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By the time the students have finished playing the serious game, what will they be able to demonstrate / explain / analyse etc.?
See if you can start your learning objective using one of Bloom's taxonomy verbs

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What is Bloom's Taxonomy

Bloom's Taxonomy is a classification of the different outcomes and skills that educators set for their students (learning outcomes). The taxonomy was proposed in 1956 by Benjamin Bloom, an educational psychologist at the University of Chicago. The terminology has been recently updated to include the following six levels of learning. These 6 levels can be used to structure the learning outcomes, lessons, and assessments of your course. :

1. Remembering: Retrieving, recognizing, and recalling relevant knowledge from long‐term memory.

2. Understanding: Constructing meaning from oral, written, and graphic messages through interpreting, exemplifying, classifying, summarizing, inferring, comparing, and explaining.

3. Applying: Carrying out or using a procedure for executing, or implementing.

4. Analyzing: Breaking material into constituent parts, determining how the parts relate to one another and to an overall structure or purpose through differentiating, organizing, and attributing.

5. Evaluating: Making judgments based on criteria and standards through checking and critiquing.

6. Creating: Putting elements together to form a coherent or functional whole; reorganizing elements into a new pattern or structure through generating, planning, or producing.

Like other taxonomies, Bloom's is hierarchical, meaning that learning at the higher levels is dependent on having attained prerequisite knowledge and skills at lower levels. You will see Bloom's Taxonomy often displayed as a pyramid graphic to help demonstrate this hierarchy. We have updated this pyramid into a "cake-style" hierarchy to emphasize that each level is built on a foundation of the previous levels.

You may use this graphic for educational or non-profit use if you include a credit for Jessica Shabatura and citation back to this website.
How Bloom's can aid in course design

Bloom's taxonomy is a powerful tool to help develop learning outcomes because it explains the process of learning:

Before you can understand a concept, you must remember it.

To apply a concept you must first understand it.

In order to evaluate a process, you must have analyzed it.

To create an accurate conclusion, you must have completed a thorough evaluation.

However, we don't always start with lower order skills and step all the way through the entire taxonomy for each concept you present in your course. That approach would become tedious-for both you and your students! Instead, start by considering the level of learners in your course:

1. Are lots of your students freshman? Is this an "Introduction to..." course? If so, many your learning outcomes may target the lower order Bloom's skills, because your students are building foundational knowledge. However, even in this situation we would strive to move a few of your outcomes into the applying and analyzing level, but getting too far up in the taxonomy could create frustration and unachievable goals.

2. Are most of your students juniors and seniors? Graduate students? Do your students have a solid foundation in much of the terminology and processes you will be working on your course? If so, then you should not have many remembering and understanding level outcomes. You may need a few, for any radically new concepts specific to your course. However, these advanced students should be able to master higher-order learning objectives. Too many lower level outcomes might cause boredom or apathy.

How Bloom's works with learning outcomes

Fortunately, there are "verb tables" to help identify which action verbs align with each level in Bloom's Taxonomy.

You may notice that some of these verbs on the table are associated with multiple Bloom's Taxonomy levels. These "multilevel-verbs" are actions that could apply to different activities. For example, you could have an outcome that states "At the end of this lesson, students will be able to explain the difference between H2O and OH-." This would be an understanding level outcome. However, if you wanted the students to be able to "... explain the shift in the chemical structure of water throughout its various phases." This would be an analyzing level verb.

Adding to this confusion, you can locate Bloom's verb charts that will list verbs at levels different from what we list below. Just keep in mind that it is the skill, action or activity you will teach using that verb that determines the Bloom's Taxonomy level.

Bloom's Level

Key Verbs (keywords)

Example Learning Outcome

Evaluate
choose, support, relate, determine, defend, judge, grade, compare, contrast, argue, justify, support, convince, select, evaluate.

By the end of this lesson, the student will be able to determine whether using conservation of energy or conservation of momentum would be more appropriate for solving a dynamics problem.

