Gamification: Measuring the Metrics of Motivation in Education

In this episode, we meet with Britanny Shelledy to break down gamification as a practical way to boost engagement and recall for lifelong learners in healthcare. We dig into where gamification comes from, why it surged after COVID, and how to use it without letting competition distract from the learning goals. 
• defining gamification through game mechanics like points, levels, rewards, and progress tracking 
• tracing the history from badges and loyalty programs to modern apps and digital learning 
• seeing how COVID-era disruption pushed educators toward interactive, morale-building tools 
• sharing real formats we use with residents and attending physicians like Jeopardy and Family Feud 
• outlining core gamification categories such as leaderboards, quests, storytelling, feedback loops, and social collaboration 
• weighing benefits like retention, active learning, teamwork, and data insights against risks like anxiety and misalignment 
• walking through implementation steps: know the audience, set objectives, pick the right type, design, then measure and refine 
• looking ahead to AI-driven personalization and higher-fidelity simulation technology 

If you have any questions or would like to offer a topic to discuss, please email info@accuityhealthcare.com.

Transcript

Welcome And Podcast Purpose

Speaker 0:03

Welcome to Chart Checkup. This podcast delivers insights that drive impact in healthcare information management. Stay current on clinical knowledge, coding updates, and industry trends through expert interviews and conversations with Accuity's own physician, CDI, and coding leaders. Today I'm joined by Clinical Content Manager for Accuity, Britanny Shelledy, a doctorally trained physician assistant. Her background includes orthopedic surgery, emergency medicine, and urgent care, as well as aesthetic medicine. Prior to joining Accuity, she's worked as an associated clinical education director for a physician's assistance program and brings a wealth of knowledge about education as well as clinical content. With that, welcome to the show, Britanny.

Speaker 1 0:49

Thanks for having me, Bill.

Meet Britanny Shelledy

Speaker 0:51

It's our pleasure. Hoping to talk to you today about uh gamification and sort of uh education techniques to engage with uh lifelong learners uh um in our medical community.

Speaker 1 1:04

Absolutely. Happy to be here and talk about it.

Speaker 1:07

I appreciate it. I think maybe just to get started, we might just give uh your your notes on the general sort of overview of gamification as an educational technique and some of the uh the history and your experiences with it.

Defining Gamification In Plain Terms

Speaker 1 1:21

Sure. So there's multiple definitions for gamification, but really what it is is taking the application of game mechanics. So things like point systems, levels, uh progress tracking rewards, those types of things, and applying them to things in non-game contexts to motivate engagement. And really, when you look at it at its core, it's about using game psychology to drive motivation because of how we as humans respond to things like progress, feedback, recognition, and even achievement.

Speaker 1:55

A great introduction to it, that it's uh such an interesting phenomenon to explore, especially um in uh in recent times since since uh we had talked a little bit offline about uh the gamification since COVID. Um it's been uh very interesting to see just the profound changes to the entire educational system. Uh absolutely.

From Badges To Apps

Speaker 1 2:19

Absolutely. Um, so really when you when we think about the history of gamification, we think it it started with the digital age, video games, those types of things. But when you look at it, we were using gamification before it even had the word to it. So humans were using game-like systems to motivate behaviors. I mean, we even see it in history books. Um, ancient societies use games to teach strategy and social skills. But we really started to see a more structured reward and recognition system to influence behavior. So, a perfect example is the Voice Scouts. They awarded badges to recognize achievements. Then we started to see businesses really starting to formalize that gamification. So we saw concepts like loyalty programs. So think of retailers who utilized a point or a reward system. Um, I'm sure you'd be hard pressed to find somebody who didn't have a punch card in their wallet back in the day. Airlines and frequent flyer programs, when you think about it at its core, those are considered gamification. And these reward systems really change how businesses interacted with not only their customers, but with employees because they realized it was not only engaging their customers and increasing that retention, but they also started to use it as a way to motivate employees to perform better. So we started seeing businesses using gamification for things like employee training and even onboarding processes. Um, we see it a lot too. Brands started using gamification as a marketing strategy. Um, how many times did we see those interactive game-like ads? I mean, those were there to capture our consumer attention. They were raising brand awareness. Um, but as I said, you really started to see the acceleration of gamification with digital technology and the video game craze. So we started to see it really evolve into um something more meaningful because it had more personalization. Uh, so now it's hard to find an app that doesn't even utilize some form of gamification. I mean, think about it, even simple things like how to learn a new foreign language or um some of these apps that are trying to get you to find your uh maybe weight loss or fitness goals, those all have forms of gamification in it. So again, even though we think it started with the apps, it started long ago. Again, when we understood that underlying human psychology about it, technology just made it much more scalable for us.

