The validation of a serious game for teaching ultrasound skills

Background: Point-of-care ultrasound (POCUS) is an important bedside diagnostic tool and is being taught in several specialties. However, mastering the required psychomotor skills takes time and learning curves are different between students. Especially learning to make the right probe movements with the corresponding changes of the ultrasound image on screen, and integrating it into a 3D mental model takes time. This precious bedside-time of trainers and physicians may be reduced using other learning methods for mastering the psychomotor skills, for example the use of serious games. Such a game is under development but it needs to be validated before widespread use can be advised. In this article we describe the development and the first three steps in the validation of a serious game for ultrasound skills. Results: We have included 18 ultrasound experts and 24 ultrasound novices who played the serious game 'Underwater" and provided feedback. They concluded that"underwater" is fun to play and that movement of the 3D-printed probe resembled real ultrasound probe movements. Participants highly valued the potential of the game for training eye-hand coordination and stability of probe handling, two very important skills in performing ultrasound in real practice. Although we compared several in-game parameters such as distance and speed, no difference was observed between novices and experts. This means that content- and face validity of the serious game is demonstrated but optimal parameters to measure differences between novices and experts still have to be determined. Conclusions: Our study shows solid content- and face validity of the serious game "UnderWater"for training ultrasound skills, although construct validity could not be demonstrated yet. The game is appreciated as a promising serious game for training eye-hand coordination and learning ultrasound, which may reduce expensive bed-side teaching.