Learning outcome examples adapted from, Nelson Baker at Georgia Tech: nelson.baker@pe.gatech.edu
How Bloom's works with Quality Matters

For a course to meet the Quality Matters standards it must have learning outcomes that are measurable. Using a verb table like the one above will help you avoid verbs that cannot be quantified, like: understand, learn, appreciate, or enjoy. Quality Matters also requires that your course assessments (activities, projects, and exams) align with your learning outcomes. For example, if your learning outcome has an application level verb, such as "present", then you cannot demonstrate that your students have mastered that learning outcome by simply having a multiple choice quiz.

Course level and lesson level outcomes

The biggest difference between course and lesson level outcomes is that we don't directly assess course level outcomes. Course level outcomes are just too broad. Instead, we use several lesson level outcomes to demonstrate mastery of one course level outcome. To create good course level outcomes, we need to ask ourselves: "what do I want the students to have mastery of at the end of the course?" Then, after we finalize our course level outcomes, we have to make sure that mastery of all of the lesson level outcomes underneath confirm that a student has mastery of the course level outcome-in other words, if your students can prove (through assessment) that they can do each and every one of the lesson level outcomes in that section, then you as an instructor agree they have mastery of the course level outcome.

How Bloom's works with course level and lesson level outcomes:

Course level outcomes are broad. You may only have 3-5 course level outcomes. They would be difficult to measure directly because they overarch the topics of your entire course.

Lesson level outcomes are what we use to demonstrate that a student has mastery of the course level outcomes. We do this by building lesson level outcomes that build toward the course level outcome. For example, a student might need to demonstrate mastery of 8 lesson level outcomes in order to demonstrate mastery of one course level outcome.

Because the lesson level outcomes directly support the course level outcomes, they need to build up the Bloom's taxonomy to help your students reach mastery of the course level outcomes. Use Bloom's Taxonomy to make sure that the verbs you choose for your lesson level outcomes build up to the level of the verb that is in the course level outcome. The lesson level verbs can be below or equal to the course level verb, but they CANNOT be higher in level. For example, your course level verb might be an Applying level verb, "illustrate." Your lesson level verbs can be from any Bloom's level that is equal or below this level (applying, understanding, or remembering).

Steps towards writing effective learning outcomes:

1. Make sure there is one measurable verb in each objective.

2. Each outcome needs one verb. Either a student can master the outcome , or they fail to master it. If an outcome has two verbs (say, define and apply), what happens if a student can define, but not apply? Are they demonstrating mastery?

3. Ensure that the verbs in the course level outcome are at least at the highest Bloom's Taxonomy as the highest lesson level outcomes that support it. (Because we can't verify they can evaluate if our lessons only taught them (and assessed) to define.)

4. Strive to keep all your learning outcomes measurable, clear and concise.

When you are ready to write, it can be helpful to list the level of Bloom's next to the verb you choose in parentheses. For example:

Course level outcome 1. (apply) Demonstrate how transportation is a critical link in the supply chain.

1.1. (understand) Discuss the changing global landscape for businesses and other organizations that are driving change in the global environment.

1.2. (apply) Demonstrate the special nature of transportation demand and the influence of transportation on companies and their supply chains operating in a global economy.

This trick will help you quickly see what level verbs you have. It will also let you check that the course level outcome is at least as high of a Bloom's level as any of the lesson level outcomes underneath.

Before you begin constructing your outcomes:

Please read our Learning Outcome : Before and After Examples page.

Additional External Resources:

For a longer list of Bloom's Verbs - TIPS tip: You can also use the "find" function (press: Ctrl-f or command-f on a mac) in your browser to locate specific verbs on this list.

To see how Bloom's can be applied specifically to distance education: Digital Approaches to Bloom's Taxonomy

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Using Bloom's Taxonomy to Write Effective Learning Outcomes

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Bloom's Taxonomy is a classification of the different outcomes and skills that educators set for their students (learning outcomes). The taxonomy was proposed in 1956 by Benjamin Bloom, an educational psychologist at the University of Chicago. The terminology has been recently updated to include the following six levels of learning.

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What are students doing and how do the students know if they are doing it well/progress?

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Think people, skills, equipment, time, support

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Can you mock up a screenshot or three together?

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Can you mock up a screenshot or three together?

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It doesn't have to look amazing! Anything from MS Paint upwards is helpful (but time is short!)

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Might there be social elements? A narrative? Unlocks? Badges...

