A brief review of online education resources on gamification in addressing antimicrobial resistance.

Background: The burden of antimicrobial resistance (AMR) is projected to be highest in Africa, with a mortality of 99 per 100 000 deaths in sub-Saharan Africa. As a result, there is an urgent need to develop education resources to raise awareness and improve understanding of AMR. Aims: The aim of this review was to evaluate selected games, and inform regarding their suitability, and that of gamification in general in promoting education, and inspiring action against AMR. Objective: This brief review of online education resources seeks to inform on the use of games in promoting education on AMR by exploring different aspects of gamification such as accessibility, usability and playability with the delivery of desired learning outcomes. The insights obtained from the game helped inform recommendations and conclusions on how to best utilize gamification to deliver AMR education to target audiences. Methods: The games to be reviewed were selected using search terms 'AMR Game', 'Antimicrobial Resistance Game', 'Antibiotic Resistance Game', 'ABR Game', 'Drug Resistance Game' and 'Superbugs Game' in Google Play Store and Apple App Store search engines, given their positioning as suitable application software that house game applications. After applying a selection criterion, the number of selected games was narrowed to two: Micro-Combat and Terebra. Results: The games were analysed through four key factors: accessibility, usability, playability and learning outcomes. Both games were found to apply visual, written and aural game mechanics but Terebra had an increased touch with reality, enhancing its playability, due to the emphasis on aural triggers positioning AMR as a dire health threat. On the other hand, Micro-Combat was found to be more educative, and learning-oriented but less associated with reality, which negatively influenced its playability. Conclusions: In overall, gamification was found to be a good online resource to promote education on AMR through the review conducted on the two games, Terebra and Micro-Combat. Coupling gamification and conventional education mechanisms can go a long way in promoting the awareness and knowledge level of AMR among diverse populations The two games, Terebra and Micro-Combat, are great pilot AMR gamification projects that have set a good pace for utilization of games in AMR education. There is a need to develop AMR educational games that portray the reality in low- and middle-income countries, which was a bit lacking in the two games.