Transforming Professional Healthcare Narratives into Structured Game-Informed-Learning Activities

A cornerstone of professional education is the practicum, "a setting designed for the task of learning a practice. In a context that approximates a practice world, students learn. . . by undertaking projects that simulate and simplify practice; or they take on real-world projects under close supervision" (Schön 1987, 37). In the healthcare professions, one of the ways the practicum is reified is in the form of internship programs in which students gain real-life clinical experience through structured interactions with doctors and their patients. However, student clinical experience has become ever more problematic for numerous reasons. Advances in clinical techniques and therapies have led to less invasive procedures, leading in turn to a significant reduction in the time spent by patients in the hospital. In addition, many countries are introducing directives limiting physicians' traditionally long working hours, and this—along with growing concerns over the liabilities associated with allowing unlicensed (and therefore less accountable) students in the clinical workplace—is exacerbating the problem further. Moreover, in light of widespread requirements for more assured core skills and experiences on the part of healthcare workers, even the traditional approach to internships can leave too many holes in an individual's education (General Medical Council 2003). These various factors result in a dichotomy whereby the healthcare practicum is increasingly problematic in real hospital settings even as greater numbers of fully qualified healthcare workers are needed.