SIMS Games 2019


The future of technology for training simulation and serious games is already emerging with the advancement in virtual reality and machine learning research.  Thus, it is timely for the Serious Games Association (SGA) and SingHealth Duke-NUS Institute of Medical Simulation (SIMS) to create and organize the inaugural SIMS Challenge 2019, a healthcare simulation game design competition to help demonstrate the possibilities how such innovative technologies can be applied in the healthcare industry.

Simulations are commonly used to create the safe environment to help employees learn a task and complete it correctly. For a long time now, educators have proclaimed “learning by doing” is the most effective way to gain knowledge. Technology now makes it possible for content-matter-experts to simulate true-to-life environments that are safe, non-threatening and affordable. This is demonstrated in the oil & gas, security and healthcare industries. These industries with high physical risks use simulation training and serious games to facilitate realistic training.

One of the stakeholders in the simulation and training industry is the instructional designers, whom should be involved in the creation of simulated learning experiences. The instructional designers approach to simulations has always been a learner-centered perspective. However, their involvement and contributions have not been documented nor recognized officially. Through this challenge, we hope to promote the clinical instructional designer’s role in the ‘pedagogical’ phase where the information which needs to be taught to the learners will be molded and created around the methodology of “learn-by-doing”. This is to ensure that the processes presented to the learners in the simulation are effective, immersive, and allow for consequences to happen within the simulation.


The inaugural SIMS Challenge 2019  was hosted by S3 Conference 2019 from 22 to 25 October 2019 at Academia (located in Singapore General Hospital Campus). The S3 Conference brought together close to 500 of the world’s leading experts in healthcare simulation and delegates from Europe, America and Singapore to lead transformation in simulation in the region. The S3 Conference 2019, themed “Beyond the Now: Transforming Healthcare Simulation”, covered a wide array of healthcare simulation topics, such as scenario-based learning, high-performance teams training, hands-on moulage training, virtual and augmented reality training, e-Learning, and the use of standardized patients in education and training to advance patient safety.

Partnering with SIMS, as a leading simulation center in Asia, with access to extensive experience and expertise in healthcare simulation education and training, we could then leverage on their healthcare and simulation partners in Singapore and around the world to develop and organize multidisciplinary and inter-professional simulation games for healthcare professionals and learners.

Highlighted at the Conference:

Neonatal Resuscitation Game

The  neonatal resuscitation game was designed as a training game for hospital-based resuscitation of high-risk infants. It is a single-player game, where learners take on the role of a team leader, and guide their team members through a series of resuscitation scenarios. Within the given time limits, they practice three categories of newborn resuscitation (term, pre-term and extreme pre-term) and its complications. At the end of the game, learners are scored on their performance and can track their progress over time. As educators of the SGH Singapore Neonatal Resuscitation Course (SNRC), the clinician saw that the learners’ knowledge and skills declined soon after the completion of a training session, especially for those who worked in areas where the need for resuscitative interventions was rare. The clinicians wanted to find a solution to help the learners retain their knowledge and skills, but were also aware of constraints that they faced, such as the cost and time needed to undergo refresher courses. After attending a talk organised by the Serious Games Association (SGA) that opened the clinicians’ eyes to the uses of serious games through computer simulation. Many clear benefits to serious games were presented: learners get to practice specific tasks in a safe environment at their convenience, which leads to improved competencies, productivity and reduced cost of training. It seemed like a good match for the challenges that the clinicians were facing, so they decided to explore using serious games to improve our learners’ proficiency in neonatal resuscitation.

At this year’s event, the winning game was the Blood Transfusion Team: Andrea Choh Chau Lin, Singapore General Hospital and Shafiah Othman, Serious Games Asia.  The Blood Transfusion Game is developed as a serious game for improving the knowledge and confidence of nurses on the blood transfusion practice.

Blood Transfusion Game

Nurses in Singapore have to undergo re-assessment every two years to refresh their knowledge on blood transfusion. Recognizing that knowledge and skills can decline four to six months after training, the game provides learners the flexibility to access the simulation program at a computer or laptop, without the need for physical manikins or a scheduled class limited to a handful of learners at a time. The game is played by a single user, with one to supporting characters assisting the player (learner) in various realistic clinical scenarios. The aim is to retrain, strengthen and assess competency of nurses. At the end of each session, the game displays a score that can be used as an assessment tool. Performance is scored based on the player’s knowledge, technical skills, appropriateness of actions taken and leadership abilities shown while interacting with other characters assisting the player.

The features of this serious game could be further developed to incorporate additional scenarios with repetitive exercises and feedback to enhance the impact on clinical performance. Given the flexibility, practicality, and scalability of such a game, they can serve as a promising approach to optimize learning.