PROGRAMME DESCRIPTION: Integration of an extended, immersive, gamified pharmacy simulation as a capstone event


  • Denise L Hope Griffith University, Gold Coast QLD, Australia
  • Gary D Grant Griffith University, Gold Coast QLD, Australia
  • Gary D Rogers Deakin University, Geelong VIC, Australia
  • Michelle A King Griffith University, Gold Coast QLD, Australia



Capstone, Competence, Gamification, Pharmacy education, Simulation


Introduction: A gamified simulation was integrated as a capstone event for a new Australian undergraduate pharmacy programme. It aimed to consolidate previous learning and deliver an authentic activity aligned with self-determination theory to develop students’ professional identity and enhance their competence, confidence, and collaborative skills.   

Description: A full-environment immersive simulation was constructed in which teams of final-year pharmacy students competitively managed their own virtual pharmacies over an extended period. Gamification of the simulation aimed to enhance student motivation and engagement while recognising the consequences of clinical and professional decision-making.       

Evaluation: Four years of gamified simulation encouraged outstanding student attendance and engagement. The quantitative evaluation revealed high student satisfaction (mean 4.7 out of 5) of the host courses, while the qualitative evaluation revealed that intended outcomes were met through the delivery of authentic, consolidated learning and enhancement of student confidence and professional identity.     

Conclusion: An extended, gamified simulation may provide a transformative learning event.

Author Biographies

Denise L Hope, Griffith University, Gold Coast QLD, Australia

School of Pharmacy and Medical Sciences

Gary D Grant, Griffith University, Gold Coast QLD, Australia

School of Pharmacy and Medical Sciences

Gary D Rogers, Deakin University, Geelong VIC, Australia

School of Medicine

Michelle A King, Griffith University, Gold Coast QLD, Australia

School of Pharmacy and Medical Sciences


Aburahma, M. H., & Mohamed, H. M. (2015). Educational games as a teaching tool in pharmacy curriculum. American Journal of Pharmaceutical Education, 79(4), Article 59.

Akl, E. A., Kairouz, V. F., Sackett, K. M., Erdley, W. S., Mustafa, R. A., Fiander, M., Gabriel, C., & Schünemann, H. (2013). Educational games for health professionals. Cochrane Database of Systematic Reviews (3), 1-47.

Anderson, L. W., Krathwohl, D. R., & Bloom, B. S. (2001). A taxonomy for learning, teaching, and assessing: a revision of Bloom's taxonomy of educational objectives: Longman

Anderson, T. (2005). Design-based research and its application to a call centre innovation in distance education. Canadian Journal of Learning and Technology/La revue canadienne de l’apprentissage et de la technologie, 31(2)

Anderson, T., & Shattuck, J. (2012). Design-based research: A decade of progress in education research? Educational Researcher, 41(1), 16-25

Apostol, S., Zaharescu, L., & Alexe, I. (2013). Gamification of Learning and Educational Games. Paper presented at the The International Scientific Conference eLearning and Software for Education

Austin, Z., O'Byrne, C., Pugsley, J., & Munoz, L. Q. (2003). Development and validation processes for an objective structured clinical examination (OSCE) for entry-to-practice certification in pharmacy: the Canadian experience. American Journal of Pharmaceutical Education, 67(3), 76

Australian Pharmacy Council Ltd. (2020). Accreditation Standards, Performance Outcomes Framework and Supporting Documents. Available at:

Bajis, D., Chaar, B., Basheti, I. A., & Moles, R. (2019). Pharmacy students' medication history taking competency: Simulation and feedback learning intervention. Currents in Pharmacy Teaching and Learning, 11(10), 1002-1015

Bajko, R., Hodson, J., Seaborn, K., Livingstone, P., & Fels, D. (2015). Guilds, Die Rolls, and Leaderboards: Gamification of Two Undergraduate Multimedia and Social Media Courses. Paper presented at the Proceedings of the EDSIG Conference

