Introduction: Given the complexity of teaching clinical reasoning to (future) healthcare
professionals, the utilization of serious games has become popular for supporting clinical
reasoning education. This scoping review outlines games designed to support teaching
clinical reasoning in health professions education, with a specific emphasis on their alignment
with the 8-step clinical reasoning cycle and the reflective practice framework, fundamental for
effective learning.
Methods: A scoping review using systematic searches across seven databases (PubMed,
CINAHL, ERIC, PsycINFO, Scopus, Web of Science, and Embase) was conducted. Game characteristics,
technical requirements, and incorporation of clinical reasoning cycle steps were
analyzed. Additional game information was obtained from the authors.
Results: Nineteen unique games emerged, primarily simulation and escape room genres.
Most games incorporated the following clinical reasoning steps: patient consideration
(step 1), cue collection (step 2), intervention (step 6), and outcome evaluation (step 7).
Processing information (step 3) and understanding the patient’s problem (step 4) were less
prevalent, while goal setting (step 5) and reflection (step 8) were least integrated.
Conclusion: All serious games reviewed show potential for improving clinical reasoning skills,
but thoughtful alignment with learning objectives and contextual factors is vital. While this
study aids health professions educators in understanding how games may support teaching
of clinical reasoning, further research is needed to optimize their effective use in education.
Notably, most games lack explicit incorporation of all clinical reasoning cycle steps, especially
reflection, limiting its role in reflective practice. Hence, we recommend prioritizing
a systematic clinical reasoning model with explicit reflective steps when using serious
games for teaching clinical reasoning.
