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Open Access Research article

An educational game for teaching clinical practice guidelines to Internal Medicine residents: development, feasibility and acceptability

Elie A Akl12*, Reem Mustafa1, Thomas Slomka34, Alia Alawneh1, Abhishek Vedavalli1 and Holger J Schünemann56

Author Affiliations

1 Department of Medicine, State University of New York at Buffalo, NY, USA

2 Department of Family Medicine, State University of New York at Buffalo, NY, USA

3 Educational Technology Center, State University of New York at Buffalo, NY, USA

4 Digital Library Center, State University of New York at Buffalo, NY, USA

5 CLARITY Research Group, Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, ON, Canada

6 Department of Epidemiology, Italian National Cancer Institute Regina Elena, Rome, Italy

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BMC Medical Education 2008, 8:50  doi:10.1186/1472-6920-8-50

Published: 18 November 2008



Adherence to Clinical Practice Guidelines (CPGs) remains suboptimal among internal medicine trainees. Educational games are of growing interest and have the potential to improve adherence to CPGs. The objectives of this study were to develop an educational game to teach CPGs in Internal Medicine residency programs and to evaluate its feasibility and acceptability.


We developed the Guide-O-Game© in the format of a TV game show with questions based on recommendations of CPGs. The development of the Guide-O-Game© consisted of the creation of a multimedia interactive tool, the development of recommendation-based questions, and the definition of the game's rules. We evaluated its feasibility through pilot testing and its acceptability through a qualitative process.


The multimedia interactive tool uses a Macromedia Flash web application and consists of a manager interface and a user interface. The user interface allows the choice of two game styles. We created so far 16 sets of questions relating to 9 CPGs. The pilot testing proved that the game was feasible. The qualitative evaluation showed that residents considered the game to be acceptable.


We developed an educational game to teach CPGs to Internal Medicine residents that is both feasible and acceptable. Future work should evaluate its impact on educational outcomes.