In addition, extrinsic factors are addressed by lowering the barrier to training by facilitating training outside the skillslab on generic, widely disseminated digital platforms. Learning in serious games occurs by increasing intrinsic motivation through gameplay that engages learners in challenges that adapt to their growing in-game skills in a non-repetitive manner.

Serious games are designed to be entertaining and to provide an active learning environment for the player to develop professional skills. Īs to voluntary simulator training, the novel educational approach of serious gaming is well positioned to mitigate the various factors that are thought to limit the utilization of laparoscopic simulators. Extrinsic factors include workweek restrictions, remote simulator locations, and the amount of mandatory training courses residents have to complete. Intrinsic (motivational) factors include perceived utility and whether or not the training activities are perceived as fun. This may be caused by intrinsic and/or extrinsic factors. The availability of validated laparoscopic simulators, however, has not resulted in sustainable, high-volume voluntary simulator training. Laparoscopic simulators have been successfully validated and skills transfer to the operating room has been established. This is caused by the need for residents to master an increasing number of highly complex surgical procedures which cannot be done in the operating room (OR) due to legal and ethical concerns regarding patient safety, resident workweek restrictions, and costs of OR time. Most surgical departments have invested in creating simulation-based skills training facilities.

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