Level Ex, the maker of surgery games popular with medical professionals, has released new levels that virtually train doctors to treat patients with COVID-19. The COVID-19 levels are available for free through the Airway Ex and Pulm Ex mobile games on Google Play, coming soon to other platforms.

CEO Sam Glassenberg said his Chicago-based company received support from an educational grant provided by the Johnson & Johnson Institute. He said more than 600,000 medical professionals currently play the Level Ex games (users list their profession when they register).

These new game levels aim to help pulmonologists, emergency medicine physicians, anesthesiologists, and other health care providers prepare for challenging COVID-19 patient scenarios and make better emergency and medical decisions. The levels distill and disseminate the latest actionable COVID-19 information into game content, supplementing traditional educational tools, Glassenberg said.

He said that the games allow players to apply concepts preemptively through experiential, active learning. Level Ex’s new COVID-19 levels grant physicians access to “need to know” information quickly as they are thrust into new roles.

Level Ex’s COVID-19 levels are based on clinical guidelines, industry recommendations, and insights from physicians on the front lines of the pandemic. The company also sifted research from medical societies and public health organizations: the Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO), the American Society of Anesthesiologists (ASA), Society of Critical Care Medicine (SCCM), World Federation of Societies of Anaesthesiologists (WFSA), Società Italiana di Anestesia Analgesia Rianimazione e Terapia Intensiva (SIAARTI), the Faculty of Intensive Care Medicine, Intensive Care Society, Association of Anaesthetists, Royal College of Anaesthetists, and others.

“What we focused on historically has been surgical procedures,” Glassenberg said. “We use game mechanics to capture the challenge of medical practice. That’s procedural stuff, physics puzzles, first-person shooter type mechanics. If you think about a lot of the challenges though the doctors face on the clinical side, they may face deductive reasoning challenges of diagnosing a difficult patient, or the strategy game of how to manage a difficult patient over time.”

The game lets the physician know if tests are expensive or time consuming, or if ventilators are available. That helps the doctor weigh decisions such as how soon to test someone. Glassenberg said, “When COVID-19 hit, there was a wave of demand from our doctors and other medical professionals to get something to practice. We scrambled to find the game mechanics to address the biggest need and started building it.”

Above: Level Ex helps doctors figure out the COVID-19 diagnosis puzzle.

Image Credit: Level Ex

The challenges include misdiagnosis or multiple illnesses that are happening at the same time. And proper testing may or may not be available. Each query you make or test you perform can eliminate some of the diseases that may be ailing a patient.

He added, “One of the big challenges that doctors face is diagnosing difficult patients. We developed this puzzle game mechanic that captures the challenge of diagnosis as a puzzle game. Your patient presents you with a chief complaint as they come into the clinic. And then you have four turns or so, and each turn, you get three action points. You have to spend them correctly, like asking questions and performing exams that are maybe more expensive or take more time.”

Glassenberg said the company tested this game mechanic with hundreds of doctors. “We need this out there, as patients are getting misdiagnosed, as we’ve seen in the news,” he said. Level Ex consulted physicians from pulmonary medicine, critical care, cardiology, anesthesiology, and emergency medicine who are actively treating high volumes of COVID-19 patients.

Level Ex created game-based learnings where players treat virtual patients in timed, scored scenarios. They get real-time feedback based on how well their actions adhered to current guidelines. In Pulm Ex’s COVID-19 Diagnosis Unit, players ask questions and run tests based on a virtual patient’s chief complaint, then try to determine a correct diagnosis of COVID-19 or a mimicking disease.

Airway Ex’s COVID-19 Safe Airway Management Unit presents virtual intubation (putting a tube into someone for a ventilator) scenarios that require players to make clinical decisions about the compromised airways of COVID-19 patients. With each choice, the game explains and reinforces best practices that minimize the risk of spreading the disease. Level Ex says it will develop more levels addressing COVID-19 treatment and management.

Level Ex has 85 employees. Glassenberg said that half of the medical students in the country have Level Ex games on their phones.