Barab, S., & Dede, C. (2007). Games and immersive participatory simulations for science education: an emerging type of curricula. Journal of Science Education and Technology, 16(1), 1-3

Barclay, S. M., Jeffres, M. N., & Bhakta, R. (2011). Educational card games to teach pharmacotherapeutics in an advanced pharmacy practice experience. American Journal of Pharmaceutical Education, 75(2)

Barnett, D. J., Everly, G. S., Parker, C. L., & Links, J. M. (2005). Applying educational gaming to public health workforce emergency preparedness. American Journal of Preventive Medicine, 28(4), 390-395

Beaubien, J., & Baker, D. (2004). The use of simulation for training teamwork skills in health care: how low can you go? Quality and Safety in Health Care, 13(suppl 1), i51-i56

Bloom, B. S., Engelhart, M. D., Furst, E. J., Hill, W. H., & Krathwohl, D. R. (1956). Taxonomy of Educational Objectives, Handbook I: The cognitive domain (Vol. 19): New York: David McKay Co Inc

Bogossian, F. E., Cant, R. P., Ballard, E. L., Cooper, S. J., Levett‐Jones, T. L., McKenna, L. G., Ng, L. C., & Seaton, P. C. (2019). Locating ‘gold standard’evidence for simulation as a substitute for clinical practice in pre‐licensure health professional education: A systematic review. Journal of Clinical Nursing

Bowers, R., Tunney, R., Kelly, K., Mills, B., Trotta, K., Wheeless, C. N., & Drew, R. (2017). Impact of standardized simulated patients on first-year pharmacy students’ knowledge retention of insulin injection technique and counseling skills. American Journal of Pharmaceutical Education, 81(6), 113.

Boyd, M., Solanki, V., Anderson, C., Sonnex, K., & Brydges, S. (2017). Pharmacy Leadership and Management: A new high fidelity simulation to prepare students for their future practise. Paper presented at the Monash Pharmacy Education Symposium, Prato, Italy

Bradley, P. (2006). The history of simulation in medical education and possible future directions. Medical Education, 40(3), 254-262

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101

Brookfield, S. (1995). The getting of wisdom: What critically reflective teaching is and why it’s important. In Becoming a Critically Reflective Teacher (pp. 1-28)

Bruno, A., Bates, I., Brock, T., & Anderson, C. (2010). Towards a global competency framework. American Journal of Pharmaceutical Education, 74(3). doi:10.5688/aj740356

Butt, M. F. (2018). Simulated patients uncovered. The Clinical Teacher, 15(1), 81-82

Cain, J., Conway, J. M., DiVall, M. V., Erstad, B. L., Lockman, P. R., Ressler, J. C., Schwartz, A. H., Stolte, S., & Nemire, R. E. (2014). Report of the 2013-2014 academic affairs committee. American Journal of Pharmaceutical Education, 78(10)

Cain, J., & Piascik, P. (2015). Are Serious Games a Good Strategy for Pharmacy Education? American Journal of Pharmaceutical Education, 79(4), 47.

Chang, Y. H., Poh, H. D. Y., Wong, L. L., Yap, G. J. Y., & Yap, Y.-L. K. (2015). Student Preferences on Gaming Aspects for a Serious Game in Pharmacy Practice Education: A Cross-Sectional Study. JMIR Medical Education, 1(1), e2.

Chen, Y.-C., Kiersma, M. E., & Abdelmageed, A. (2015). Evaluation of student perceptions of standardized patient simulation on patient counseling confidence during introductory pharmacy practice experiences. Currents in Pharmacy Teaching and Learning, 7(6), 811-818.

Crea, K. A. (2011). Practice Skill Development Through the Use of Human Patient Simulation. American Journal of Pharmaceutical Education, 75(9), 188.

