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    Playing with the Mind: Tech Meets Neuroscience in the Future of Medical Education


    Neuroscientist Adam Gazzaley, MD, PhD, studies the neurons and regions of the brain associated with perception, attention, and memory, looking specifically at how distraction and multitasking can affect these abilities. His unique research combines functional magnetic resonance imaging (fMRI), electroencephalography (EEG), and transcranial magnetic and electrical stimulation to augment what we know about how changes in the aging brain can lead to cognitive decline. His current work focuses on neuroplasticity and how custom-designed video games can bolster cognitive abilities.

    Gazzaley is a professor of neurology, physiology, and psychiatry at the University of California, San Francisco (UCSF), School of Medicine. He is the founding director of UCSF’s Neuroscience Imaging Center and directs the cognitive neuroscience Gazzaley Lab. In addition, he is co-founder and chief science adviser of Akili Interactive Labs, a company focused on developing therapeutic video games. He holds several patents, has authored more than 100 scientific articles, and has given more than 425 invited presentations globally. Gazzaley’s presentation at the AAMC’s 2015 Medical Education Meeting will focus on how medical education can use gaming and technology to enhance learning.

    Based on your research, what areas of cognition and memory do action video games touch? Do we know why?

    It depends on what type of game—even an action video game—that you’re talking about, as well as its intended impact. There are consumer games out there that were developed for entertainment purposes and sold as consumer products. And there is literature that emerged in 2002 in Nature by my friends and colleagues Daphne Bavelier, PhD, and Shawn Green, PhD, that showed action video games designed to be entertainment in the hands of young people who played them seemed to enhance their cognitive control abilities, including attention and working memory. That is the sort of research that has led to games like the one we built. [The game] was not designed as a primary entertainment tool, though that’s still important with a video game, but it was designed with the particular goal of boosting cognitive abilities. It has been shown, in older adults, to help cognitive control abilities that also are impacted by consumer games. We are continuing to explore a whole host of areas dealing with cognition.

    What is it about action video games that led you to want to study how they help us understand cognitive function?

    There was an impressive body of scientific literature that was published in the early 2000s showing that action video games improved cognitive ability of the young people who played them. Also, I have been creating tasks for the last decade to study the brain. I felt that building a video game could be thought of as an extension of that skill, although it’s a complex extension, for sure.

    What are the challenges in using action video games for therapeutic interventions and formal educational programming to make positive cognition and memory changes? What can be done to overcome those roadblocks?

    There are two major challenges to using action video games in this way. First, we have to build these games at a high level so they’re fun and engaging to play. They have to have all the critical elements of adaptivity and feedback that will lead to change. In addition, we must validate the games at a high level so we actually know if they are doing what we hope they will.

    What significant changes do EEGs, MRIs, and other tests identify? And how would a person experience the impact of neural stimulation from video games? Are there benefits for people without cognitive deficits?

    Those tools allow us to understand what is changing in the brain from both a structural and functional perspective. We can then associate them with the changes in cognition that we also record to understand the basic mechanisms of enhancement effects. People who play the action video games may actually notice the cognitive benefits in their real-life activities. But this seems to be more likely if the person started with a deficit. We’re not studying the impact on healthy individuals without deficits. We are optimistic, based on the pilot data, that we will have some ability to induce positive effects.

    Many people are skeptical about the effect of action video gaming on mental processing. What issues do the games raise to challenge what you have seen in your research?

    Many games seem to improve only performance without transfer to other aspects of cognition, which are not directly trained. We have had success with a couple of games and have published results showing that at least some degree of transfer can occur. We now are working to extend that to the next level. There are many factors involved that we still need to explore, such as new game mechanics, motivation factors, dosage, delivery schedule, as well as the basis for individual differences.

    How do you envision action video gaming being used to enhance learning? In what ways can it best be used in medical education?

    I am trying to determine through both game development and research if we can use these games to improve the brain’s basic information processing systems—attention, working memory, task switching, multitasking—and thus positively impact the learning process. Medical education involves a lot of memorization, but also high-level thinking and decision-making. It should benefit from a cognitive enhancement approach.

    This article originally appeared in print in the October 2015 issue of the AAMC Reporter.