Video games as warm-up and non-procedural training tools for technical skills in healthcare: a systematic review

The transferability of skills from gaming to procedures such as endoscopy, laparoscopy, and others has been repeatedly demonstrated. Whether video games may be harnessed as interventions to enhance performance is the subject of multiple studies to date. This systematic review aims to analyse the evidence. A systematic search of PubMed, Embase, CINAHL Plus, and Scopus was performed for prospective studies, including video game intervention(s), aimed at procedural competency, involving healthcare professionals in training or service. Risk of bias in studies was assessed using Cochrane’s RoB2 and ROBINS-I V2 tools for randomised and non-randomised studies respectively. Studies determined to be at high or serious/critical risk of bias were excluded. One thousand five hundred seventy-one records were identified of which nineteen were included in the review. Narrative synthesis was performed owing to the heterogeneity of study outcome measures. Two study approaches were identified; the use of video games for task warm-up, and the use of video games as non-procedural training. Both approaches showed favourable findings for selected outcomes, although results were inconsistent across studies. The certainty of evidence was very low for warm-up and low for non-procedural training using Grading of Recommendations Assessment, Development and Evaluation criteria. Video game interventions may have a role as a supplementary strategy in technical-skills training, but observed effects are inconsistent and predominantly based on simulator outcomes. Evidence for pre-procedural warm-up is of very low certainty. Robust conclusions await further well-designed studies employing standardised outcomes and clinically relevant endpoints.