Getting It Wrong the Right Way: Development and Early Implementation of a Gamified Sexual and Gender Diversity in Cancer Care Curriculum

Abstract Background Sexual and Gender Diversity in Cancer Care (SGDc) patients experience inequities across the cancer continuum, driven in part by healthcare providers’ (HCPs) limited knowledge and low confidence communicating about sexual orientation, gender identity, pronouns, and relationship diversity. To address this gap, a virtual education curriculum was developed to improve HCPs’ knowledge of SGDc patients’ experiences and strengthen their ability to communicate inclusively. Methods Guided by Kern’s curriculum development model, adult learning principles, social learning theory, and gamification, an interdisciplinary team based in Toronto, Canada, co-developed a virtual SGDc e-learning program comprising a Knowledge Hub and bilingual gamified virtual patient encounters. The curriculum was iteratively refined with input from SGDc HCPs and patient partners. Early implementation was evaluated using the RE-AIM framework, drawing on Google Analytics platform data to characterize reach, adoption, and implementation. Effectiveness was not assessed. Results Between May 17, 2024, and December 31, 2025, the program was accessed by 2,217 unique users from 34 countries. Most learners were based in Canada (n = 1,366, 61.9%), and 840 (38.1%) were international. A total of 798 learner avatars were created, and 554 virtual patient scenarios were completed (69.4%). Learners generated 5,800 page views, primarily to the home page (n = 3,403, 58.7%) and game module (n = 1,292, 22.3%), with fewer visits to the Knowledge Hub (n = 418, 7.2%). Mean session duration was 1 minute and 45 seconds. The program was accessed predominantly on desktop devices (n = 1,799, 81.5%). Conclusions A framework-guided process supported the development and early implementation of a gamified SGDc e-learning program that achieved reach across 34 countries, adoption by individual learners and by the host institution, and engagement concentrated in its interactive components. The program offers an interactive environment designed to support learners in practicing inclusive communication with virtual SGDc patients and chosen family members. Future evaluation will examine the impact of the e-learning program on provider learning and patient experience to guide iterative refinement and broader dissemination.