{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T10:29:54Z","timestamp":1762338594907,"version":"build-2065373602"},"reference-count":48,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Serious Games"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec sec-type=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Population aging underlines the critical need to improve health professional training to adequately care for adults aged &gt;60 years. Developing educational resources to support academics and professionals presents a valuable opportunity to enhance understanding of health conditions and improve clinical management. Serious games are designed to develop teaching, training, and learning skills. Their use in the educational setting is warranted, as they integrate digital aspects and gamification to create a playful experience for content acquisition. Deepening this theme in nursing education will improve assistance to the older adult population, leading to more qualified care based on gerontological practices and comprehensive health care for older adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aims to develop and validate a serious game on older adult health for undergraduate nursing students.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This quantitative and descriptive methodological study, conducted between February 2023 and December 2023 at a public university in the Federal District of Brazil, involved the active participation of 27 undergraduate nursing students in their eighth to tenth semesters. The game, Health Unit in Focus (HUF), was developed and validated with their input. It features 75 clinical cases distributed across 3 themes: pharmacology, metabolic syndrome, and semiology. Of the 40 students initially enrolled, 27 completed the study. The app was validated using the System Usability Scale and student feedback, and the results were reported following the Game-Based Intervention Reporting Guidelines (GAMING).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The participants had a mean age of 22.67 (SD 1.44) years, were mostly female (20\/27, 74%), and were in their eighth semester (26\/27, 96%). The game received an average System Usability Scale score of 85.75 (median 86.57), classified as excellent, as all evaluated items scored &gt;75. Participants considered the game easy to use; accessible; practical; and rich in well-founded, useful content. This high usability score, coupled with the overwhelmingly positive feedback from the students, instills confidence in the game\u2019s effectiveness. Furthermore, 100% (27\/27) of students agreed that learning through games is effective and expressed interest in incorporating more interactive games into their training. The serious game HUF showed good usability, as its overall score was \u201cexcellent,\u201d with its highest score in the odd-numbered items that addressed the positive aspects identified in the analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The serious game HUF is not just a valid and reliable tool for training nursing students but also an engaging and interactive approach to learning. Its ability to captivate and involve students in the learning process is a testament to its potential to revolutionize nursing education. It is essential that the development of new methodological resources, such as serious games, be based on scientific evidence to guarantee greater reliability and success in achieving their established objectives.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/66289","type":"journal-article","created":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T13:55:06Z","timestamp":1745502906000},"page":"e66289-e66289","source":"Crossref","is-referenced-by-count":0,"title":["A Serious Game (Health Unit in Focus) for Enhancing Undergraduate Education on Older Adults\u2019 Health: Design and Validation Study"],"prefix":"10.2196","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5584-998X","authenticated-orcid":false,"given":"Yuri Gustavo de Sousa","family":"Barbalho","sequence":"first","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9064-0735","authenticated-orcid":false,"given":"Calliandra Maria de Souza","family":"Silva","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7251-5829","authenticated-orcid":false,"given":"Carla S\u00edlvia Neves da Nora","family":"Fernandes","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6155-9073","authenticated-orcid":false,"given":"Ra\u00edza Rana de Souza Lima","family":"Trombini","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0204-8628","authenticated-orcid":false,"given":"Patr\u00edcia Littig","family":"Melo","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7323-6407","authenticated-orcid":false,"given":"Aline