Game-based approaches in medical education: theoretical analysis and conceptual model of digital simulator for development of clinical reasoning

Objective. To analyze psychological and pedagogical concepts, as well as data on effectiveness of game-based approaches to substantiate design of simulator for development of clinical reasoning. Material and methods. We reviewed the PubMed, Scopus, and eLibrary databases regarding self-determination theory, flow theory, Bedwell’s taxonomy, systematic reviews of gamification and Russian regulatory documents. Results. Gamification and cognitive simulations are effective for knowledge acquisition (SMD 0.40—1.95), while VR simulators are effective for motor skills. Clinical reasoning remains the least explored. The following mechanisms of engagement have been identified: autonomy, competence, connectedness, and flow. Conclusion. The identified gap justifies the need to create a digital simulator. A conceptual model integrating game mechanics with clinical scenarios and adapted to requirements of Russian medical education system is proposed. These results underlie subsequent development and validation of the tool.