Speaker 4:49

I love it. Touching into that hardwired uh uh mammalian brain of ours. It's it's something else, really.

Speaker 1 4:57

It really is. It is.

Speaker 4:58

As we sort of move from the history, could we uh jump into a little bit of your personal experience, both in sort of uh um a teaching background and then in a uh research-associated background?

Gamification For Residents And Attendings

Speaker 1 5:10

Absolutely. So unfortunately, I didn't get much exposure to gamification during my master's program because it wasn't widely integrated into healthcare education at that time. So uh my real first exposure, as you had touched on before, Bill, was actually during my doctoral program, which uh I started shortly after the height of the COVID-19 pandemic. And yeah, and what really stood out to me were it was unfortunately, um, but it also motivated me because I wanted to do more for the medical community. And what really touched me about learning about gamification after this COVID-19 pandemic was the stories that we were hearing, not just from our faculty members, but also from other colleagues in the cohort about how their institutions really had to pivot overnight because their clinical students were pulled away from rotations. Obviously, social distancing was mandated. And morale really became low for a lot of these uh educational institutions. But obviously, education couldn't stop. So gamification really became one of those tools that help fill that educational gap. And we saw professors and students alike really having to step outside of their comfort zone, particularly since some of these medical institutions weren't even set up to do interactive or game-based learning. But they had to find ways to keep their students engaged and connected and motivated, particularly in a time when everything just felt so uncertain. And it wasn't just about the content delivery, it was about some of the intangibles. So things like community, morale, and again, preparing these students to enter a workforce during a global crisis. And at that time when students couldn't be in clinical environments and didn't know what they were potentially walking into professionally, this gamified learning really helped reinforce their knowledge that they already learned during didactics. It really helped maintain that engagement again when you're sitting alone in your apartment. Um, and it really helped unify the cohorts as well during that isolation. So that was, again, really my first exposure and really got me kind of invested in gamification and how it was shaping uh education and not only medical education. When I was in academics, I was more on the clinical side of education. But uh, regardless, when I did my clinical practice, uh, I was in clinical practice for about 12 years and I had the opportunity to work for an academic medical center. Um, so I saw a lot of it used. Um, gamification, again, really helped reinforce a lot of knowledge uh for a lot of healthcare systems. So even if we're not in academics, we see it often um review competitions for board exams as a common one. Case-based learning competitions are another big one. Uh, depending on how advanced your educational institution is, simulation labs, they'll often have scoring metrics. Uh, those are becoming more popular. Uh, one you'll see often, you see it a lot of times in school, even non-medical uh audience response systems with live polling or those uh live auto-graded quizzes, um, those are becoming really popular too. And even though they're not necessarily labeled as gamification, uh, anything that has that structured competition, point system, time challenges, all those types of things are really at the core gamification. So, in my current role here at Accuity, uh, we're certainly utilizing gamification, uh, often using it with residents, sometimes attending physicians. Uh, we're utilizing formats like Jeopardy style sessions, family feud style review, deal or no deal has been a little popular. Uh, often when we're doing CDI encoding educations, we're again using some of that live polling to get that interaction. And again, we're obviously not often teaching them brand new material. We're just really reinforcing what they already know and then applying that gamification to help with recall and retention on maybe some tips or tricks that have been reviewed during the educational session. Uh, and again, we're taking those documentation principles or maybe coding concepts that they're already familiar with and then presenting them in an interactive, competitive format to again help with retention and recall.