Farias de","family":"Oliveira","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6203-9670","authenticated-orcid":false,"given":"Alayne Larissa Martins","family":"Pereira","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3513-7034","authenticated-orcid":false,"given":"Alessandro de Oliveira","family":"Silva","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2709-6335","authenticated-orcid":false,"given":"Luciano Ramos de","family":"Lima","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6830-4914","authenticated-orcid":false,"given":"Marina Morato","family":"Stival","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4212-2340","authenticated-orcid":false,"given":"Diana L\u00facia Moura","family":"Pinho","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9332-9029","authenticated-orcid":false,"given":"Silvana Schwerz","family":"Funghetto","sequence":"additional","affiliation":[]}],"member":"1010","published-online":{"date-parts":[[2025,11,4]]},"reference":[{"issue":"8","key":"R1","doi-asserted-by":"publisher","first-page":"61871","DOI":"10.34117\/bjdv6n8-564","article-title":"The aging population: aspects of Brazil and the world, under the look of literature","volume":"6","author":"Barroso","journal-title":"Braz J Dev"},{"key":"R2","unstructured":"World population prospects 2022: summary of results population division. United Nations. URL: https:\/\/www.un.org\/development\/desa\/pd\/sites\/www.un.org.development.desa.pd\/files\/wpp2022_summary_of_results.pdf [Accessed 22-09-2025]"},{"issue":"suppl 3","key":"R3","doi-asserted-by":"publisher","DOI":"10.1590\/0034-7167-2020-0110","article-title":"Active ageing among elderly community members: structural equation modeling analysis","volume":"73","author":"Oliveira","journal-title":"Rev Bras Enferm"},{"issue":"11","key":"R4","doi-asserted-by":"publisher","DOI":"10.1590\/0102-311X00173317","article-title":"Active aging: prevalence and gender and age differences in a population-based study","volume":"34","author":"Sousa","journal-title":"Cad Saude Publica"},{"issue":"4","key":"R5","doi-asserted-by":"publisher","first-page":"1308","DOI":"10.47222\/2526-3544.rbto53872","article-title":"Proposal for an educational guide on active aging and cognitive stimulation for the elderly","volume":"6","author":"Gonzaga","journal-title":"Revisbrato"},{"key":"R6","unstructured":"Abt CC . Serious Games. Viking Press; 1970. ISBN: 9780819161482"},{"issue":"1","key":"R7","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1111\/bjet.12223","article-title":"Benefits, barriers and guideline recommendations for the implementation of serious games in education for stakeholders and policymakers","volume":"47","author":"Tsekleves","journal-title":"Brit J Educational Tech"},{"issue":"3","key":"R8","doi-asserted-by":"publisher","first-page":"142","DOI":"10.18502\/npt.v6i3.1257","article-title":"An aging simulation game\u2019s impact on the attitudes of nursing students","volume":"6","author":"da Nova Fernandes","journal-title":"Nurs Pract Today"},{"key":"R9","doi-asserted-by":"publisher","DOI":"10.1590\/s1980-220x2017013903309","article-title":"Giving voice to caregivers: a game for family caregivers of dependent individuals","author":"Fernandes","journal-title":"Rev Esc Enferm"},{"issue":"1","key":"R10","doi-asserted-by":"publisher","DOI":"10.1186\/s12911-024-02558-4","article-title":"Comparison of the effects of burn assessment mission game with feedback lecture on nursing students\u2019 knowledge and skills in the burn patients\u2019 assessment: a randomized clinical trial","volume":"24","author":"Nasirzade","journal-title":"BMC Med Inform Decis Mak"},{"key":"R11","doi-asserted-by":"publisher","DOI":"10.2196\/56037","article-title":"Effects of a serious smartphone game on nursing students\u2019 theoretical knowledge and practical skills in adult basic life support: randomized wait list-controlled trial","volume":"12","author":"Fija\u010dko","journal-title":"JMIR Serious Games"},{"issue":"9","key":"R12","doi-asserted-by":"publisher","DOI":"10.2196\/30390","article-title":"Conceptual ambiguity surrounding gamification and serious games in health care: literature review and development of Game-Based Intervention Reporting Guidelines (GAMING)","volume":"23","author":"Warsinsky","journal-title":"J Med Internet Res"},{"key":"R13","unstructured":"Jaffe L . Games are multidimensional in educational situations. In: Bradshaw M Lowenstein A , editors. Innovative Teaching Strategies in Nursing and Related Health Professions. Jones and Bartlett Publishers; 2011:175. ISBN: 9781284170177"},{"issue":"3","key":"R14","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1111\/j.2047-3095.2012.01213.x","article-title":"Methods