Frontiers in Public Health (Nov 2015)
Gamification of cognitive assessment and cognitive training: A systematic review of applications, approaches and efficacy
Abstract
Background: Cognitive tasks are typically viewed as effortful, frustrating and repetitive, and these factors may lead participants to disengage with the task at hand. This, in turn, may negatively impact our data quality and reduce any intervention effects. Gamification may provide a solution. If we can successfully import game design elements into cognitive tasks without undermining their scientific value, then we may be able improve the quality of data, increase the effectiveness of our interventions, and maximise participant engagement. Aims: This systematic review aims to explore and evaluate the ways in which gamification has already been used for cognitive training and testing purposes. Essentially, we seek to answer five questions: 1. For what reasons have researchers opted to use gamification? 2. What scenarios has gamification been used in? 3. What game mechanics have been used and to what effect? 4. Which methods have been used to determine whether a gamified application is successful? 5. How successful has gamification been in cognitive testing and training thus far? Method: Using several online databases, we searched the titles, abstracts and keywords of database entries using the search strategy (gamif* OR game OR games) AND (cognit* OR engag* OR behavi* OR health* OR attention OR motiv*). Searches included articles published in English between January 2007 and October 2015. Non-peer reviewed studies such as abstracts or conference posters were excluded. Furthermore, due to the specific focus on cognitive assessment and training we excluded several other common uses of gamification including: gamification for education purposes, advertising purposes, disease management, health promotion, physical activity promotion, exposure therapy or rehabilitation. We also excluded studies that were merely used virtual reality or a 3D environment without involving any game mechanics: engagement had to be the primary reason for using a game-like design. Results: Our review identified 33 relevant studies, covering 31 gamified cognitive tasks used across a wide range of disorders and cognitive domains. Gamified cognitive training to relieve attention deficit hyperactivity disorder symptoms was particularly prominent. We describe the game mechanics used in gamified cognitive tasks, their effectiveness and frequency of use by designers. We also found that the majority of gamified cognitive tasks were rated as enjoyable or engaging by the study participants. Gamified assessments were typically validated successfully; however the efficacy of game-like cognitive training is more difficult to interpret due to several poor quality studies. High heterogeneity of study designs and small sample sizes highlight the need for further research in both training and testing. Conclusions: The evidence suggests that gamified cognitive training is motivating for users, though not necessarily an effective intervention. Nevertheless, gamification can provide a way to develop engaging and yet scientifically valid cognitive assessments and it is likely worthwhile to continue to develop gamified cognitive tests in the future.
Keywords