Speaker 9:37

Amazing. Just earlier today, we were on a the same a similar call, and I was just looking for a way to play the Family Feud music for the Family Feud program with a technical issue we had. But that it really is very interesting to see the dynamic shift when giving an uh educational presentation, where we begin to then see uh a change in engagement, just as we touch touch on um just even partial uh elements of this gamification, sort of magic almost. That as a uh long-term educator, I I have been impressed really with um the flexibility and the dynamic engagement you can get, especially out of uh you know adults, which to be honest, having taught the whole spectrum, I feel like uh engagement um with more senior learners has been a very difficult thing to cultivate. But the this gamification um really seems to be a shortcut that I have been very, very impressed by.

Speaker 1 10:37

Absolutely. Even some of the research shows that's one of the advantages of doing gamification is you can tailor it to meet the needs of your diverse learners because of its adaptability to various learning styles, preferences, environments. So, as you said, I was a little surprised myself when I got to this job. I'm thinking your senior learners, as you put them, our residents, our attendings, are they really going to be as engaged as some of your younger audience, um, even again, medical PA nursing students, those uh types of learners. And like you said, we were just on a call. They were laughing, they were having a good time, they were engaged. So it really shows just truly the spectrum of learners, as you said, lifelong learners that can benefit from gamification.

Speaker 11:27

Absolutely. I certainly don't mean to suggest that I'm not uh amongst the most senior of senior learners. So I don't need to paint a uh a wrong picture there and that I continue absolutely not only to learn about gamification, but as I do more work with acuity to learn about the the scope and importance of the work here. And that has certainly been uh an a learning experience for me.

Speaker 1 11:48

Yes.

Speaker 11:48

Game, games and otherwise.

Speaker 1 11:50

Yes, absolutely.

Speaker 11:52

We might go hopefully maybe into a little bit about uh you've touched on some of the examples we use here at Accuity, but do you have some other thoughts on like um other ways to incorporate it, like live polling, other kinds of examples like that?

Points, Quests, Stories, Feedback

Speaker 1 12:04

Absolutely. So when you look at it online, they'll break it down into several different categories, but uh it really comes down to a couple of key concepts. So one is using a points and reward system, or maybe even things like badges or other achievements. And that's where you're really incentivizing success and help reform reinforce that desired behavior. Um, so again, we had already talked about badges and Boy Scouts. This type is also often utilized by marketing companies and other businesses to retain consumers. So again, the points and reward system, uh, Starbucks, uh, punch cards, again, a lot of point system for retailers, as we talked about again, uh airline uh frequent flyer points. The next one are leaderboards and rankings. So this is where you have public ranking of learners or teams, and it helps support healthy competition and social comparison. So we often see this utilized in a lot of our gaming apps that we use. Um, in medical education, we are seeing it often utilized for online review boards. So if students are utilizing certain apps to help prep for maybe an upcoming review board, sometimes they'll use these leadership boards. Um, there's also quest and challenge-based gamification. So this really frames learning activities as missions, and it helps to really add narrative and purpose, but also autonomy. Uh, this one's probably one of my favorites. Uh, so this is an example is this escape room. That one's always my favorite. I find it the most interactive, uh, but that's probably the most common example for that one. Uh, next, you have more of a narrative and storytelling type gamification. And this really increases that emotional investment and contextual learning, which I think we're going to see a lot more integration of this in medical education with the impact of simulation technology. So, again, this is really that, like I said, that emotional investment into it. And then you have an immediate feedback system. And again, this is often used by marketing companies because you're getting this real-time response to a learner's action to help reinforce some of these learning loops. Uh, so we've already talked about these. So, this would be like auto-graded quizzes or those live polls. So, again, getting that immediate feedback. And then probably the last big category would be social sharing gamification. And this really kind of promotes that collaboration. Again, we see a lot of this in our online gaming apps. Uh, as I said, really promotes that collaboration and community with gamification. So, those are kind of your big categories when we talk about gamification.