for establishing the accuracy of clinical indicators in predicting nursing diagnoses","volume":"23","author":"Lopes","journal-title":"Int J Nurs Knowl"},{"issue":"2","key":"R15","doi-asserted-by":"publisher","first-page":"1","DOI":"10.5294\/aqui.2022.22.2.8","article-title":"Translation and cross-cultural adaptation of the system usability scale to Brazilian Portuguese","volume":"22","author":"Louren\u00e7o","journal-title":"Aquichan"},{"issue":"1","key":"R16","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1590\/1984-0462\/;2019;37;1;00019","article-title":"Evaluation of usability of a neonatal health information system according to the user\u2019s perception","volume":"37","author":"Padrini-Andrade","journal-title":"Rev Paul Pediatr"},{"volume":"4","journal-title":"J Usability Stud","author":"Bangor","key":"R17"},{"issue":"3","key":"R18","volume":"8","author":"Savi","journal-title":"Revista Nova Tecnol Educ"},{"key":"R19","unstructured":"Gliem JA Calculating GRR . Interpreting, and reporting Cronbach\u2019s alpha reliability coefficient for Likert-type scales. In: Proceedings of the 2003 Midwest Research to Practice Conference in Adult, Continuing, and Community Education. University of Wisconsin; 82-88."},{"issue":"12","key":"R20","doi-asserted-by":"publisher","first-page":"BMi","DOI":"10.1002\/jbmr.4088","article-title":"Issue Information-Declaration of Helsinki","volume":"36","journal-title":"J Bone Miner Res"},{"issue":"3","key":"R21","first-page":"110","volume":"8","author":"Deguirmendjian","journal-title":"J Health Inform"},{"issue":"3","key":"R22","doi-asserted-by":"publisher","first-page":"63","DOI":"10.17083\/ijsg.v2i3.75","article-title":"Validation of games for behavioral change: connecting the playful and serious","volume":"2","author":"Visch","journal-title":"Int J Serious Games"},{"issue":"5","key":"R23","doi-asserted-by":"publisher","first-page":"2570","DOI":"10.1590\/0034-7167-2017-0513","article-title":"Mobile technologies in the nursing area","volume":"71","author":"Silva","journal-title":"Rev Bras Enferm"},{"issue":"1","key":"R24","doi-asserted-by":"publisher","DOI":"10.22456\/1679-1916.85928","article-title":"Uma Experi\u00eancia na Cria\u00e7\u00e3o de Game Design de Jogos Digitais Educativos a partir do design thinking","volume":"16","author":"Fernandes","journal-title":"RENOTE"},{"key":"R25","unstructured":"Jewell D . Design thinking in higher education. ResearchGate. URL: https:\/\/www.researchgate.net\/publication\/376206883_Design_Thinking_in_Higher_Education [Accessed 14-10-2025]"},{"key":"R26","unstructured":"Chandler HM . Manual de Produ\u00e7\u00e3o de Jogos Digitais. Bookman; 2012."},{"issue":"4","key":"R27","doi-asserted-by":"publisher","DOI":"10.2196\/18258","article-title":"Web-based virtual learning environment for medicine administration in pediatrics and neonatology: content evaluation","volume":"8","author":"Pereira","journal-title":"JMIR Serious Games"},{"issue":"2","key":"R28","doi-asserted-by":"publisher","first-page":"16","DOI":"10.11606\/issn.1806-6976.smad.2023.188483","article-title":"Development and validation of an educational game about drug abuse and the risk of suicide","volume":"19","author":"Viana","journal-title":"SMAD"},{"issue":"3","key":"R29","doi-asserted-by":"publisher","first-page":"89","DOI":"10.33448\/rsd-v11i3.26088","article-title":"Parameterization and usability of the nursing process system","volume":"11","author":"de","journal-title":"Res Soc Dev"},{"key":"R30","doi-asserted-by":"crossref","unstructured":"Brooke J . SUS: a \u201cquick and dirty\u201d usability scale. In: Jordan PW Thomas B McClelland IL Weerdmeester B , editors. Usability Evaluation In Industry. CRC Press; 1996:207-212. [doi: 10.1201\/9781498710411-35] ISBN: 9781498710411","DOI":"10.1201\/9781498710411-35"},{"key":"R31","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmedinf.2021.104473","article-title":"Content validation and usability of a chatbot of guidelines for wound dressing","volume":"151","author":"da Silva Lima Roque","journal-title":"Int J Med Inform"},{"key":"R32","doi-asserted-by":"publisher","DOI":"10.3389\/fdgth.2021.600333","article-title":"Toward a conversational agent to support the self-management of adults and young adults with sickle cell disease: usability and usefulness study","volume":"3","author":"Issom","journal-title":"Front Digit Health"},{"issue":"3","key":"R33","doi-asserted-by":"publisher","DOI":"10.1093\/jamiaopen\/ooad073","article-title":"A chatbot for hypertension self-management support: user-centered design, development, and usability testing","volume":"6","author":"Griffin","journal-title":"JAMIA Open"},{"issue":"1","key":"R34","doi-asserted-by":"publisher","DOI":"10.2196\/67338","article-title":"Reward