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Highlights

*
Motivational effects of gamification are analysed from an educational psychology perspective.

*
Gamification is not effective per se, but different game design elements can trigger different motivational outcomes.

*
A self-determination theory framework was used to study the effects of different configurations of game design elements.

*
Competence and autonomy regarding task meaningfulness was affected by badges, leaderboards, and performance graphs.

*
Social relatedness was positively influenced by avatars, a meaningful story, and teammates.

Abstract

The main aim of gamification, i.e. the implementation of game design elements in real-world contexts for non-gaming purposes, is to foster human motivation and performance in regard to a given activity. Previous research, although not entirely conclusive, generally supports the hypothesis underlying this aim. However, previous studies have often treated gamification as a generic construct, neglecting the fact that there are many different game design elements which can result in very diverse applications. Based on a self-determination theory framework, we present the results of a randomized controlled study that used an online simulation environment. We deliberately varied different configurations of game design elements, and analysed them in regard to their effect on the fulfilment of basic psychological needs. Our results show that badges, leaderboards, and performance graphs positively affect competence need satisfaction, as well as perceived task meaningfulness, while avatars, meaningful stories, and teammates affect experiences of social relatedness. Perceived decision freedom, however, could not be affected as intended. We interpret these findings as general support for our main hypothesis that gamification is not effective per se, but that specific game design elements have specific psychological effects. Consequences for further research, in particular the importance of treatment checks, are discussed.

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How gamification motivates: An experimental study of the effects of specific game design elements on psychological need satisfaction

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Motivational effects of gamification are analysed from an educational psychology perspective. * Gamification is not effective per se, but different game design elements can trigger different motivational outcomes. * A self-determination theory framework was used to study the effects of different configurations of game design elements.

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How is digital accessibility defined? Are there any standards you can find? What about students who may not have the latest devices?

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How will this serious game work alongside the existing curriculum? 

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How will this serious game work alongside the existing curriculum? 

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For example, do they do scenarios based on what they've seen in a clinical placement?

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Think Kirkpatrick levels - level 1 is usually straightforward, as a stretch goal, can you explore levels 2 and ideally 3? You would usually use a mix of quantitative data (maybe in-game analytics) and qualitative data

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All students can put hearts on the last box; please vote for one other column (not your own!) and we will see which game is the most popular

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Students are given an avatar that can interact with the MDT to complete various scenarios pertaining to GMC guidelines as presented in cases (Immersive Experience?)

Students will be able to embed and demonstrate the application of GMC guidance in preparation for the SJT

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Objectives:
Differentiating between ECG readings.

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visual novel concept
text heavy as reflects the fact clinicians need to read between lines
different outcomes open up depend ent on what the player chooses at each stage

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Learning objective

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The aim is to review the patient's prescriptions for their ailments, and see what could be narrowed down/what needs to be introduced.

- mental health
- cardiology
- polypharmacy

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Take History
Determine if ECG is appropriate
Make an ECG reading
Determine next steps

Feedback provided after each case.

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Choose your own adventure style serious game

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Choose your own adventure style serious game

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> Develop history taking skills through first person video experiences
> Analyse investigations
> Apply suitable management plans in a simulated setting

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Learning the most common emergency medicine presentations

Different levels depending on year:
- History taking
- A to E
- Triage
- Examination
- Investigations
- Interpretation of result
- Management
- Future care

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Demonstrate: understand how to select the appropriate method of imaging for each clinical scenario presented, if it is needed. Then be able to interpret it the clinical image produced. Then understand what further clinical information is needed and devising a plan.

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Increase BNF competency
Writing prescriptions
Medicine reconciliation

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 Educate Pre-Clinical Students About Professionalism 

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 Educate Pre-Clinical Students About Professionalism 

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Objectives: Students should be able to explain and successfully demonstrate knowledge of the concepts detailed in the Good Medical Practice handbook (e.g., teamwork, leadership, communication)

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programmers
permissions from a textbook
medical writers
artists to make it visually appealing
3d modelling expertise
sound designers to create an enjoyable experience

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not many assets so easy to code

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Interpret radiological imaging:
- identify anatomical structures
- indentify pathology
- make clinical decisions based on imaging
- select appropriate imaging modalities

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Programmers
Doctors
Technicians
Graphic Designers
ECG database
University funding?
Software

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Stages of pregnancy

identify

describe

progression

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stages from conception to delivery

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Broad aim to get a broad experience out of it

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MI identification and management.