Why Simulation Creates Lasting Memory

Speaker 14:47

Fantastic. I uh it's such a potent memory now that you have uh brought it up, but that uh as a Boy Scout, um earning my emergency preparedness merit badge, we had a simulation where uh a I lived near an army base, and a group of army medics came out to train us on emergency preparedness, and they had the most amazing simulation wounds that were just essentially a piece of latex or rubber that you uh velcroed around someone, but it had a little bag of blood that would shoot blood at you, and you had to really squeeze on it to get it to stop bleeding. And uh that uh I as a as a 12-year-old boy, it's very very intense uh simulation.

Speaker 2 15:24

Sure.

Speaker 15:25

But that that exact idea that even uh all these years and years and years later, that I can uh recall that memory and uh and and some of the um intellectual material that I was meant to retain from that is such a great point. It's really powerful. Um, the way that it it's changed the way we get in touch with both our teaching agendas, but then also our our knowledge goals and and I think also what we might find being attainable, that we can get to a broader spectrum or or a greater, greatly enhanced curriculum using these techniques.

Speaker 1 15:59

Sure. And as you said, how powerful it is. I mean, look at how long ago you went through this, but you still have a vivid memory of it. And I think that's really um, but all of us really have something that we can remember. Again, I still remember having like, was it a subway punch card or something? It's just those are memorable, even though, again, we didn't really have truly the name gamification. There's all these examples that we can remember. And this is really the core of it. Getting to that human psyche of the engagement and the motivation is what makes gamification really impactful.

Real Benefits And Real Risks

Speaker 16:36

This has been a fascinating discussion, Britanny. I really appreciate it. But uh, as we kind of wrap up our thoughts on gamification, I was hoping maybe we could touch on some of the pros and cons for uh our lifelong learners and then uh get into maybe some ideas on implementation. What do you what do you think are about uh what's in favor and against gamification as a a new a new tool in our teaching toolkit?

Speaker 1 17:01

Sure. So I think globally gamification again really encourages that engagement and motivation. What I find interesting too is also provides a lot of data-driven insights. So employers, educators, marketing companies, uh, they can all use this real-time objective data to look at things like performance and engagement, uh, evaluate retention, uh, look at academic or professional performance, and really make informed decisions from that data. If you look at it more specifically from a business and marketing perspective, again, data does show that gamification can help increase customer engagement, improve employee performance, and really enhance brand awareness. If we're focusing more from an education perspective, research shows that gamification again enhances that student engagement, it promotes active learning, and it aids in cognitive development. And when we see students more engaged in the content, it's usually because they're actively involved in that problem solving and they're making decisions. And ultimately, too, they're motivated because of that reward system, which is that visualized progress. Um, research has also shown that gamification helps improve knowledge retention, which obviously leads to better academic performance and overall productivity. When you think about the core concepts of gamification, too, it can also help develop soft skills that may be difficult to teach in a traditional classroom setting. So think of things like working in teams, um, the ability to collaborate and communicate with colleagues. Uh, and it helps really foster resilience. I mean, when you think of it's a reward system, unfortunately, not everybody can win. Um, so it can help foster some of that resilience as well.

Speaker 2 18:53

Absolutely.

