Modern slavery is no game, yet sensitive gamification could be game changing in providing education to identify and safeguard victims in the healthcare setting

Abstract

Introduction: Anyone can be a victim of modern slavery and approximately one in eight NHS professionals during their career will encounter victims of modern slavery.1 Though The Modern Slavery Act 2015 reconsolidated criminalisation of modern slavery, identifying victims remains difficult. Healthcare professionals are perfectly poised to intervene and advocate for the 20% of victims who present to healthcare institutions but often feel ill prepared to detect the signs of modern slavery.1-2 Evidence has emerged supporting the incorporation of gamification elements into educational sessions covering sensitive topics. However, minimal literature exists exploring the suitability of gamification in modern slavery education for healthcare professionals.3-4 Therefore a gamification imbued modern slavery session was created for final year medical students soon to be newly qualified doctors assuming their role on the NHS frontline. Materials and methods: An interactive modern slavery lecture interspersed with quiz questions was created. The students were split into teams and mobile devices were silenced to minimise digital distraction. Quiz questions ascertained baseline understanding of modern slavery and ability to identify potential victims. Question difficulty increased gradually and included three different fictional patient cases. In their teams, they decided if the patient was likely a victim of modern slavery earning points for their reasoning and conclusion. Methods to detect a potential perpetrator, maintaining personal and patient safety and complex communication skill techniques were taught by chunking important information in a didactic fashion. Additionally, the teaching explicitly delineated key history and examination findings that should raise suspicion of modern slavery and the escalation pathways in England and Wales. Results and discussion: All the medical students (n=11) completed pre- and post-session questionnaires to infer the session's immediate impact and the usefulness of sensitive gamification. On session completion, confidence to identify signs of modern slavery, sensitively gather patient information and methods to isolate a patient from a suspected perpetrator increased by 70%. Preparedness to escalate patients via the emergency and non-emergency pathways increased by 54% and the students felt better prepared to identify victims of modern slavery as foundation trainees. Qualitatively, all students felt their learning benefited from sensitive gamification. Some reported the gamification elements including the sense of competition made the complex topic more engaging without diminishing the content's serious nature. Importantly, every student felt their concerns about sensitively and safely caring for potential victims of modern slavery were alleviated by this session. Conclusion: As evidenced, sensitive gamification is a sustainable method of modern slavery education for medical students and potentially for healthcare professionals. However, more data is needed to establish whether these findings could be extrapolated to larger cohorts of students and professionals. The initial results suggest there could be scope for high-fidelity expansion if desired. Nonetheless, the results also demonstrate the effectiveness of this simple low-fidelity and low-cost session to improve, knowledge and recognition of modern slavery. Incorporating sensitive gamification into modern slavery teaching could prove a useful tool to attenuate the knowledge gap experienced by many healthcare professionals with promise to increase the number of modern slavery survivors not victims.