Identification - cover main signs and symptoms

Management - initial management (aspirin, clopidogrel, etc.) and definitive management (PCI)

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Chatboxes/Discussion areas.
Scores and Badges.
Leaderboards and competition between students.

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Getting a presentation (person presents with vague symptoms), triaging to A and E/GP and get more information, select tests, make diagnosis, management

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unity
knowledgable embryologist and obgyns

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Ultrasound, CT, MRI, retinal photography.

Identify pathologies on the X-ray for example, using a mouse or a touch screen.

Stratified on type of scan and pathology and levels of difficulty (red, amber, green depending on the stage of medical education).

User function of scanning in patient imaging and the app correlates it with existing images on the app.

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Game software (unity)?
Access to clinical data (what people present with)
Bank of ECGs, can be actual clinical data or mockups

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Can you mock up a screenshot or three together? 

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Can you mock up a screenshot or three together? 

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level up stages
progression stages
customisation to make more personable
alternate pregnancies to "normal" pregnancy

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use coding platform like unity to make it possible to use on low end devices

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How will this serious game work alongside the existing curriculum? 

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How will this serious game work alongside the existing curriculum? 

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integrate into development and ageing module to replace very long pregnancy and embryology lectures

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will it still teach the students the information in sufficient detail

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Learning Objectives: Teach Histology Better (More Clinically Integrated)

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Learning Objectives: Teach Histology Better (More Clinically Integrated)

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Teaching Histology:
- Recognising types cells and tissue
- Grade dysplasia
- Differentiate between normal and pathological plates

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comparison between different year groups and/or same year but spilt into groups

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People skills: Pharmacists, doctors, programming
Equipment: BNF, computer?, gaming console, calculator.
Time:
Support: Tech

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Using the Google Doodle Olympics idea. Go round the RPG game using retrograde. Each part of the compass - going through different things. The games would be the following:
1) Anatomy
2) History Taking
3) ECG taking
4) Examination (Resp/Cardio)
5) Imaging (click on the pathology)
6) blood Result interpretation (move character to it)
7) Pharmacology side effects

Confetti thrown at you at the end with a winning video. Terrible retro graphics to aid remembering learning).

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- Students will be presented with various scenarios and have answer options
- Ranking/ point system based on student responses (where it is assumed that higher points =   knowledge acquisition) with in-built text explanation following each scenario to help educate students on why (or why not) their responses were correct
- Different levels of difficulty to assess progress

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Serious game works alongside main curriculum

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Serious game works alongside main curriculum

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- Practice core / key clinical skills under time-pressure and a 'close to reality' environment
- Demonstrate competency in key skills
- Analyse performance of clinical skills and have the opportunity to reflect / receive feedback

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Everyone starts with medical student level taking hx and then if you answer correctly you can move on to the next step so for example A to E.

If get something wrong you don't terminate the game but patient outcome is unfavourable (patients deteriorate) and you need to try and go back to right path. Some key steps will terminate the game if wrong

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Select correct imaging -> feedback
Review imaging and note findings -> feedback
Diagnosis -> feedback
Management plan -> feedback

Depending on level students could only go up to a certain level

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different music options
creating and writing enjoyable characters
build in unpredictability into game to make it spontaneous
tertiary gameloop could involve building up relationships / your own career/practice, sense of self-development
competitive angle through creation of leaderboard , friend groups

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Students are asked to rank the options given for each case in accordance with GMC guidance

Traffic light system to identify where students are progressing well and to identify areas for needed focus

Continuous motivational texts

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Netflix style vitual gameplay

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As the game has a narrative, students can follow the patient through each step of their treatment and get to witness the consequences of their actions, making the game interactive throughout.

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Students are given the opportunity to practice clinical skills in a VR simulated environment, such as carrying out a 3- / 12- lead ECG, taking bloods, carrying out a urine test etc. A traffic light system (red, amber, green) will indicate how accurately or well the student is carrying out the skill. Pop ups will allow the student to improve performance as they go along (tutor or supervisor can watch and add this as they carry out the task).

