Introduction: Given the complexity of teaching clinical reasoning to (future) healthcare professionals, the utilization of serious games has become popular for supporting clinical reasoning education. This scoping review outlines games designed to support teaching clinical reasoning in health professions education, with a specific emphasis on their alignment with the 8-step clinical reasoning cycle and the reflective practice framework, fundamental for effective learning. Methods: A scoping review using systematic searches across seven databases (PubMed, CINAHL, ERIC, PsycINFO, Scopus, Web of Science, and Embase) was conducted. Game characteristics, technical requirements, and incorporation of clinical reasoning cycle steps were analyzed. Additional game information was obtained from the authors. Results: Nineteen unique games emerged, primarily simulation and escape room genres. Most games incorporated the following clinical reasoning steps: patient consideration (step 1), cue collection (step 2), intervention (step 6), and outcome evaluation (step 7). Processing information (step 3) and understanding the patient’s problem (step 4) were less prevalent, while goal setting (step 5) and reflection (step 8) were least integrated. Conclusion: All serious games reviewed show potential for improving clinical reasoning skills, but thoughtful alignment with learning objectives and contextual factors is vital. While this study aids health professions educators in understanding how games may support teaching of clinical reasoning, further research is needed to optimize their effective use in education. Notably, most games lack explicit incorporation of all clinical reasoning cycle steps, especially reflection, limiting its role in reflective practice. Hence, we recommend prioritizing a systematic clinical reasoning model with explicit reflective steps when using serious games for teaching clinical reasoning.
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This paper examines how a serious game approach could support a participatory planning process by bringing stakeholders together to discuss interventions that assist the development of sustainable urban tourism. A serious policy game was designed and played in six European cities by a total of 73 participants, reflecting a diverse array of tourism stakeholders. By observing in-game experiences, a pre- and post -game survey and short interviews six months after playing the game, the process and impact of the game was investigated. While it proved difficult to evaluate the value of a serious game approach, results demonstrate that enacting real-life policymaking in a serious game setting can enable stakeholders to come together, and become more aware of the issues and complexities involved with urban tourism planning. This suggests a serious game can be used to stimulate the uptake of academic insights in a playful manner. However, it should be remembered that a game is a tool and does not, in itself, lead to inclusive participatory policymaking and more sustainable urban tourism planning. Consequently, care needs to be taken to ensure inclusiveness and prevent marginalization or disempowerment both within game-design and the political formation of a wider participatory planning approach.
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The Maritime Spatial Planning (MSP) Challenge simulation platform helps planners and stakeholders understand and manage the complexity of MSP. In the interactive simulation, different data layers covering an entire sea region can be viewed to make an assessment of the current status. Users can create scenarios for future uses of the marine space over a period of several decades. Changes in energy infrastructure, shipping, and the marine environment are then simulated, and the effects are visualized using indicators and heat maps. The platform is built with advanced game technology and uses aspects of role-play to create interactive sessions; it can thus be referred to as serious gaming. To calculate and visualize the effects of planning decisions on the marine ecology, we integrated the Ecopath with Ecosim (EwE) food web modeling approach into the platform. We demonstrate how EwE was connected to MSP, considering the range of constraints imposed by running scientific software in interactive serious gaming sessions while still providing cascading ecological feedback in response to planning actions. We explored the connection by adapting two published ecological models for use in MSP sessions. We conclude with lessons learned and identify future developments of the simulation platform.
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This paper introduces a creative approach aimed at empowering desk-bound occupational groups to address the issue of physical inactivity at workplaces. The approach involves a gamified toolkit called Workplace Vitality Mapping (WVM) (see Figure 1) designed to encourage self-reflection in sedentary contexts and foster the envision of physical vitality scenarios. This hybrid toolkit comprises two main components: A Card Game (on-site) for context reflection and a Co-design Canvas (Online) for co-designing vitality solutions. Through the card games, participants reflect on key sedentary contexts, contemplating their preferable physical vitality scenarios with relevant requirements. The co-design canvas facilitates the collaborative construction and discussion of vitality scenarios’ development. The perceptions and interactions of the proposed toolkit from the target group were studied and observed through a hybrid workshop, which demonstrated promising results in terms of promoting participants’ engagement experience in contextual reflections and deepening their systemic understanding to tackle the physical inactivity issue. As physical inactivity becomes an increasingly pressing concern, this approach offers a promising participatory way for gaining empathetic insights toward community-level solutions.
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Studies on city‐building games as educational tools show positive results in addressing different learning objectives, but also identify a missing link to reality, as they are mostly computer‐based. Given the differences between existing games and their capabilities, the exact function of these games in an urban planning curriculum is unclear. The city‐building game Cities: Skylines currently has three different versions (Digital, Tabletop, VR). Through an affordance analysis of the game’s three versions, this study analyses how the versions afford four primary knowledge dimensions, and in doing so identifies different educational applications for each version of Cities: Skylines in different planning disciplines. The results show that: (a) the board game is strong in fostering player participation and critical thinking more suited for the social and health studies, public policy, and citizen participation domains of urban planning; (b) the digital version functions as moddable simulator, ensuring familiarity with existing systems and monitoring their effects, useful in logistics and transportation planning; (c) the VR form viscerally involves players in the simulated processes, applicable in design‐focused segments of urban planning, such as sustainable design theory, housing, and land‐use management. The results of this study can help urban planning educators identify possible uses for different versions of Cities: Skylines.
