Game-Based Training Improves Nurse Detection of Breastfeeding Fungal Infections

A new educational game is helping nurses improve their ability to identify and manage fungal nipple infections, a common complication of breastfeeding that can lead to pain and early cessation of lactation. The game, called “AleitaGame,” simulates real-world breastfeeding scenarios, providing a practical training tool for healthcare professionals.

The Impact of Fungal Infections on Breastfeeding

Pain during breastfeeding is a significant reason why mothers discontinue lactation prematurely, despite the well-documented benefits of breastfeeding for both mother, and infant. Fungal infections, often caused by Candida albicans, frequently lead to nipple and areola injuries. These infections can present with symptoms like redness, peeling skin, discoloration, itching, pain, or burning sensations, but clinical signs can be subtle or even absent, making diagnosis challenging.

Introducing AleitaGame: A Serious Game for Nurse Training

Researchers developed AleitaGame as a “serious game”—an educational simulation—to address the require for improved training in recognizing and managing these infections. The game is designed for use in Basic Health Units (nursing offices) and presents clinical case scenarios, starting with the patient’s history and clinical features.

Game Development and Validation

The development of AleitaGame followed a standard educational software framework, incorporating research-based clinical cases, appropriate media, and expert-approved content. The game’s user interface was designed to be attractive and user-friendly. The prototype was initially based on 40 documents describing fungal lesions and related injuries.

The game underwent evaluation by two panels of judges: nurses, lactation consultants, and healthcare professionals with extensive experience working with lactating women, and technology and education graduates. Feedback from both groups was used to refine the game’s content, usability, and functionality.

Effectiveness of AleitaGame

A study involving 43 participants demonstrated that playing AleitaGame effectively increased knowledge of breast candidiasis. Participants’ mean scores improved by 0.6 points after playing the game, and 86% of players rated it as an excellent learning tool.

Even as usability scores were somewhat lower, the researchers attribute this to differing levels of expertise and interest among the judges. The results suggest that AleitaGame can equip nurses with the skills to recognize, prevent, and treat fungal infections of the nipple-areola region.

Key Features and Educational Focus

AleitaGame not only helps nurses identify infections but also provides information on potential sources of fungal contamination, including the infant’s mouth, diaper area, and the mother’s reproductive tract. The game emphasizes the importance of hand hygiene and cleaning frequently contaminated objects. It also discourages the use of pacifiers and bottles.

Future Applications and Accessibility

The researchers suggest that this approach—integrating health education into interactive game scenarios—can be applied to continuing medical education, medical student training, and knowledge review. They emphasize the importance of basing such games on sound scientific evidence and validating them with professionals in the field. Similar games have been used successfully in other medical settings, such as training nursing students during the COVID-19 pandemic and familiarizing them with the influenza vaccine.

The prototype version of AleitaGame is currently available for free access at https://aleitagame.github.io/. Further validation through larger studies and real-world testing is planned.