution's values and the meanings it wants to instil in the internal audience. We should also consider there whether the healthcare service already has a mascot, as this could be relevant for including it in some way in the gamification process.

From the point of view of the gamification goals, it is essential to understand what results we are aiming to achieve with the game. Are we seeking changes in behaviour, improvements in care or the adoption of best practices in project and process management?

Regardless of the result expected, gamification needs to be well evaluated as an instrument of positive change in the healthcare organisation. To achieve this, we need to establish the starting point through a current diagnosis. For example, if we want to improve adherence to the effective communication protocol among healthcare professionals, we need to assess the current level of adherence is and set clear improvement targets for the short, medium and long term.

Example: Currently, our adherence to the effective communication protocol in the paediatric ICU stands at 65%. To address this, we plan to implement a gamification strategy aimed at increasing adherence to the protocol from 65% to 85% by October 2025.

By establishing clear indicators and a well-defined SMART goal—Specific, Measurable, Achievable, Realistic and Time-bound—we can focus our gamification efforts on achieving desired results. This approach enhances clarity for the project and for everyone involved in its development.

3. Storytelling

Now that we know what we want to achieve, we can consider what story would help us reach that outcome. Some healthcare organisations may opt for new themes or adapt stories that are already familiar to those involved. The most important thing here is to select a theme that motivates and engages participants to play.

It is also important to consider the feeling of belonging when telling stories. We should craft narratives that make sense for the profiles of the leaders and healthcare professionals participating in the gamification process. This consideration will also affect the next steps, as all symbolic elements will be anchored in this reality.

So, if we want to implement a sustainability programme through gamification, it makes sense to incorporate elements from nature and its developments. Conversely, if we are discussing healthcare processes, we could use a pizzeria theme to illustrate the clear steps of inputs and outputs of this processing. In other words, we need to make deliberate choices about the themes and stories we are going to tell, recognising that all the subsequent elements will be connected to it.

Format and Method

Now we have a clear understanding of the result we desire and the story we want to tell. The time has come to decide how are we going to tell this story and how we want people to interact and engage in this gamification.

One option is to develop digital strategies, which can take the form of software, application or live events held via videoconference. For in-person games, some aspects specific to healthcare need to be addressed.

If the activities are carried out in care environments, it is essential to consult with the infection control team to determine the appropriate areas for the experience. This includes evaluating the types of materials that can be used, sanitised or discarded, as well as assessing the team's availability and the suitability of the environment for the game.

In both digital and face-to-face formats, the choice will be based on the profile of the audience we want to reach and how best to present the activity. If it is a one-time event, we need to consider the available resources for this investment. If it is an ongoing programme, we must think about how to maintain engagement among participants.

In the case of digital strategies, there are several effective examples, including:

• a scoring system and rewards for adherence to patient safety practices;
• monitoring panels for training in specific areas;
• badges of recognition of compliance with quality requirements;
• games featuring missions designed to improve communication between the participants etc.

For physical or face-to-face strategies, we can utilise:

• board games for learning certain topics;
• card games to promote cooperation in various activities;
• realistic simulations with rewards for correct answers;
• question-and-answer games;
• treasure hunts and other possibilities aligned with the defined storytelling.

There is not a universally "good" or "bad" form of gamification; rather, its adequacy and effectiveness depend on how well it aligns with the objectives set for the healthcare organisation. So, allow yourself to learn and innovate with different formats.

Other essential points during this phase include the structuring of game levels, identifying challenges to overcome, providing practical solutions, defining missions to complete and mapping the player's entire journey.

5. Structuring and Communication

After conducting all these steps of gamification planning, it is time to structure the game itself. To do this, you can hire suppliers or collaborate with your internal team to develop a digital strategy or physical materials.

At this stage, you will bring your ideas to life and identify elements that effectively tell all the stories of your gamification project in a suitable way and to the expected standard. Creating a good game does not necessarily require a large budget; instead, it is important to find the materials and equipment that align with your intended investment.

Therefore, this phase requires thorough research to identify quality suppliers and companies that can either provide, create or customise the items needed for your healthcare unit game. In addition to the elements of the game itself, it may be important to evaluate costumes that fit the theme and to create video and audio content that help participants visualise their experience. Practical role-playing contributions from those involved also enhance the experience.

As with the entire structuring of gamification, the communication of this strategy to the participants must align with the storytelling and the desired objectives. That is why it is important to develop a specific communication plan that should focus on engaging professionals, creating suspense and interest, and sharing the results achieved through gamification.

6. Implementation and Evaluation

After preparing everything with great enthusiasm and dedication, it is time to put the plan into action. Regardless of the format, digital or physical, this game and its gamification project for healthcare require mastery in the execution of each part of the story.

Since this is a playful endeavour, the professionals facilitating the gamification need to be fully immersed in the theme. They need to understand every part and stage of the process to guide the participants in a safe and effective way. Inadequate instruction can lead to significant frustration within a team, as they may feel harmed. Therefore, just as thorough planning was essential, effective execution is equally important.

To ensure a good result, we strongly recommend conducting preliminary tests and providing intense training for the gamification promoters. This ensures that everyone is aligned and fully aware of their roles.

After completing the gamification, it is crucial to conduct a reaction evaluation and satisfaction survey. The insights collected should inform revisions for future projects. In addition, a follow-up evaluation in the medium term is important: this allows you, for example, to check the effectiveness of the training and the retention of content.

Considerations

Developing healthcare skills is a growing challenge due to the complexity of the sector, which demands both technical and behavioural skills that must be constantly updated. Gamification has emerged as an innovative strategy to train leaders and professionals by allowing them to experience practical situations in a safe environment. This approach promotes learning, engagement and knowledge retention. When gamification is well-structured and aligned with organisational objectives, it transforms training into meaningful experiences, strengthening the culture of excellence and well-being in the workplace (Pereira et al. 2014).

The effectiveness of gamification depends on careful planning that considers the target audience, establishes clear aims and evaluates available resources. Incorporating elements such as storytelling, game mechanics and alignment with organisational values enhance the impact of the method. In addition, the creation of a cooperative environment during the game favours communication, strengthens teams and helps internalise safe care and management practices, contributing to improvements in the organisational climate.

Finally, the success of gamification is linked to its continuous execution and evaluation. Training facilitators, conducting tests and monitoring results are essential to ensure the effectiveness of the training. Additionally, adapting strategies to meet the specific needs of the institution allows gamification to serve not only as a learning tool but also as a mechanism for transformation and strategic alignment within healthcare organisations.

Conflict of Interest

None