What does gamification offer to healthcare research?

Joanna Thompson |  Adelphi Research UK   —   Paola Franco |  Janssen   —   Jon Puleston |  GMI/AllGlobal

BHBIA Best Conference Paper 2014. Talk of gamification is on the increase. Not just in market research – but across a breadth of industries.

Evidence from consumer research suggests that applying gamification mechanics can produce dramatic improvements in drop-out rates and data that better represents respondent’s true behaviours (Deborah Sleep and Jon Puleston, ‘The Game Experiments’ – ESOMAR ‘Best Methodological Paper’ 2011).

With little evidence of gamification in healthcare market research is gamification worth all the hype for our industry?

So what is gamification?

NOT-BHBIA gamification article-03Gamification can be a bit of a misleading term. Think of it instead as copywriting and art directing. Think about a survey as an advertising agency thinks about it – as an advertisement, a piece of communication or entertainment.

It’s not always about making things fun – it’s actually about making it less boring, which we call the “deborification” of research. It’s all about making it more rewarding for respondents.

How did we apply gamification mechanics to the survey?

We focused on three key elements:

  • Working on the visual experience
  • Working on the language and wording

Working on motivation factors

Visual design

We treated it as if we were designing a website or a brochure. We tried to make every question look appealing through visuals and iconography to make it simpler and easier for people to navigate through. Our objective was to focus on ergonomics and the speed you can communicate the idea of the question to make it as easy as possible for respondents to answer.


Good copywriting is a skill and often it involves stepping back from what you want to know and getting people to think in certain ways. For example take a look at the question – ‘Would you say this is a perfect treatment?’ You’d ask this question purely to start a thinking process. What you are actually interested in is the follow on question ‘Why?’ Adding the precursor question gets people to react to that and you get more feedback out of the ‘Why?’

Motivating factors

We asked respondents to compare their answers to a group of other doctors. They were challenged to guess what the other doctors thought and then we told them whether or not their own answers were in agreement. This encourages people to think more about what they are doing. It gives a sense of feedback and rewards and doctors can learn something from what other doctors feel about the same topic.

Gamification myths

We explored the following gamification myths:

  • Respondents have a better experience
  • Surveys can be more time efficient
  • Respondents tell us more
  • Results are more accurate and closer to reality

Survey design:

NOT-BHBIA gamification article-04We designed two parallel questionnaires to address the myths – one that would represent a typical, traditional survey – the sort of thing that has been fielded in recent online surveys. The other was a gamified version, building in many of the elements mentioned above.

We also added a small twist and experimented with two different ways of framing the questions to see if this made a difference to how people responded.
We used a single methodology, an online approach, to avoid any additional levels of complexity and to focus purely on the impact of gamification.

NOT-BHBIA gamification article-05

Respondents have a better experience

Respondents in the gamified survey were more engaged and found it more rewarding. And the traditional survey wasn’t all bad - respondents were familiar with the question styles and found it simple and straightforward, although for a third of people the best thing they could say about it was that it was short!

Surveys can be more time efficient

We asked the same question but using two different layouts. In the traditional survey respondents had to type in numbers to the sum of 100%. In the gamified version they had sliding bars that automatically created a donut chart. For example:

NOT-BHBIA gamification article-06Reassuringly there was no difference in the answers given by the two surveys but by changing the question layout and making the task more interactive for respondents we saved over half a minute on just one question. Feedback from respondents also suggested that the sliding bars and a visual representation were more intuitive than just entering numbers in text boxes.

Based on this there could be some significant time-savings to be made on a full survey. Reducing survey length could make research quicker and cheaper to conduct, or alternatively more efficient question styles give scope to include more questions.

Respondents tell us more

By contextualising open ended questions we found that respondents wrote more and the quality of their responses was better – being more structured, with clearer rationale for their answers. In contrast in the traditional arm there was a tendency towards single word responses or lists of attributes.

In another example, we allowed respondents to critique their peers – so rather than asking what are the barriers to their prescribing we asked what is stopping other doctors and what barriers other people might not want to admit to.

This gave respondents permission to talk more freely and we learned more from them than from the equivalent questions in the traditional arm, where respondents gave more standard and predictable responses.

Results are more accurate and closer to reality

There is no straightforward answer for this. How can we tell which out of two answers is more truthful without comparing the responses to real life, behavioural or observational data – maybe something to consider in another experiment!
But we know from respondent feedback that framing questions around what others do made them think more carefully about what they do and this was reflected in their answers. The gamified approach also revealed more differentiation between brands on an attribute rating question – but is this reality or something we have created by the way we asked the question?

What does this all mean for healthcare market research?

The healthcare research environment is different to the consumer world, and we face a number of additional challenges. But this was an encouraging first step towards investigating gamification and there is enough to suggest that it is a valuable addition to our survey design toolbox. We’ve also raised a number of other questions that need more investigation.

  • We’ve only looked at one respondent type and we don’t know whether different specialties will be more or less receptive to gamification ideas.
  • We’ve only tried gamification in a short survey, which is where those completing a traditional survey are also relatively satisfied – we can suggest that the benefits of gamification might be enhanced in a longer survey, but we can’t be sure without trying it.
  • This experiment has only evaluated one channel, with an online quantitative survey. There is potential for gamification principles to bring benefits in other research settings.

With the population as a whole becoming increasingly digital and engaged in gaming in all areas of our lives, the opportunities are ever increasing and we believe it could be just the beginning for gamification!

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