KAMK’s nursing education and serious game development team, Clever Simulation Entertainment, have been collaborating and developing various XR technological and gamified solutions for about ten years. Now the Wellbeing services county of Kainuu will be involved in the development work, as the InnoXR project (ESF+, 2025–2028) was launched on 1 March 2025. The project will utilize the work already done and create new, innovative competence development solutions for the Kainuu social and health care sector.
The beginning of the cooperation
Cooperation with nursing and the Clever team began in the SIMPPELI – Simulator and game competence in the development of teaching project (ESF, 2015–2017), which developed the first virtual reality game (VR) for nursing education. In this Aging game, the player gets to step into the world of an elderly person and experience the impact of age-related changes such as loss of vision, hearing, or memory on their functioning. The game has been found to illustrate the world of an elderly person surprisingly well. It has been particularly gratifying to see that the game is also suitable for distance learning, which significantly increases its uses. In the future, the game will hopefully be updated and developed further.
A VR game can also be used in distance learning. Students can experience e.g. the effect of tube vision on functional capacity. Photo: T. Romppanen.
A big leap was taken in the development of games in the social and health care sector in the national SotePeda project (Ministry of Education and Culture, 2018–2020), which developed KAMK’s first virtual escape game in cooperation between KAMK’s nursing education and the Clever team. This virtual puzzle room (in Finnish) illustrates the possibilities of digitalisation in different environments, and the target group of the game is all university students, regardless of their field. A PC-playable version of the game was also made.
In the virtual puzzle room players can solve challenges related to the digitalisation of health and social services. Photo: Clever Simulation Entertainment.
With the development of the virtual puzzle room, the possibilities of VR games and pedagogical escape games as a teaching method were concretely understood in nursing education: they really can be used to learn. Inspired by this insight, physical escape games were also developed for nursing education. The students felt that the games were a useful and inspiring addition to their studies. This motivated to continue the development of the games.
The escape game challenges students to solve nursing problems together. Photo: T. Romppanen
Quality has been a pleasure to make
The next significant development step was taken in the Mystery 24/7 project (in Finnish) coordinated by KAMK, which developed a VR escape game for Kela’s vocational rehabilitation. The game was the first of its kind for Kela (the Social Insurance Institution of Finland), so it was a real pioneering work. The game was awarded as the best Finnish learning solution of 2023 in the Finnish eLearning Centre competition, and it has been made just as well as you would expect from a winner. Close cooperation was carried out with the target group, i.e. young people and the professionals working with them, and their perspectives were genuinely considered. At KAMK, the Bachelor of Social Services education was launched during the project period, and this game was included in the education from the beginning. A separate blog post has been written about this (in Finnish).
The following gamified innovations were strongly developed in relation to nursing. The PedaXR project (Ministry of Education and Culture, 2020–2023) produced two VR games: VResuscitation for teaching CPR and WoundED for teaching wound care. The latter has aroused a lot of interest both in Finland and internationally, and it has been translated into English and Belgium. The game is actively used in wound care teaching, and it has also been found to work in distance teaching. What is particularly important in the game is the visuals and the fact that during the game you can see the response to the care actions you have taken. When using the game, it has also been noted that learning by playing does not know age limits and does not require special technical skills or even an interest in games. When you give the game a chance, it may surprise you.
- ”An addictive experience, I would like to continue!”
- ”I wouldn’t have thought it would be so illustrative.”
- ”Talking together teaches.”
Comments from wound care students from autumn 2024.
In the wound care VR game, the whole group participates in the game. Photo: T. Romppanen
The latest virtual escape game was developed in the UraXR project (ESF, 2022–2023), which developed a two-player escape game, a sneak peek into nursing studies. The game can be used, for example, to motivate those considering the field to study, as an orientation to VR gaming or as a means of grouping, and it has also been written about in the Suuria tekoja blog (NursED: diving into the work of a nurse) (in Finnish).
In addition to the games, in cooperation with nursing education and the Clever team, other teaching methods have also been developed. These are different kind of exercises for students, such as Horror room exercises for studying pharmacotherapy and an exercise guided by a ”holographic assistant” for practicing surgical wound dressing sterile change with the help of Microsoft HoloLens.
Augmented reality can be used to practice nursing skills in the real world with the support of technology. Photo: Clever Simulation Entertainment.
The most important thing is learning
Through years of co-creation, a lot of new things have been added to education in the social and health care sector, and various games have also been developed without the Clever team as physical versions as well as digital games. For example, the international NursEduPal project (Erasmus+) developed an escape game for palliative care. The game was made to be as simple and easy to use as possible, a classroom version that fits in a small box, as well as a digital version in collaboration with the DIGIHOI – DON’T LEAVE project (ESF, 2022–2023).
The key elements of escape games, such as teamwork, problem-solving and decision-making, are essential in all escape games. These are important skills in nursing, and when you add to the whole the preparation for the game by delving into the topic and the debriefing discussion after the game, it is, also according to research, an effective teaching method.
”It’s like solving the patient’s situation with colleagues.”
Student’s comment on the first remotely played escape game in KAMK’s nursing education.
However, not everyone likes gaming or feels that they learn by playing. It doesn’t have to be this way, after all, not everyone benefits from sitting and listening. The most essential lesson for the health and social services sector is probably the shaking up of prejudices and the understanding that games can bring a new dimension to teaching and learning, and gaming is not only harmful or only for young people. Games also don’t always have to be ”high tech” or even very complicated. Under no circumstances should they be so complex that the essentials, i.e. learning, are left in the background. Experience has also been gained in this by testing a 3D escape game in the teaching of anatomy and physiology: an overly complex game and a difficult subject do not motivate or support learning.
In other words, the use of games in teaching requires strong pedagogical skills. This is the focus of the ongoing Escape Together! project (Finnish National Agency for Education, 2024–2026), implemented in cooperation with the University of Eastern Finland and Humak University of Applied Sciences, which develops the pedagogical escape game skills of comprehensive school and upper secondary vocational teachers in cooperation between KAMK’s nursing education and the Clever team.
InnoXR: looking to the future
The InnoXR project develops methods for developing competence in the entire Kainuu social and health care sector in a comprehensive manner. Photo: V. Neuvonen.
Through joint projects, the cross-disciplinary cooperation between KAMK’s nursing education and the Clever team has thus become strong and well-welded together. The next significant step is to continue the development of XR technology and serious games in cooperation with the wellbeing services county of Kainuu in the InnoXR project, which has just begun.
The project will create new XR technological competence development solutions to increase customer understanding of neurodevelopmental/psychiatric disorders, practice encountering workplace violence and wound care. In addition, other topics that require new teaching content and methods, such as AR technology exercises, remote simulations or gamified entities, will be mapped.
The implementation of the InnoXR project considers the opportunities for remote participation and different ways of learning, and the aim is to provide all current and future professionals in the social and health care sector with equal opportunities for competence development throughout the Kainuu region. The development work is carried out in close cooperation with the target group, and the aim is to make the developed innovations genuinely usable. More information about the project will be featured in the Suuria tekoja blog, highlighting innovations in developing competence within Kainuu’s social and health care sector.
The future of cross-sectoral cooperation in KAMK and Kainuu therefore looks bright. Nursing, which has strong traditions, and the social welfare and health care sector in general, and the innovative gaming industry, work well together. Or not badly, as we say in Kainuu.