Playful Reflection: Impact of Gamification on a Virtual Reality Simulation of Breastfeeding

Gamification is a popular technique to improve task engagement, and has broadly been deployed in health and education to a point where many users now expect gameful experiences in these settings. However, gamification has been criticised for being a potential obstacle to the experience of reflection. Motivated by this tension, our work examines how the addition of gamification to a Virtual Reality simulation of breastfeeding impacts player experience and reflection. Using a within-subjects design, we invited 34 participants to take part in a mixed-methods evaluation of a gamified and non-gamified variant of the simulation that included questionnaires and semi-structured interviews. Results show that gamification improved player experience and encouraged players to reflect on goal achievement and performance. However, it also diverted players' attention from nuances within the act of nursing. Drawing on our findings, we contribute considerations for the application of gamification in personal and sensitive settings such as breastfeeding.