Video games have health benefits Editor—The article by Edroos on video games as learning aids was interesting but selective. w1 Evidence indicates that impor- tant skills may be built or reinforced by video games—for example, spatial visuali- sation. w2 Video games have also been used to improve children’s health care. One of the best studied is Packy and Marlon (Kidz Health Software). w3 It was designed to improve self care and compliance in children with diabetes. In a controlled study, 8 to 16 year olds were assigned to either playing Packy and Marlon or an entertainment game. w3 In addition to more communication with parents and improved self care, the treatment group needed fewer urgent medical visits. Several case reports describe the use of video games for rehabilitation. In one, an electronic game was used to improve arm control in a 13 year old boy with Erb’s palsy. w4 The game’s format capital- ised on the child’s motivation to succeed and focused attention away from poten- tial discomfort. Electronic games have also been used to increase adolescents’ awareness in HIV/AIDS prevention pro- grams. w5 Studies have shown that video games can provide cognitive distraction—hence less nausea and need for painkillers— during chemotherapy in children. w6–w8 Parents would support the use of video games if they were sure that they helped their children educationally. There are several elements that the teacher, parent, or facilitator should evaluate when choosing a health promot- ing, or educational, or helping, video game. w9 Educational or therapeutic objective— The objective of the game should be clear Type of game—Some games need physi- cal skill and strategy and others are games of chance Required level and nature of involvement—Should the video game player be passive or active? Information and rules—Some games allow the player to have a range of know- ledge and information about past experi- ences with the game, others give the player minimal amounts of information The role of luck—Some games are driven by chance Difficulty—Some games allow the player to choose the difficulty level Competition—Some players are attracted by competition Duration—Rewards, personal chal- lenges, or changes in surroundings can maintain interest Participant age and characteristics— Computerised games have been devel- oped for a range of ages Number of players—Some videogames are solitary in nature, others pit players against each other or the computer Facilitator’s role—In some videogames, the facilitator observes. In others, the facilitator is an important part of the game. Video games bring new challenges to education and medicine. Video games may possess advantages not present in other learning strategies—for example, the ability to choose different solutions to a difficult problem and then to see the effect of those decisions in a fictional game allows players to experiment with problem solving. Video games have great positive potential in addition to their entertainment. There has been consider- able success when games are designed to tackle a specific problem or to teach a certain skill. However, generalisability outside the game playing situation remains an important research question. Mark D Griffiths professor of gambling studies, International Gaming Research Unit, Nottingham Trent University mark.griffiths@ntu.ac.uk Happiness is . . . more feedback and better appraisals Editor—I cannot agree enough with Peile and Carter’s editorial about making happy doctors. 1 The penultimate para- graph sums up the feeling of so many of my fellow students. Many of us have recently become disillusioned by the sheer volume, and the non-stop nature, of the work. After revising throughout the Christmas break and then returning to exams, we have now worked a further six weeks. We have 10 weeks (including Easter) until our summer exams. Our lectures continue until 4 pm on the Friday before the exams. And after the exams we are expected to begin work toward projects (as we are doing interca- lated degrees). Little time is allocated for feedback and tutorials (two sessions this semester), and these will probably last 10 minutes at most. The General Medical Council should push for better feedback and appraisals for students. These would help us to keep sight of the light at the end of the tunnel and encourage us to keep working towards it. At the moment we finish one set of exams and go straight back to work, with little feedback or constructive criticism. I am sure that I am not the only medical student who feels like this, or perhaps other medical schools are doing better. Sarah Jones second year intercalated medical student, University of Nottingham mzyxslj@nottingham.ac.uk 1 Peile E, Carrter Y. Making happy doctors. studentBMJ 2005;13:91. (March.) Give me a break; fast track me Editor—Doctors today are under the kind of pressure that is not exerted on other professions. Doctors are pilloried in the press for making mistakes, condemned for not picking up the most esoteric of diagnoses, and the victims of uncalled for litigation in an era in which unintentional mistakes, negligence, and premeditated harm are all viewed as one entity. We are also expected to make difficult management decisions, some- times under the most adverse of conditions. And we also have to face the indignity of non-medically qualified managers and executives blocking our attempts to render service in the name of meeting targets. And the European Working Time Directive and its per- ceived detrimental effect on the training of future doctors has resulted in a general air of confusion. Doctors have to sacrifice more of themselves and their families than mem- bers of any other profession, not just during working hours but for all of their professional lives. They also have to spend vast amounts of time reading and attending courses just to keep up with the daily developments in all specialties. One mistake and all the years of toil can be wiped out as a career is lost. As a group, however, doctors accept the lifestyle that they signed up to, with little complaint. And after all this, it is considered wrong for us to be fast tracked when it comes to medical care. Give me a break. 1 Tarek Arab specialist registrar in obstetrics and gynaecology, King Khalid National Guard Hospital, Jeddah, Saudi Arabia captflashheart@yahoo.com 1 Mann C. We should get fast tracked in hospital. studentBMJ 2005;13:127. (March.) Please submit letters as electronic responses at www.studentbmj.com or send emails to studenteditor@bmj.com References w1-w9 are on studentbmj.com LETTERS letters 172 STUDENTBMJ | VOLUME 13 | APRIL 2005 |