Croft, H., Gilligan, C., Rasiah, R., Levett-Jones, T., & Schneider, J. (2019). Current trends and opportunities for competency assessment in pharmacy education–a literature review. Pharmacy, 7(2), 67.

de Freitas, S., & Oliver, M. (2006). How can exploratory learning with games and simulations within the curriculum be most effectively evaluated? Computers & Education, 46(3), 249-264

Deci, E. L., & Ryan, R. M. (2008). Self-determination theory: A macrotheory of human motivation, development, and health. Canadian Psychology, 49(3), 182-185.

Electronic Arts Inc. (2020). EA Games: SimCity™. Available at:

Englund, C., & Sjöström, H.-E. (2011). Communication training in a virtual pharmacy. In Reformation, Revolution, Evolution (pp. 11)

Fens, T., Dantuma-Wering, C. M., & Taxis, K. (2020). The Pharmacy Game-GIMMICS® a Simulation Game for Competency-Based Education. Pharmacy, 8(4), 198.

Fens, T., Hope, D. L., Crawshaw, S., Tommelein, E., Dantuma-Wering, C., Verdel, B. M., Trečiokienė, I., Solanki, V., van Puijenbroek, E. P., & Taxis, K. (2021). The international Pharmacy Game: a comparison of implementation in seven universities world-wide. Pharmacy, 9(125).

Fernandez, R., Parker, D., Kalus, J. S., Miller, D., & Compton, S. (2007). Using a Human Patient Simulation Mannequin to Teach Interdisciplinary Team Skills to Pharmacy Students. American Journal of Pharmaceutical Education, 71(3), 51.

Gaba, D. M. (2004). The future vision of simulation in health care. Quality and Safety in Health Care, 13(suppl 1), i2-i10.

Gleason, B. L., Peeters, M. J., Resman-Targoff, B. H., Karr, S., McBane, S., Kelley, K., Thomas, T., & Denetclaw, T. H. (2011). An active-learning strategies primer for achieving ability-based educational outcomes. American Journal of Pharmaceutical Education 75(9)

Harden, R. M. (1999). What is a spiral curriculum? Medical Teacher, 21(2), 141-143.

Harrow, A. J. (1972). A Taxonomy of the Psychomotor Domain: A Guide for Developing Behavioral Objectives: D. McKay

Hirsch, A. C., & Parihar, H. S. (2014). A capstone course with a comprehensive and integrated review of the pharmacy curriculum and student assessment as a preparation for advanced pharmacy practice experiences. American Journal of Pharmaceutical Education, 78(10), Article 192.

Hope, D. L., Rogers, G. D., Grant, G. D., & King, M. A. (2021). Experiential learning in a gamified pharmacy simulation: a qualitative exploration guided by semantic analysis. Pharmacy, 9(81).

Huang, H.-M., Rauch, U., & Liaw, S.-S. (2010). Investigating learners’ attitudes toward virtual reality learning environments: Based on a constructivist approach. Computers & Education, 55(3), 1171-1182

Hussainy, S. Y., Styles, K., & Duncan, G. (2012). A Virtual Practice Environment to Develop Communication Skills in Pharmacy Students. American journal of pharmaceutical education, 76(10)

Johnson, D. W., Johnson, R. T., & Smith, K. (2007). The state of cooperative learning in postsecondary and professional settings. Educational Psychology Review, 19(1), 15-29

Kaplonyi, J., Bowles, K. A., Nestel, D., Kiegaldie, D., Maloney, S., Haines, T., & Williams, C. (2017). Understanding the impact of simulated patients on health care learners’ communication skills: a systematic review. Medical Education, 51(12), 1209-1219

Kapp, K. M. (2012). The Gamification of Learning and Instruction: Game-based Methods and Strategies for Training and Education: Wiley

Kim, B. (2015). Understanding Gamification. 51(2). Chicago: American Library Association

Koster, A., Schalekamp, T., & Meijerman, I. (2017). Implementation of competency-based pharmacy education (CBPE). Pharmacy, 5(1), 10.

