Applying ‘Gamification’ Can Make Learning More Fun - VHA SimLEARN
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Applying ‘Gamification’ Can Make Learning More Fun

By Ethan Burch, MS
Simulation Fellow D
urham VA Medical Center

DURHAM, N.C. - Gamification has been called the “ideal adult learning environment” through its use of game design and behavioral psychology (Peters, 2014). Why the buzz? In simple terms, gamification is the use of game design elements and game principles in non-game contexts.

Over the past decade gamification has been integrated into a multitude of diverse arenas, including Microsoft’s call centers to incentivize successful customer resolutions, fitness applications on our phones that track and reward physical activity, and even biology classrooms where students role-play as Jurassic Park geneticists. Gamification is particularly exciting due to how easily it can intersect with simulation, not unlike game-based learning activities such as escape rooms.

To that end, recent discussions have included gamifying nurse residency seminars and creating gamified simulations based on escape rooms (Adams, et al. 2018). This tutorial seeks to introduce a basic gamification framework to be integrated into various simulation-based training environments.

  • Define your goals

When developing simulations, we’re constantly evaluating our learning objectives, and how they are measured. A gamified system similarly lives or dies by measurable goals, and what problem gamification solves.

  • Weave your narrative

Human beings are story driven creatures. It’s the reason every escape room has a theme, and every simulation has a rough story. The Oregon Trail[1] would not be The Oregon Trail without its narrative of intrepid pioneers relocating their families during 1800’s westward expansion. Pick a simple narrative and integrate elements into your simulation. This ranges from characters, plots, conflict and resolution.

  • Learning outcomes

Define your learning outcomes so your participants earn or acquire knowledge or skill and strategically place learning events that integrate with narrative beats. Right as your story is about to get truly intriguing, make it so the newest bit of information your learners have uncovered is what reveals the latest development.

  • Game Design and Mechanics

A mechanic refers to the verbs or actions you take when playing a game. In chess it is moving a piece; in Super Mario it is running and jumping. Your goal at this point is to pick the mechanics that best fit your objectives and narrative. This can range from something as simple as a scoreboard, to group cooperation, to solving a puzzle, to even simple rewards. Part of why escape rooms lend themselves to our needs is due to the overlapping mechanics and design. If we abstractly look at a simulation as a group-based, problem-solving exercise, then it is that much easier to parcel elements from escape rooms into simulations.

  • Aesthetics

Aesthetics doesn’t just refer to visual components like moulage – try to find an emotional connection that your learners can grasp. Ask yourself what emotions you want your learners to experience, as well as how it benefits your learning objectives. If your simulation involves a degree of patient rapport, then an emotional connection will make the experience much more engaging and memorable.

These steps, while not all inclusive, provide a jumping off point for gamification. Look to elements of games that you find enjoyable and relevant to your work, and see how it could fit into your learning objectives. One thing to note is that not everyone will enjoy the same types of gamification. For example, leaderboards may excite a sizable portion of our learners, but not others. It’s important that you place yourself in the shoes of your learners and apply game elements that appeal to them.

Finally, and most importantly, have fun!


Peters, M. C. (2014). Sententia Gamification Certification Level 1 - Apprentice. Workshop conducted at Sententia Gamification Certification. Durham, North Carolina.

Adams, V., Burger, S., Crawford, K., & Setter, R. (2018). Can you escape? Creating an escape room to facilitate active learning. Journal for Nurses in Professional Development, 34(2), E1-E5.


[1] The Oregon Trail is an educational game developed by history teachers with the goal of teaching students about westward expansion more effectively than traditional methods. It has since become a staple of elementary school computers since the 1980s.