Game-based e-learning: The next level of staff training

E-learning is taking hold in popularity in many fields, including long-term care. However, Fortune 500 companies, to take one prominent example, are discovering that e-learning is often simply “e-boring.”

“Companies in the U.S. spend about $60 billion a year on training their employees, but there’s a good chance much of that is wasted. The reason: Most training sessions are just too dull. (Web-based e-learning classes were supposed to fix that, but in reality, they just allow employees to get bored at their own pace.) As a result, employees aren’t coming away from the training with the knowledge or skills their employers are paying for,” reports the Wall Street Journal.1

One of the challenges with e-learning, or online learning as it’s also called, is that programmers, not educators, have too often been at the controls. It’s easy to take a series of PowerPoint slides and, with the click of a button, create a “course.” Add a few simple multiple-choice questions, and you’ve got e-learning. Or maybe not.

E-learning, like any other learning, is most effective when designed and executed by educators and experienced trainers who understand learner motivation, both intrinsic and extrinsic. Educators understand that outlines don’t convey learning, but stories that help the learner integrate concepts into his or her life and work do.

Cutting-edge e-learning is not about simply using technology to replace traditional methods, as in the online learning approach that is focused only on content. One solution? Let them play games. “Playing games reinforces learning,” reports Dan Yaman, president of LearningWare, Inc., a company that specializes in game-based learning.2 “Just like children, adults enjoy playing games,” writes Yaman. “They like to laugh, and they remember information that is tied to strong emotions. When a game is introduced into a serious classroom environment, participants relax, they get excited, they compete and, most importantly, they remember the event and the information tied to it.”

Researchers reinforce these observations by studying influences on recall of new learning. The Learning Pyramid (figure 1) displays the results of research conducted by National Training Laboratories in Bethel, Maine. Learning games fall into the 75% retention rate category—significantly higher than the typical e-learning approach.

The Learning Pyramid charts the average retention rate for various methods of teaching. These retention percentages represent the results of research conducted by National Training Laboratories in Bethel, Maine

In fact, a study at Indiana University found that game-based learning increased retention by more than 300% in immediate posttesting, and by as much as 10 times when subjects were tested six weeks later (figure 2).3

Retention rates: game-based vs. traditional training

The big difference? Repetition and competition.

Imagine getting employees to sit willingly through four showings of the same training video. Now imagine those same employees addressing the same material in three different game formats following the initial presentation, including familiar formats like those of the game shows Wheel of Fortune and Who Wants to Be a Millionaire?

“Never, ever underestimate the power of competition,” says Wynn Johnson, sales manager for Borland Software Corporation. “People on my team not only played games again and again, aiming for the top score, but they also gravitated to those who excelled in specific areas for targeted help.” The team played, for example, such classics as Choices (multiple-choice questions), Dichotomy (true-false questions), and Hangman (the basis of the Wheel of Fortune TV game show). “The competitive nature of games raised the bar of expectation of quality and performance by all our team members,” Johnson adds.

Johnson found that using the learning games “really helped our company make optimal use of our limited human resources by allowing me to spot quickly which team members wanted to be the best, and who simply didn’t care. We found that we could quickly identify those individuals who just weren’t a good fit for our company, rather than waiting the typical six to nine months from hiring. Surprisingly, we found the learning games not only great for training, but also a great management tool.”

The application of this approach to staff training within the senior care profession comes at a time when staff training and associated technology are at the top of the industry’s radar. The American Association of Homes and Services for the Aging (AAHSA) contends that “[t]echnology may be the key integrator for a new vision for long-term care.” AAHSA is challenging the nation with its “5 Big Ideas” initiative, which explicitly incorporates a focus on technology.4 One of the most significant problems in the senior care profession, as identified by AAHSA, relates directly to staff needs. “With staff turnover being a $4.5 billion per year problem, emphasis needs to be placed on enabling providers to transform their cultures to help attract, retain and reinforce front-line caregivers and their supervisors. Staffing is the best proxy for quality,” the AAHSA report contends.

Clearly, any staff training program that is significantly more effective than traditional training approaches can be a valuable tool for transforming the culture of caregiving; technology can play a big part in achieving that effectiveness. The payoff from such a transformation can be huge. For example, if a 500-bed facility could reduce turnover by 10% and increase census by an additional 5%, the result for the facility is a net gain of $1 million.

With these kinds of numbers at stake, it pays to invest in training that goes beyond the old objective of mere compliance and beyond the old models of delivering content. Whether mission-driven or profit-driven, tomorrow’s successful companies must integrate effective training into their long-range strategies.

But technology alone is not the answer. As AAHSA points out, “…technology for tech sake alone is not enough—it must be innovative, effective technological change that the long-term care profession embraces.”4 For long-term care staff, games that are simple in design (i.e., not requiring advanced computer skills), have visual impact, and include a fast-paced element of challenge would meet the AAHSA criteria of being innovative and effective. Corporate America echoes AAHSA’s views: Technology must be innovative and effective. Game-based training scores high on both these criteria, making full use of both 21st century technology and the most current thinking regarding learning.

Sharon K. Brothers, MSW, is President and CEO of the Institute for Senior Living Education. The Institute has launched a new game-based staff training program, aQuire Training Solutions.

For further information, visit or contact Ed Hansen at or (877) 843-8374. To send your comments to the author and editors, e-mail


  1. Business solutions: Better training through gaming. Wall Street Journal, April 25, 2006:R6.
  2. Why Games Work. A White Paper by Dan Yaman, president of Learning Ware, Inc. Available at:
  3. Indiana University. Private study commissioned by QBInternational. Details available from QBInternational, 900 Larkspur Landing Circle, Suite 115, Larkspur, CA 94939, or visit
  4. AAHSA’s 5 Big Ideas. Available at:

Topics: Activities , Articles , Technology & IT