Krathwohl, D. R., Bloom, B. S., & Masia, B. B. (1964). Taxonomy of Educational Objectives, Handbook II: The affective domain. New York: David McKay Company. New York: David McKay Co., Inc

Kubota, R., Shibuya, K., Tanaka, Y., Aoki, M., Shiomi, M., Ando, W., Otori, K., & Komiyama, T. (2018). Clinical Pharmacy Education in Japan: Using Simulated Patients in Laboratory-Based Communication-Skills Training before Clinical Practice. Pharmacy, 6(2), 49

Lin, K., Travlos, D. V., Wadelin, J. W., & Vlasses, P. H. (2011). Simulation and Introductory Pharmacy Practice Experiences. American Journal of Pharmaceutical Education, 75(10), 209.

Lok, B., Ferdig, R. E., Raij, A., Johnsen, K., Dickerson, R., Coutts, J., Stevens, A., & Lind, D. S. (2006). Applying virtual reality in medical communication education: current findings and potential teaching and learning benefits of immersive virtual patients. Virtual Reality, 10(3-4), 185-195

Lyons, J. (2012). Learning with technology: theoretical foundations underpinning simulations in higher education. Paper presented at the ascilite Conference

Mardjan, N. P. (2016). Serious gaming for systemic entrepreneurialism. 2nd and 3rd Regional Innovation and Entrepreneurship Conference

Marken, P. A., Zimmerman, C., Kennedy, C., Schremmer, R., & Smith, K. V. (2010). Human Simulators and Standardized Patients to Teach Difficult Conversations to Interprofessional Health Care Teams. American Journal of Pharmaceutical Education, 74(7), 120.

McDougall, A. (2017). When I say… gamification. Medical Education

McGaghie, W. C., Issenberg, S. B., Petrusa, E. R., & Scalese, R. J. (2010). A critical review of simulation‐based medical education research: 2003–2009. Medical Education, 44(1), 50-63.

Moncada, S. M., & Moncada, T. P. (2014). Gamification of Learning in Accounting Education. Journal of Higher Education Theory & Practice, 14(3)

Mottner, S. (2009). Experimenting with team norms in a marketing simulation. Journal for Advancement of Marketing Education, 15, 1-13

Mylrea, M. F., Sen Gupta, T., & Glass, B. D. (2017). Developing professional identity in undergraduate pharmacy students: a role for self-determination theory. Pharmacy, 5(2), 16.

Nash, R. E., Chalmers, L., Brown, N., Jackson, S., & Peterson, G. (2015). An international review of the use of competency standards in undergraduate pharmacy education. Pharmacy Education, 15

Okuda, Y., & Quinones, J. (2008). The use of simulation in the education of emergency care providers for cardiac emergencies. International Journal of Emergency Medicine, 1(2), 73-77.

Orsini, C., Evans, P., & Jerez, O. (2015). How to encourage intrinsic motivation in the clinical teaching environment?: a systematic review from the self-determination theory. Journal of Educational Evaluation for Health Professions, 12.

Oxford Reference. (2019). World-Building Definition. Available at:

Paravattil, B., Kheir, N., & Yousif, A. (2017). Utilization of simulated patients to assess diabetes and asthma counseling practices among community pharmacists in Qatar. International Journal of Clinical Pharmacy, 39(4), 759-768

Pharmaceutical Society of Australia. (2016). National Competency Standards Framework for Pharmacists in Australia. Available at:

Pharmaceutical Society of Australia. (2017). Professional Practice Standards - Version 5. Retrieved from

Phillips, B. B., Newsome, A. S., Bland, C. M., Palmer, R., Smith, K., DeRemer, D. L., & Phan, S. V. (2019). Pharmacy Student Performance in a Capstone Course Utilizing the Pharmacists’ Patient Care Process. American Journal of Pharmaceutical Education, 83(8), Article 7357.

Prensky, M. (2001). Fun, play and games: What makes games engaging. In Digital Game-Based Learning (pp. 1-31). California: McGraw-Hill

Reeve, J. (2002). Self-determination theory applied to educational settings. Handbook of self-determination research, 2, 183-204

Rogers, G. D., McConnell, H. W., De Rooy, N. J., Ellem, F., & Lombard, M. (2014). A randomised controlled trial of extended immersion in multi-method continuing simulation to prepare senior medical students for practice as junior doctors. BMC Medical Education, 14, 90.

