While simulation games are typically associated with recreation and fun, Chapel Hill-based Clinical Tools is at the forefront of building games with a different goal in mind: to foster learning in healthcare professionals and medical students.
The company has a long history, having been founded around 25 years ago by Dr. Bradley Tanner and Maripat Metcalf, who initially hoped to develop education materials for patients on their illnesses and medication regimens.
When Metcalf—Clinical Tools’ Co-Founder and Vice President—began interviewing doctors, nurses and social workers about what they wished patients knew, she came to a surprising conclusion.
“What I found was that the care providers often didn’t know the basics,” Metcalf said. “And I realized that in order to improve patient care, we need to take a step back and start training providers.”
Suddenly, Clinical Tools saw a need to educate the medical students, doctors, nurses and counselors as the first line to improving patient health and patient education.
But the first game project came in the mid 2000s, as Clinical Tools built a program that helped children understand how the brain functions when under the influence of drugs and ultimately to make healthy choices.
Metcalf said games are exciting ways to present health messages without being scary or intimidating, and this was something they could also apply to adults, including in the training of healthcare professionals.
“We’ve all played games, and we all know that there’s a certain amount of learning that goes on,” Metcalf said.
Even in Assassin’s Creed, players walk out knowing a bit more about medieval Italy than they did beforehand.
“But to capture that level of engagement, that flow of enthusiasm, and channel it towards something where there’s a structured educational objective and a targeted goal is a little more tricky,” Metcalf said.
The most recent Clinical Tools game—”Lift: Medical Student Peer Support”—helps medical students develop coping skills and avoid exhaustion in a medical school environment by leaning on and lifting up their peers. Lift recently won a silver medal from the International Serious Play Awards.
The National Institutes of Health has supported Clinical Tools’ projects through Small Business Innovation Research (SBIR) grants, enabling the company to create a widespread VR training base for pain treatment, alcohol, obesity, opioids and more.
The same support has gone to Lift, which Metcalf said can make so much more learning stick because of its engaging simulation nature.
“A two-hour lecture on how you should be more resilient does not necessarily increase your resiliency,” Metcalf said. “So what we wanted to do was develop a wide range of interactive tools for medical students.”
Peer support is not necessarily a huge focus in medical school, Metcalf said, and while it may seem simple enough, when students are stressed out themselves, it can be hard to put these skills in action. The current Lift game is developed in Adobe XD, but a new 3D interactive version using Unreal Engine is set to be released soon.
Learning Games Through The Pandemic
While it might seem the pandemic would present a perfect opportunity for learning-based games to pick up steam alongside remote learning, Metcalf said the sector actually faced market oversaturation. Clinical Tools struggled to keep efficiency levels up, since remote working diminished the interaction and cooperation needed to create something engaging, she said.
“To come up with something that’s engaging in the game space, you really need that collaborative effort,” Metcalf said. “It’s far more synergetic and far more effective to have a team of five in the room, working together, playing through a prototype, bouncing ideas off each other.”
This was at the same time that colleges and high schools had to shift to online schooling. Instead of a rush of competitors that were forging innovative educational games, they mostly saw an increase in mediocre programs that gave the field a bad name.
“That was actually, I think, a very tough time for online education to be creative and innovative and forward-thinking because the market was just flooded with the lowest-hanging fruit,” Metcalf said.
As a company in the healthcare education field for so long, Metcalf has witnessed all the key changes over time. While at one point two decades ago infographics were new and exciting. Over time PowerPoint, Choose Your Own Adventure and now 3D VR simulation games have all rushed to innovate the sector. Notably, game simulations present a competitive advantage when comparing them to traditional ways of learning, Metcalf said.
“Individuals can go at their own pace, and they can return to things over and over and reinforce the messages that they didn’t get the first time,” Metcalf said, “rather than being swept along with the needs of a group the way you are in a more traditional classroom.”
A simulation game can more easily evolve with the new needs of a patient or healthcare professional, too. These user needs are something Clinical Tools, and really all startups, have to be cognizant of, according to Metcalf, who said it’s easy for founders to lose sight of the fact that they are not their own customer.
“You are not your user,” Metcalf said. “You’re not your learner. One of the biggest things that’s overlooked in games, in serious games and education in general, is formative analysis, needs analysis, to really learn what it is that your target audience wants to know and then to balance that out against what the literature and content experts tell you they need to know.”
While Clinical Tools may be entering new market verticals, their goal has remained the same, which is to improve healthcare. Now they are just doing that by starting with the healthcare providers themselves. The logic goes that if they have better experiences, so will patients.
“If we don’t have providers and professionals who are well-trained and excited about patient care, you and I are just never going to get the best care that we can,” Metcalf said.
Clinical Tools plans to fully launch Lift in the fall, and they already have the next project on the horizon for spring 2023.
This game will be focused on women scientists interested in entrepreneurship. Women will be able to rotate through a structured learning environment to see different challenges they may face in running their own businesses, including looking for funding, mentorship, pitching ideas and more.