ultrasound examination training game

Refine the ultrasound skills of your sonography students

Get to know Underwater: a serious game that is developed to measure and practice the fine mobility of echoing. The game allows the students to improve their skills in performing ultrasound examinations. Underwater is developed in collaboration with UMCG, tested with students and sonographers and played at medical fairs.

Research papers

How does Underwater work?

The game uses a self developed controller that resembles a real ultrasound probe to provide students a fun, challenging and realistic training module.

The controller measures the hand-eye coordination and calculates the ‘ultimate’ movement. The performance can be measured based on own performance as well as compared to other players. That makes it possible for the students to monitor their progress in a competitive way. They get immediate feedback on their actions and suggestions to improve the specific action.

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What are the benefits of using Underwater for students?

The use of Underwater brings a number of advantages in terms of time, motivation, money and measurability.

Time saving

Players are able to practice without a person's supervision, The intelligent software will provide them useful feedback.

Money saving

It is possible to save on expenses by reducing instruction time. In addition, the game provides more insights into the progress of the players.

Increased motivation

Through the clever use of game elements in combination with real echo examinations, the game increases the intrinsic motivation of the player. The immediate feedback keeps the player's attention and rewards the player for achievements in the game.

Measuring values

The so-called 'gold standard' is a system that compares a user to ultrasound experts. The system assesses a player on his handling of a transducer in game parts inspired by real ultrasound guided examinations and procedures.

Underwater compared to traditional learning methods

Use of intrinsic motivation

Intrisic motivation is not used in the traditional training sessions. The intrinsic motivation of the player is reinforced by the use of the game elements in Underwater. It ensures that the player wants to practice more often and ultimately gets better in handling the transducer.

Fun and challenging

Underwater makes practicing more fun and challenging by using clever puzzles and game mechanics. This makes it possible for the players to train the required skills, without them immediately noticing this during the game.

Direct Feedback

By providing players with clear and direct feedback, they know exactly what went wrong, how it went wrong and how they can improve their skills. Due to the objective feedback provided by the game, no interventions by a doctor are needed during a training session.

Research papers and publications

Within the development and use of Underwater, we value research. An overview of recent research papers and publications can be found below:

The validation of a serious game for teaching ultrasound skills

23 July 2022
T. J. Olgers, J.M. van Os, H. R. Bouma & J.C. ter Maaten

This study shows solid content- and face validity of the serious game “UnderWater” for training ultrasound skills.The game is appreciated as a promising serious game for training eye–hand coordination and learning ultrasound, which may reduce expensive bed-side teaching.

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Sonography students try ‘Underwater’ ultrasound game to practice imaging technique

20 December 2023
Cat Pastoor

College of DuPage Sonography students recently had the opportunity to test their skills using a new, gameified training tool in development called “Underwater,” a simulator where students use an ultrasound probe to navigate an underwater world.

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Teaching point-of-care ultrasound using a serious game: a randomized controlled trial

19 December 2023
Tycho Olgers, Jelle Rozendaal, Sanne van Weringh, Rachel van de Vliert, Ranek Laros, Hjalmar Bouma & Jan ter Maaten

Point-of-care ultrasound (POCUS) is an important diagnostic tool for internists. However, there are important barriers in learning POCUS, including lack of practice time and lack of experts for supervision. Alternative learning tools may assist in overcoming these barriers. A serious game is being developed specifically for teaching ultrasound. In this study, we assessed the use of a serious game in learning POCUS.

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About Sfinx Games

Sfinx Games is a company specialized in developing games, with the focus on serious games. These games offer more than just entertainment value. Their main goal is to teach, convince or change the target group's view.

The mission of Sfinx Games is to develop each of their games with a good distribution of serious and fun elements.

Robert Mertens

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