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getting points and progression if they select the clinical imaging required. Rank the most appropriate or interpret the clinical image

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- Apply different dyes or stains to narrow down differentials or clinical pictures
- Progression of the cell plates as the disease gets worse
- Role play as a histologist (generating the report afterwards, inc. clinical interpretation, feedback to patient)
- Follow the journey of tissue developing/cells

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The student role plays as the chief medical officer in a pandemic. They make decisions about key public health measure - place the country into lockdown or take no action. Throughout the game, the student will receive alerts about new variants and make choices on international travel etc.

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Happy patient sends you a thank you card
Also you level up with each successful review- maybe rewards at 1, 5, 10 etc: you unlock a new patient type/more difficult task would present itself.

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Identify pathologies on the X-ray for example, using a mouse or a touch screen.
Recognise types of cells and tissues
Differentiate between physiological and pathological states to reach an accurate diagnosis
Be able to identify the body system affected
Correctly identify the pathology

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You are presented with a history and then they make a decision of tests to do (e.g x rays, blood tests)

The tests then show up with results
You have a limit of how many tests you can do
Then you write your diagnosis

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Core gameplay loop: Patients given short presenting complaint and then ABG/VBG output,

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Stratified on type of scan and pathology and levels of difficulty (red, amber, green depending on the stage of medical education).

User function of scanning in patient imaging and the app correlates it

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Students to Trial the Game
Doctors
Graphic Designers
Computer Engineers
Funding
Admin Teams
Bank of possible scenarios

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Scenarioa> ask questions aboutmedic

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Smart phone or tablet with a functioning camera
X-ray, MRI and CT scans and images

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Free
Work offline (Without internet)
Available at public spaces such as libraries and University computers.
Available on all devices.

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- Students should be able to identify useful questions to ask based on information provided/gained
- Students should learn to avoid missing critical diagnoses

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- consultation with radiology specialists
- image bank
- funding
- programmers
- game-building platform
- students - who would test the beta version
- a lot of ideas for clinical scenarios
- consultation with technicians and anatomy leads

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Compatibility with a large number of devices. Have it on browsers instead of an app.

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Imagine having a bank of images showing various pathologies, be able to scroll, zoom in and out. Identify different pathologies. Have multiple choice options to choose most appropriate diagnosis. There will be a progress tracker to see your score and areas you need to improve on

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programmers to build realistic scenarios
virtual reality tools (e.g. able to use your hands in the game to control what you're doing)

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Hospital style ward setting- patient, bed, nurses office

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- Point system
-Social element (i.e., can interact with peers)
-reg Feedback

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- subtitles
- tactile feedback
- tech provided by uni

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How will this work alongside the curriculum?

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How will this work alongside the curriculum?

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Tied to lectures.
Release level packs as students learn more.

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-tackle misinformation
-see impact of public health measures
-see existing views and perceptions medical students have about a pandemic through choices they make (informal research)
-tackling frustration surrounding public health choices

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Gain confidence in history taking

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- simulations based on compulsory DOPs
- clinical skill session to teach/practise can also have VR sessions to practise
- monitored by clinical skills tutor who can provide feedback

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Willingness to participate.
Funding for the game development.
Making it realistic and clinically relevant.

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using simple colour schemes
light download size
programs with high cross-accessibility eg python

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Host website/programme
Image or video bank/ Consent
Histologist to describe and explain diagnosis/ clinical interpretation

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reflections and rating by students who have completed the tasks

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Unlock new levels by asking the right questions and ruling out emergency diagnoses

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Actual scans
Prizes at the end of the year

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Users
Polls and student feedback.

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- software engineers
- ethics lead

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Use of various formats (e.g,. online, app etc)

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How will this serious game work alongside the existing curriculum? 

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How will this serious game work alongside the existing curriculum? 

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Be a part of the pharmacology lectures

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Leader board based on players medical school

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Leader board based on players medical school

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Exclusion if not able to access online and the resources needed.

People not finding the game as interactive or feel it is not meeting their needs.

May prefer to have in person experience rather than online.