Simple Implementation Playbook

Speaker 1 18:54

Um, specifically looking at educators, uh, we really like utilizing gamification because it can help us achieve our learning outcomes. And as I'd already touched on before, it really helps tailor to meet the needs of our diverse learners. Uh, again, different learning styles, different preferences, different environments. But that does kind of lead into maybe some of the cons because again, not everybody is going to unfortunately maybe benefit or get the same out of gamification as others. So, again, we know based on the definition of gamification, it is based on that human psyche and that innate drive and motivation for maybe a reward system. But we also have to consider maybe some of the negative psychological impacts, because again, some learners they may have anxiety or frustration because of that. Um, some may even feel inadequate due to the competitive nature of gamification. And again, too, not all learners are intrinsically motivated by competition rewards. So, certainly something to keep in mind. There could be some pedagogical pitfalls, uh, particularly if it's not implemented appropriately. So, gamification may not align uh 100% with our object uh educational objectives, or maybe some of the game elements can be too distracting from those core learning goals and it can lead to some confusion, distraction for some learners. Research is also a bit mixed on the effectiveness of gamification across different contexts, different age groups, and different cultures. Um, so something to also consider as well. And um, probably the other big challenge is maybe some implementation challenges. So, as educators, do we have the time and the resources to put into this? Or even do we have the most up-to-date technology to be able to implement it? Um, same thing with students. Not all students have the capability to access some of this technology. Um, so it really kind of is an art to be able to figure out truly what is the best way to utilize gamification. And that really goes into how to implement it because the biggest parts of implementing it is not actually the gamification itself, it's the prep work and then the feedback afterwards. So when you want to set up some sort of game, uh, what you really want to start with is again understanding your audience. So, as I just said, with some of the cons, who are you aiming this for? Um, are you again working with really young children and you're looking for that cognitive development? Are you gearing more towards medical students, PA students, nursing students, whoever, that maybe you're teaching some new information, some retention and recall? Are you working more with attending in residence where you're not teaching them new information at all? You just want them to really recall uh some information uh or maybe some of the the New educational tips and tricks again in our world, maybe some documentation integrity tips that we want them to really make sure that they're recalling. And then you really want to define your objectives. So again, what are your uh learning outcomes and educational objectives? What do you want your learners to achieve with this gamification to make sure that really aligns with it? Uh, and then you choose the right type. So, again, based on all this data that you have accumulated, your audience, your objectives, what gamification is going to be most suitable for them? And then you design it. So you create the game, you create the award system, and then you implement it. And now the other important component is gathering that data and that feedback. And again, using that measurable objective data to measure your success, to track your key metrics and really evaluate the effectiveness of the gamification and then make any necessary changes to really refine your strategies and improve learning outcomes.

The Future: AI And Simulation Tech

Speaker 23:06

Wow, amazing. That's such a rich way to approach the toolkit there to especially with the idea of incorporating that feedback of uh objective data that you can then touch on to both measure success and then um ideally enhance your reach. It's amazing. Absolutely. Do you see some uh what do you see on the horizon for some of the uh gamification techniques or technologies or in corporations?

Speaker 1 23:38

So we're already seeing a lot of continued integration of gamification in social media and different apps, uh, certainly a large component for businesses and marketing companies. Uh, I think we're going to see continued integration of gamification education, particularly in medical education. Uh, with the expansion of AI technology, uh, the increased sophistication of simulation technology, we're gonna continue to see gamification evolve. Because as we already talked about, with that implementation and that real-time feedback, AI is gonna provide us a lot of that real-time feedback to further engage students and add up personalization, uh, making it really, again, more intelligent. Simulation technology, again, it's bringing these experiences and making them feel real for the students, but also in a very safe environment for them to learn it. So I think that's gonna be a really useful tool in medical education. So uh I'm really excited to see where game is heading for the medical education.

Speaker 24:42

Absolutely. It's uh it's a fantastic uh space to be in, tool set to have, and um, and then a technique to either be uh um used on or to use. That it's uh Absolutely. It's it works all ways. It's amazing.

Speaker 1 24:59

It is.

Speaker 25:00

Well, Britanny, I really appreciate your joining us here on the podcast. Um, thank you very much, and uh, we really look forward to hearing from you again sometime.

Closing Thanks And How To Reach Us

Speaker 1 25:08

Thank you so much for having me, Bill. It's been a pleasure.

Speaker 25:10

At Accuity, we're transforming healthcare reimbursement with a provider-driven, innovative approach. We share valuable clinical and coding insights and current best practices to improve financial outcomes across health systems. If you have any questions or would like to offer a topic to discuss, please email info at acuityhealthcare.com. Opinions expressed in this production are those of the host or guests and do not represent official stances of acuity. The suggestions, advice, and guidance provided by the individuals featured in this podcast are not intended to replace any medical advice, consultation, or treatment you may receive from your healthcare provider.