The inherent complexity of planning at sea, called maritime spatial planning (MSP), requires a planning approach where science (data and evidence) and stakeholders (their engagement and involvement) are integrated throughout the planning process. An increasing number of innovative planning support systems (PSS) in terrestrial planning incorporate scientific models and data into multi-player digital game platforms with an element of role-play. However, maritime PSS are still early in their innovation curve, and the use and usefulness of existing tools still needs to be demonstrated. Therefore, the authors investigate the serious game, MSP Challenge 2050, for its potential use as an innovative maritime PSS and present the results of three case studies on participant learning in sessions of game events held in Newfoundland, Venice, and Copenhagen. This paper focusses on the added values of MSP Challenge 2050, specifically at the individual, group, and outcome levels, through the promotion of the knowledge co-creation cycle. During the three game events, data was collected through participant surveys. Additionally, participants of the Newfoundland event were audiovisually recorded to perform an interaction analysis. Results from survey answers and the interaction analysis provide evidence that MSP Challenge 2050 succeeds at the promotion of group and individual learning by translating complex information to players and creating a forum wherein participants can share their thoughts and perspectives all the while (co-) creating new types of knowledge. Overall, MSP Challenge and serious games in general represent promising tools that can be used to facilitate the MSP process.
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Clinical decision support systems (CDSSs) have gained prominence in health care, aiding professionals in decision-making and improving patient outcomes. While physicians often use CDSSs for diagnosis and treatment optimization, nurses rely on these systems for tasks such as patient monitoring, prioritization, and care planning. In nursing practice, CDSSs can assist with timely detection of clinical deterioration, support infection control, and streamline care documentation. Despite their potential, the adoption and use of CDSSs by nurses face diverse challenges. Barriers such as alarm fatigue, limited usability, lack of integration with workflows, and insufficient training continue to undermine effective implementation. In contrast to the relatively extensive body of research on CDSS use by physicians, studies focusing on nurses remain limited, leaving a gap in understanding the unique facilitators and barriers they encounter. This study aimed to explore the facilitators and barriers influencing the adoption and use of CDSSs by nurses in hospitals, using an extended Fit Between Individuals, Tasks, and Technology (FITT) framework.
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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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Nurses are accountable to apply the nursing process, which is key for patient care: It is a problem-solving process providing the structure for care plans and documentation. The state-of-the art nursing process is based on classifications that contain standardized concepts, and therefore, it is named Advanced Nursing Process. It contains valid assessments, nursing diagnoses, interventions, and nursing-sensitive patient outcomes. Electronic decision support systems can assist nurses to apply the Advanced Nursing Process. However, nursing decision support systems are missing, and no "gold standard" is available. The study aim is to develop a valid Nursing Process-Clinical Decision Support System Standard to guide future developments of clinical decision support systems. In a multistep approach, a Nursing Process-Clinical Decision Support System Standard with 28 criteria was developed. After pilot testing (N = 29 nurses), the criteria were reduced to 25. The Nursing Process-Clinical Decision Support System Standard was then presented to eight internationally known experts, who performed qualitative interviews according to Mayring. Fourteen categories demonstrate expert consensus on the Nursing Process-Clinical Decision Support System Standard and its content validity. All experts agreed the Advanced Nursing Process should be the centerpiece for the Nursing Process-Clinical Decision Support System and should suggest research-based, predefined nursing diagnoses and correct linkages between diagnoses, evidence-based interventions, and patient outcomes.
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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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Both gaming and group (decision) support systems (GDSS) are frequently used to support decision-making and policymaking in multi-actor settings. Despite the fact that there are a number of ways in which gaming and GDSS can be used in a complementary manner, there are only sporadic examples of their combined use. No systematic overview or framework exists in which GDSS are related to the functions of gaming or vice versa. In this article, we examine, why, how and for what purpose GDSS can be used to enrich and improve gaming simulation for decision support, and vice versa. In addition to a review of examples found in the literature, four games are discussed where we combined gaming and GDSS for complex decision-making in a multi actor context: INCODELTA, a game about transportation corridors; INFRASTRATEGO, a game about a liberalizing electricity market; CONTAINERS A DRIFT, a game about the planning of a container terminal, and; DUBES, a game about sustainable urban renewal. Based on the literature and these four experiences, a classification is presented of (at least) four ways in which GDSS and gaming can be used in a complementary or even mutually corrective, manner: the use of GDSS for game design, for game evaluation, for game operation and the use of gaming for research, testing and training of GDSS.