feedback mechanism in virtual reality serious games in interventions for children with attention deficits: pre- and posttest experimental control group study","volume":"13","author":"Fang","journal-title":"JMIR Serious Games"},{"key":"R35","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmedinf.2020.104166","article-title":"Serious game for teaching undergraduate medical students in cleft lip and palate treatment protocol","volume":"141","author":"Palee","journal-title":"Int J Med Inform"},{"issue":"4","key":"R36","doi-asserted-by":"publisher","DOI":"10.1590\/2317-1782\/20232022149pt","article-title":"Usability evaluation of the Agente Escuta application: translational research","volume":"35","author":"Amorim","journal-title":"Codas"},{"issue":"8","key":"R37","doi-asserted-by":"publisher","DOI":"10.2196\/37290","article-title":"System usability scale benchmarking for digital health apps: meta-analysis","volume":"10","author":"Hyzy","journal-title":"JMIR Mhealth Uhealth"},{"issue":"1","key":"R38","doi-asserted-by":"publisher","DOI":"10.2196\/55333","article-title":"Interactive serious game to teach basic life support among schoolchildren in Brazil: design and rationale","volume":"12","author":"Flato","journal-title":"JMIR Serious Games"},{"issue":"1","key":"R39","doi-asserted-by":"publisher","DOI":"10.2196\/54193","article-title":"A virtual reality serious game for the rehabilitation of hand and finger function: iterative development and suitability study","volume":"12","author":"Bressler","journal-title":"JMIR Serious Games"},{"issue":"2","key":"R40","doi-asserted-by":"publisher","DOI":"10.3205\/zma001598","article-title":"Development and evaluation of a virtual reality training for emergency treatment of shortness of breath based on frameworks for serious games","volume":"40","author":"Rickenbacher-Frey","journal-title":"GMS J Med Educ"},{"issue":"2","key":"R41","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1590\/1983-1447.2021.20190384","article-title":"Evaluation of the usability of a mobile application in early detection of pediatric cancer","volume":"42","author":"Cavalcanti","journal-title":"Rev Ga\u00facha Enferm"},{"issue":"1","key":"R42","doi-asserted-by":"publisher","DOI":"10.1590\/2177-9465-ean-2019-0094","article-title":"Satisfaction and self-confidence in the learning of nursing students: randomized clinical trial","volume":"24","author":"Costa","journal-title":"Esc Anna Nery"},{"issue":"3","key":"R43","doi-asserted-by":"publisher","first-page":"845","DOI":"10.1590\/1806-93042021000300007","article-title":"Educational technology on expressing breast milk: development and validation of a Serious Game","volume":"21","author":"Moraes","journal-title":"Rev Bras Saude Mater Infant"},{"key":"R44","doi-asserted-by":"publisher","DOI":"10.1590\/s0080-62342012000700016","article-title":"Multimedia application in mobile platform for teaching the measurement of central venous pressure","volume":"46 Spec No","author":"Galv\u00e3o","journal-title":"Rev Esc Enferm USP"},{"key":"R45","doi-asserted-by":"publisher","DOI":"10.1590\/1518-8345.0661.2726","article-title":"Development of the TabacoQuest app for computerization of data collection on smoking in psychiatric nursing","volume":"24","author":"Oliveira","journal-title":"Rev Lat Am Enfermagem"},{"key":"R46","doi-asserted-by":"publisher","DOI":"10.1590\/1980-220X-REEUSP-2022-0470EN","article-title":"Mobile applications as a strategy to support parents in the care of newborns: a scoping review","author":"Araujo","journal-title":"Rev Esc Enferm"},{"key":"R47","doi-asserted-by":"publisher","DOI":"10.1093\/femsle\/fnad034","article-title":"Using gamification to improve engagement and learning outcomes in medical microbiology: the case study of \u201cBacteriaGame\u201d","volume":"370","author":"Pineros","journal-title":"FEMS Microbiol Lett"},{"issue":"1","key":"R48","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1016\/j.jmir.2020.10.003","article-title":"A scoping review of randomised controlled trials to assess the value of gamification in the higher education of health science students","volume":"52","author":"Arruzza","journal-title":"J Med Imaging Radiat Sci"}],"container-title":["JMIR Serious Games"],"original-title":[],"language":"en","deposited":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T10:21:27Z","timestamp":1762338087000},"score":1,"resource":{"primary":{"URL":"https:\/\/games.jmir.org\/2025\/1\/e66289"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,4]]},"references-count":48,"URL":"https:\/\/doi.org\/10.2196\/66289","relation":{},"ISSN":["2291-9279"],"issn-type":[{"type":"electronic","value":"2291-9279"}],"subject":[],"published":{"date-parts":[[2025,11,4]]},"article-number":"v13i8e66289"}}