Rogers, G. D., Mey, A., & Chan, P. C. (2017). Development of a phenomenologically derived method to assess affective learning in student journals following impactive educational experiences. Medical Teacher, 39(12), 1250-1260.

Rogers, G. D., Mey, A., Chan, P. C., Lombard, M., & Miller, F. (2018). Development and validation of the Griffith University Affective Learning Scale (GUALS): A tool for assessing affective learning in health professional students’ reflective journals. MedEdPublish, 1-8.

Ryall, T., Judd, B. K., & Gordon, C. J. (2016). Simulation-based assessments in health professional education: a systematic review. Journal of Multidisciplinary Healthcare, 9, 69

Sauvé, L., Renaud, L., Kaufman, D., & Marquis, J.-S. (2007). Distinguishing between Games and Simulations: A Systematic Review. Educational Technology & Society, 10(3), 247-256

Schaafsma, E., Dantuma-Wering, C., Van Wieren, D., Sarre, S., & De Paepe, K. (2010). A Pharmacy Game: Experiencing the Possibilities of an Active and Reflective Learning Style. Paper presented at the 16th International Social Pharmacy Workshop: Communication and Information in Pharmacy Lisbon, 23-26 August

Schoenly, L. (1994). Teaching in the affective domain. Journal of Continuing Education in Nursing, 25(5), 209-212.

Schwabe, G., & Göth, C. (2005). Mobile learning with a mobile game: design and motivational effects. Journal of Computer Assisted Learning, 21(3), 204-216.

Shreve, J. (2005). Let the Games Begin. Video Games, Once Confiscated in Class, Are Now a Key Teaching Tool. If They're Done Right. George Lucas Educational Foundation

Sillius, A., & Van Der Werf, J. J. (2005). GIMMICS: How to organize, manage and control a pharmacy practice game. E-Learning: Design, Development and Delivery

Smithson, J., Bellingan, M., Glass, B., & Mills, J. (2015). Standardized patients in pharmacy education: An integrative literature review. Currents in Pharmacy Teaching and Learning, 7(6), 851-863

Social Research Centre Pty Ltd, & Commonwealth of Australia. (2020). QILT Quality Indicators of Learning and Teaching. Available at:

Thomas, D. R. (2006). A general inductive approach for analyzing qualitative evaluation data. American Journal of Evaluation, 27(2), 237-246.

Van Der Werf, J. J., Dekens-Konter, J., & Brouwers, J. R. (2004). A new model for teaching pharmaceutical care services management. Pharmacy Education, 4(3-4), 165-169.

Virvou, M., Katsionis, G., & Manos, K. (2005). Combining Software Games with Education: Evaluation of its Educational Effectiveness. Educational Technology & Society, 8(2), 54-65

Vyas, D., McCulloh, R., Dyer, C., Gregory, G., & Higbee, D. (2012). An Interprofessional Course Using Human Patient Simulation to Teach Patient Safety and Teamwork Skills. American Journal of Pharmaceutical Education, 76(4), 71.

Whelan, D. L. (2005). Let the games begin. School Library Journal, 51(4), 40-43

Whitton, N., & Hollins, P. (2008). Collaborative virtual gaming worlds in higher education. Research in Learning Technology, 16(3)

Wiggins, G., & McTighe, J. (2005). Understanding by Design: ASCD

Williams, G. C., Saizow, R. B., & Ryan, R. M. (1999). The importance of self-determination theory for medical education. Academic Medicine




How to Cite

Hope, D. L., Grant, G. D., Rogers, G. D., & King, M. A. (2021). PROGRAMME DESCRIPTION: Integration of an extended, immersive, gamified pharmacy simulation as a capstone event. Pharmacy Education, 21, p. 656–669.



Programme Description