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Digitalization is gaining increasing attention in Higher Education (HE). The integrationof digital tools into instructional settings is particularly challenging, However, it offers manyopportunities to improve the learning process of students, especially in interdisciplinary teachingscenarios such as teaching sustainable usage of space and resources i.e. for the coastal zones and themarine areas. Worldwide, Marine Spatial Planning (MSP) and Integrated Coastal Zone Management(ICZM) are much needed approaches to manage and organize the increasing use of the sea andcoastal areas. Both are complex fields that are attracting more and more attention in interdisciplinaryHE. Correspondingly designed, the module ‘Planning and Management of Coastal Zones and SeaBasins’ at the University of Oldenburg, Germany, provides a case for integrating digital tools intoHE. In 2020, the digital serious game ‘MSP Challenge´ was used in an online learning format. Thisinteractive and collaborative tool supports informed decision making based on real and simulateddata, comparable to business (decision) processes based on environmental information systems(EIS). Therefore, the MSP Challenge game fosters not only the understanding of the complex topicbut additionally methodological skills which can be transferred to the usage EIS. While playing,students become able to (1) evaluate and simulate impacts of uses on coastal and marineenvironments, (2) describe the main interactions in ecosystems, (3) conceptualize information forsectoral or integrated MSP and (4) reflect on the role and use of data. In the presented case masterstudents studying “Water and Coastal Management” participated in the module. Moreover, thedigital serious game and the interdisciplinary topics of MSP and ICZM provides additionalopportunities to explore subtopics (e.g. IT-related) from other disciplinary perspectives.
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In flexible education, recommender systems that support course selection, are considered a viable means to help students in making informed course selections, especially where curricula offer greater flexibility. However, these recommender systems present both potential benefits and looming risks, such as overdependence on technology, biased recommendations, and privacy issues. User control mechanisms in recommender interfaces (or algorithmic affordances) might offer options to address those risks, but they have not been systematically studied yet. This paper presents the outcomes of a design session conducted during the INTERACT23 workshop on Algorithmic Affordances in Recommender Interfaces. This design session yielded insights in how the design of an interface, and specifically the algorithmic affordances in these interfaces, may address the ethical risks and dilemmas of using a recommender in such an impactful context by potentially vulnerable users. Through design and reflection, we discovered a host of design ideas for the interface of a flexible education interface, that can serve as conversation starters for practitioners implementing flexible education. More research is needed to explore these design directions and to gain insights on how they can help to approximate more ethically operating recommender systems.
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This report maps different programs that supportrefugees on the road to entrepreneurship. The municipality of The Hague, along with the refugee and migrant support organization EnterStart (MigrantINC) asked for an evaluation of the program The Hague Test Garden (from now on called The Test Garden) where refugees can ask for help starting their own businesses. The evaluation is not just based on the experiences in The Test Garden; other programs have been included in the evaluation to come to a broader view of the road to entrepreneurship and the obstacles encountered. The increased inflow of refugees in Dutch society and on the Dutch labor market has generated different support programs for starting-up a business. Some of these programs already existed but shifted to accommodate the needs of this specific target group. Other programs were initiated to support refugees because of perceived barriers in Dutch society. Most programs are private initiatives, funded on a project basis. In the Netherlands, refugees that hold a residence permit are called ‘status holders’. Upon arrival, they received a temporary permit for at least five years. They need to follow a civic integration and language program and they are expected to be part of the (regular) education system or labor market as soon as possible. The Test Garden started in 2016, a time when multiple support systems for refugee-entrepreneurs began their programs. This report starts with a short overview ofrefugee flows to the Netherlands. The main part of the report consists of the comparison and evaluation of the different programs. The information was gathered through literature, websites, and in-depth interviews with program managers and others involved. Interviews with the participants are only included for The Test Garden (Appendix 1 gives an overview of the meetings and interviews). LinkedIn: https://www.linkedin.com/in/karijn-nijhoff-89589316/
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Chronic diseases represent a significant burden for the society and health systems; addressing this burden is a key goal of the European Union policy. Health and other professionals are expected to deliver behaviour change support to persons with chronic disease. A skill gap in behaviour change support has been identified, and there is room for improvement. Train4Health is a strategic partnership involving seven European Institutions in five countries, which seeks to improve behaviour change support competencies for the self-management of chronic disease. The project envisages a continuum in behaviour change support education, in which an interprofessional competency framework, relevant for those currently practising, guides the development of a learning outcomes-based curriculum and an educational package for future professionals (today’s undergraduate students).
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