Development of a Serious Game to Simulate Neonatal Intensive Care Unit Experiences: Collaborative Quasi-Experimental Study

BackgroundOpportunities for neonatal intensive care unit (NICU) training are limited for medical and nursing students due to patient safety concerns and the complexities of neonatal care. In addition, the COVID-19 pandemic significantly disrupted clinical training opportuniti...

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Main Authors: Yukihide Miyosawa, Koichi Hirabayashi, Kodai Yamada, Fumiya Kobayashi, Nanami Ogihara, Noa Takeda, Eri Okamura, Shogo Matsumura
Format: Article
Language:English
Published: JMIR Publications 2025-06-01
Series:JMIR Formative Research
Online Access:https://formative.jmir.org/2025/1/e73009
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author Yukihide Miyosawa
Koichi Hirabayashi
Kodai Yamada
Fumiya Kobayashi
Nanami Ogihara
Noa Takeda
Eri Okamura
Shogo Matsumura
author_facet Yukihide Miyosawa
Koichi Hirabayashi
Kodai Yamada
Fumiya Kobayashi
Nanami Ogihara
Noa Takeda
Eri Okamura
Shogo Matsumura
author_sort Yukihide Miyosawa
collection DOAJ
description BackgroundOpportunities for neonatal intensive care unit (NICU) training are limited for medical and nursing students due to patient safety concerns and the complexities of neonatal care. In addition, the COVID-19 pandemic significantly disrupted clinical training opportunities, further underscoring the need for alternative educational tools that can provide immersive and practical learning experiences. Serious games have garnered attention as potential tools for medical education; however, few are designed to simulate the complete NICU environment and its unique challenges. ObjectiveTo address the educational gaps in neonatal care training, we aimed to develop and evaluate a serious game that provides a comprehensive NICU simulation experience for students and the general public. MethodsThe game was developed over 14 months by a collaborative team that included a neonatologist, 4 medical students, and 1 art student, with a total cost of US $10,000. Initially created in TyranoBuilder (STRIKEWORKS), the game was later redeveloped in Unity with Naninovel to support multilingual functionality. Structured as a 6-chapter visual novel, the game follows a high school student observing the NICU during a hospital internship. Scenario-based decision-making and interactive dialogues guide the player through both the clinical and emotional aspects of neonatal care. After completing the game, players were invited to participate in an optional web-based survey that assessed demographic information, gameplay quality, and educational value using Likert scales. Descriptive and inferential statistics were used for data analysis. ResultsThe game, titled First Steps in the NICU, was released for iOS, Android, and Steam. As of May 2025, it has been downloaded 2799 times (2260 on iOS and 539 on Android). A total of 160 survey responses were collected, with 46.3% of respondents identifying as health care professionals or students. The majority of participants were female (114/160, 71.3%) and aged 20-29 years (59/160, 36.9%). Mean scores for length, difficulty, and gameplay were 3.05 (SD 0.62), 2.49 (SD 0.76), and 3.65 (SD 0.77), respectively, indicating a well-balanced design. The educational usefulness of the game received high ratings: empathy with the story (4.24), usefulness for knowledge acquisition (4.16), and effectiveness of serious games as a learning tool (4.37). No significant differences in evaluations were found between health care professionals and students and the general public, suggesting broad accessibility and appeal. ConclusionsWe developed a low-cost serious game that simulates NICU experiences through collaboration between a neonatologist and students. The game received positive feedback and demonstrated educational value for a diverse audience. Positioned as formative research, this study highlights the potential of serious games to supplement neonatal care education. Future updates will incorporate user feedback, leading to improvements in gameplay and expanded content.
