Medical Science Educator

, Volume 29, Issue 1, pp 205–214 | Cite as

Maximizing Authentic Learning and Real-World Problem-solving in Health Curricula Through Psychological Fidelity in a Game-Like Intervention: Development, Feasibility, and Pilot Studies

  • Derek A. KuipersEmail author
  • Gijs Terlouw
  • Bard O. Wartena
  • Jelle T. Prins
  • Jean Pierre E. N. Pierie
Original Research


High fidelity is regarded as a hallmark of educational games and simulations for health education. Mainly physical and functional fidelity are associated with authenticity, resulting in the pursuit of a true-to-life simulation and suggesting the imposition of a generally accepted and often unintentional design rationale that assumes that the greater the fidelity of a game or simulation to the real world, the more authentic the intervention is perceived as. Psychological fidelity receives significantly less attention, although it correlates strongly to credibility, suspension of disbelief, and engagement. The BABLR simulator reduces physical and functional fidelity to a minimum and explores the use of psychological fidelity as the main carrier of an authentic learning experience. BABLR was assessed using 26 participants with varying backgrounds in health innovation and social work. In several pilot studies, we collected data on perceived realisticness and real-world relevance. Results show that experts, as well as participants, attest to BABLR’s engagement, immersiveness, and motivational qualities. Practical implications of these findings for future research into developing low-fidelity simulations with high psychological fidelity will be discussed.


Serious games Health education Fidelity Simulation Learning innovation 



This study was carried out on behalf of the research groups iHuman and Serious Gaming, both research groups of the NHL Stenden University of Applied Sciences. The BABLR artifact was developed for usage in a health innovation curriculum course for a master’s degree in digital innovation in health and social work. The authors express their thanks to Dr. Job van ’t Veer and Dr. Hylke van Dijk for support and funding. You rock.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that there is no conflict of interest.

Ethical Approval

For this type of study, formal consent is not required.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© International Association of Medical Science Educators 2018

Authors and Affiliations

  1. 1.NHL Stenden University of Applied SciencesLeeuwardenNetherlands
  2. 2.Medical Faculty LEARN, University Medical Center GroningenUniversity of GroningenGroningenNetherlands
  3. 3.Industrial Design EngineeringDelft University of TechnologyDelftNetherlands
  4. 4.MCL AcademyMedical Center LeeuwardenLeeuwardenNetherlands
  5. 5.Surgery DepartmentMedical Center LeeuwardenLeeuwardenNetherlands
  6. 6.Post Graduate School of Medicine, University Medical Center GroningenUniversity of GroningenGroningenNetherlands

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