Overall, 227 medical students responded though 10 incomplete surveys were eliminated. This report is based on data from 217 respondents, and from a subgroup of 109 respondents who were self-identified game players and provided game play data. Table provides the overall demographics of the respondents. The UW provided 125 respondents and the UM provided 92. The distribution was nearly equal by gender. Approximately half the respondents (55%) were in their first two years of study. Nearly 97% of the respondents considered themselves to be intermediate or advanced users of computers. Virtually all (99.5%) reported having broadband access to the Internet. Respondents spent a mean time of 98 minutes (standard deviation, 68 minutes) in a session of video game play; the median time was 90 minutes. These numbers suggest a slight positive skew due to a few heavy gamers.
In assessing for gender differences, we found that there was a higher proportion of males with advanced familiarity with computers (p < 0.001, Fisher's exact) and that a significantly higher proportion of males owned Microsoft's X-box. Female respondents started playing video games at a later age than male respondents (p = 0.03). There were more females from UW than from UM (p = 0.03), and more female MD/PhD respondents than male MD/PhDs (70% vs. 52%) (p = 0.008).
Experience with Video Games
Table illustrates the participants' experiences with video games. Of eight game genres presented, the three most popular were puzzle (27%), strategy (24%), and role-play (18%). Most students (70%) reported that their time spent playing games had decreased since entering professional school, though 20% reported it stayed the same, and 10% reported it had increased somewhat. The most frequently chosen reasons for playing video games were: "help me relax" (77%); "fun way to spend time with existing friends" (67%); "allow me to avoid studying" (63%); and "challenge me in problem solving" (62%).
Experience with Game Play among Medical Students
The following gender differences were also elucidated. Males are about 4.4 times more likely than females to play video games (95% CI: (2.3, 8.4)) (p <0.001). As regards favorite types of games: females are about 5.2 times more likely than males to play puzzle games (95% CI: (2, 13)) (p = 0.001); females are about 29% as likely as males to play role-playing games (95% CI: (.11, .78)) (p < 0.001); females are about 23% as likely as males to play sports games (95% CI: (.08, .64)) (p = 0.005); females are about 15% as likely as males to play strategy games (95% CI: (.05, .41)) (p < 0.001); and females are about 3% as likely as males to play shooter games (95% CI: (.005, .13)) (p < 0.001).
As to the reasons why respondents enjoy playing video games, females were: about 24% as likely as males to enjoy video games for fun (95% CI: (.09, .68)) (p = 0.007); about 35% as likely as males to enjoy the competitive aspects of the video games (95% CI: (.14, .91)) (p = 0.03); and about 13% as likely as males to enjoy the learning aspects of the video games (95% CI: (.03, .66)) (p = 0.01). Male students are more likely than females to have decreased the number of hours spent in playing video games (p = 0.01). With respect to frequency of game play, younger students and students with an advanced level of familiarity are more likely to play more frequently (p = 0.04, and 0.03, respectively).
Video Games and Medical Education
Regardless of whether they identified themselves as game players, the respondents were very positive about the potential roles of new media technology and video games in medical education. Table shows that an overwhelming majority of students liked the idea of using technology to enhance healthcare education (98%) and thought that medical education should make better use of new media technology (95%). A solid majority thought that real life is migrating online in many aspects (88%) and that video games can have educational value (80%). Thirty percent said they would like to be part of the design team that creates multiplayer online healthcare simulations. Interestingly, females are only about 39% as likely as males to believe in the potential educational value of video games (95% CI: (.17, .89)) (p = 0.03). Females are about 31% as likely as males to want to be part of a team to design an educational video game (95% CI: (.15, .64)) (p = 0.002). Also, students with a basic or intermediate level familiarity with computers are only about 24% as likely as those with an advanced familiarity to like to be part of a design team (95% CI: (.11, .54)) (p < 0.001).
Medical Student Attitudes about Video Games
Multiplayer Online Healthcare Simulations
Students supported using multiplayer online healthcare simulations. For example, a majority of students (77%) indicated that if a multiplayer online healthcare simulation helped to accomplish a personal goal, they would be willing to use it, even on their own time (Table ). Eighty-five percent were either very interested or somewhat interested in multiplayer online healthcare simulations (Table ). Females are much less interested than males (p < 0.001), and students with an advanced level familiarity are much more interested (p = 0.004) than their counterparts in multiplayer online healthcare simulations that realistically replicate the experience of what it's like to be in professional practice. The factors that would make a multiplayer online healthcare simulation most interesting included the simulation being "fun"; "helpful for developing skills and comfort in patient interactions"; "helpful for modeling the economics of different healthcare systems"; and "helpful for experiencing firsthand authentic experiences that shaped the views and values of professors they admire." There is no difference between male and female students with respect to these items. However, students with advanced level familiarity with computers are more likely than their counterparts to find multiplayer online healthcare simulations interesting if (a) it is for credit (p = 0.005), (b) it is based on authentic experience (p = 0.04), (c) it is visually crafted (p = 0.045), (d) it overcomes challenges (p = 0.02), and (e) it models politics (p = 0.05). No other statistically significant gender differences were elucidated.
Beliefs about Multiplayer Online Healthcare Simulations and Relative Value of Clinical Facts, Critical Thinking and Interpersonal Skills