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Global society is confronted with various challenges: climate change should be mitigated, and society should adapt to the impacts of climate change, resources will become scarcer and hence resources should be used more efficiently and recovered after use, the growing world population and its growing wealth create unprecedented emissions of pollutants, threatening public health, wildlife and biodiversity. This paper provides an overview of the challenges and risks for sewage systems, next to some opportunities and chances that these developments pose. Some of the challenges are emerging from climate change and resource scarcity, others come from the challenges emerging from stricter regulation of emissions. It also presents risks and threats from within the system, next to external influences which may affect the surroundings of the sewage systems. It finally reflects on barriers to respond to these challenges. http://dx.doi.org/10.13044/j.sdewes.d6.0231 LinkedIn: https://www.linkedin.com/in/sabineeijlander/ https://www.linkedin.com/in/karel-mulder-163aa96/
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Aim: Improvement and harmonization of European clinical pharmacology and therapeutics (CPT) education is urgently required. Because digital educational resources can be easily shared, adapted to local situations and re-used widely across a variety of educational systems, they may be ideally suited for this purpose. Methods: With a cross-sectional survey among principal CPT teachers in 279 out of 304 European medical schools, an overview and classification of digital resources was compiled. Results: Teachers from 95 (34%) medical schools in 26 of 28 EU countries responded, 66 (70%) of whom used digital educational resources in their CPT curriculum. A total of 89 of such resources were described in detail, including e-learning (24%), simulators to teach pharmacokinetics and/or pharmacodynamics (10%), virtual patients (8%), and serious games (5%). Together, these resources covered 235 knowledge-based learning objectives, 88 skills, and 13 attitudes. Only one third (27) of the resources were in-part or totally free and only two were licensed open educational resources (free to use, distribute and adapt). A narrative overview of the largest, free and most novel resources is given. Conclusion: Digital educational resources, ranging from e-learning to virtual patients and games, are widely used for CPT education in EU medical schools. Learning objectives are based largely on knowledge rather than skills or attitudes. This may be improved by including more real-life clinical case scenarios. Moreover, the majority of resources are neither free nor open. Therefore, with a view to harmonizing international CPT education, more needs to be learned about why CPT teachers are not currently sharing their educational materials.
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This chapter presents the currently not established and identifies design requirements for new systems to address this challenge and provide directions for possible improvement. As a result, this chapter introduces the concept of SamenMarkt®, a participatory system in which multi-agent system technology enables distributed price negotiation, distribution and communication between producers, retailers and consumers.
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This paper introduces a novel distributed algorithm designed to optimize the deployment of access points within Mobile Ad Hoc Networks (MANETs) for better service quality in infrastructure less environments. The algorithm operates based on local, independent execution by each network node, thus ensuring a high degree of scalability and adaptability to changing network conditions. The primary focus is to match the spatial distribution of access points with the distribution of client devices while maintaining strong connectivity to the network root. Using autonomous decision-making and choreographed path-planning, this algorithm bridges the gap between demand-responsive network service provision and the maintenance of crucial network connectivity links. The assessment of the performance of this approach is motivated by using numerical results generated by simulations.
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Abstract Background: COVID-19 was first identified in December 2019 in the city of Wuhan, China. The virus quickly spread and was declared a pandemic on March 11, 2020. After infection, symptoms such as fever, a (dry) cough, nasal congestion, and fatigue can develop. In some cases, the virus causes severe complications such as pneumonia and dyspnea and could result in death. The virus also spread rapidly in the Netherlands, a small and densely populated country with an aging population. Health care in the Netherlands is of a high standard, but there were nevertheless problems with hospital capacity, such as the number of available beds and staff. There were also regions and municipalities that were hit harder than others. In the Netherlands, there are important data sources available for daily COVID-19 numbers and information about municipalities. Objective: We aimed to predict the cumulative number of confirmed COVID-19 infections per 10,000 inhabitants per municipality in the Netherlands, using a data set with the properties of 355 municipalities in the Netherlands and advanced modeling techniques. Methods: We collected relevant static data per municipality from data sources that were available in the Dutch public domain and merged these data with the dynamic daily number of infections from January 1, 2020, to May 9, 2021, resulting in a data set with 355 municipalities in the Netherlands and variables grouped into 20 topics. The modeling techniques random forest and multiple fractional polynomials were used to construct a prediction model for predicting the cumulative number of confirmed COVID-19 infections per 10,000 inhabitants per municipality in the Netherlands. Results: The final prediction model had an R2 of 0.63. Important properties for predicting the cumulative number of confirmed COVID-19 infections per 10,000 inhabitants in a municipality in the Netherlands were exposure to particulate matter with diameters <10 μm (PM10) in the air, the percentage of Labour party voters, and the number of children in a household. Conclusions: Data about municipality properties in relation to the cumulative number of confirmed infections in a municipality in the Netherlands can give insight into the most important properties of a municipality for predicting the cumulative number of confirmed COVID-19 infections per 10,000 inhabitants in a municipality. This insight can provide policy makers with tools to cope with COVID-19 and may also be of value in the event of a future pandemic, so that municipalities are better prepared.
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