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spelling doaj-art-e7325fa408f54c66a0e10d14ae56670b2025-08-20T03:31:11ZengJMIR PublicationsJMIR Formative Research2561-326X2025-06-019e7300910.2196/73009Development of a Serious Game to Simulate Neonatal Intensive Care Unit Experiences: Collaborative Quasi-Experimental StudyYukihide Miyosawahttps://orcid.org/0000-0002-7034-1148Koichi Hirabayashihttps://orcid.org/0000-0002-2193-1184Kodai Yamadahttps://orcid.org/0009-0009-5307-6897Fumiya Kobayashihttps://orcid.org/0009-0008-7780-2585Nanami Ogiharahttps://orcid.org/0009-0009-7915-8997Noa Takedahttps://orcid.org/0009-0008-1784-9787Eri Okamurahttps://orcid.org/0009-0002-6488-2797Shogo Matsumurahttps://orcid.org/0009-0003-4119-3320 BackgroundOpportunities for neonatal intensive care unit (NICU) training are limited for medical and nursing students due to patient safety concerns and the complexities of neonatal care. In addition, the COVID-19 pandemic significantly disrupted clinical training opportunities, further underscoring the need for alternative educational tools that can provide immersive and practical learning experiences. Serious games have garnered attention as potential tools for medical education; however, few are designed to simulate the complete NICU environment and its unique challenges. ObjectiveTo address the educational gaps in neonatal care training, we aimed to develop and evaluate a serious game that provides a comprehensive NICU simulation experience for students and the general public. MethodsThe game was developed over 14 months by a collaborative team that included a neonatologist, 4 medical students, and 1 art student, with a total cost of US $10,000. Initially created in TyranoBuilder (STRIKEWORKS), the game was later redeveloped in Unity with Naninovel to support multilingual functionality. Structured as a 6-chapter visual novel, the game follows a high school student observing the NICU during a hospital internship. Scenario-based decision-making and interactive dialogues guide the player through both the clinical and emotional aspects of neonatal care. After completing the game, players were invited to participate in an optional web-based survey that assessed demographic information, gameplay quality, and educational value using Likert scales. Descriptive and inferential statistics were used for data analysis. ResultsThe game, titled First Steps in the NICU, was released for iOS, Android, and Steam. As of May 2025, it has been downloaded 2799 times (2260 on iOS and 539 on Android). A total of 160 survey responses were collected, with 46.3% of respondents identifying as health care professionals or students. The majority of participants were female (114/160, 71.3%) and aged 20-29 years (59/160, 36.9%). Mean scores for length, difficulty, and gameplay were 3.05 (SD 0.62), 2.49 (SD 0.76), and 3.65 (SD 0.77), respectively, indicating a well-balanced design. The educational usefulness of the game received high ratings: empathy with the story (4.24), usefulness for knowledge acquisition (4.16), and effectiveness of serious games as a learning tool (4.37). No significant differences in evaluations were found between health care professionals and students and the general public, suggesting broad accessibility and appeal. ConclusionsWe developed a low-cost serious game that simulates NICU experiences through collaboration between a neonatologist and students. The game received positive feedback and demonstrated educational value for a diverse audience. Positioned as formative research, this study highlights the potential of serious games to supplement neonatal care education. Future updates will incorporate user feedback, leading to improvements in gameplay and expanded content.https://formative.jmir.org/2025/1/e73009
spellingShingle Yukihide Miyosawa
Koichi Hirabayashi
Kodai Yamada
Fumiya Kobayashi
Nanami Ogihara
Noa Takeda
Eri Okamura
Shogo Matsumura
Development of a Serious Game to Simulate Neonatal Intensive Care Unit Experiences: Collaborative Quasi-Experimental Study
JMIR Formative Research
title Development of a Serious Game to Simulate Neonatal Intensive Care Unit Experiences: Collaborative Quasi-Experimental Study
title_full Development of a Serious Game to Simulate Neonatal Intensive Care Unit Experiences: Collaborative Quasi-Experimental Study
title_fullStr Development of a Serious Game to Simulate Neonatal Intensive Care Unit Experiences: Collaborative Quasi-Experimental Study
title_full_unstemmed Development of a Serious Game to Simulate Neonatal Intensive Care Unit Experiences: Collaborative Quasi-Experimental Study
title_short Development of a Serious Game to Simulate Neonatal Intensive Care Unit Experiences: Collaborative Quasi-Experimental Study
title_sort development of a serious game to simulate neonatal intensive care unit experiences collaborative quasi experimental study
url https://formative.jmir.org/2025/1/e73009
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