Table 3 Description of domains of the narrative engagement framework and relationship to selection of intervention components

Narrative knowledge

Narrative knowledge is defined as information that is presented already integrated within a mental model (defined as a representation of the decision problem)

• Reduces cognitive load required for processing complex information

• Reduces counter-arguing provoked by exposure to a new or controversial argument

• Increases memorability of the knowledge contained in the story

• Game content – Teaching cases

Behavioral modeling

Behavioral modeling is defined as opportunities to observe others’ behavior

• Allows the development of new rules for one's own actions.

• Offers vicarious experience with the consequences of effective and ineffective behavior

• Game content – Teaching cases

Engagement

Engagement is defined as immersion in the health narrative promoted by:

• Realism: believable actions and consequences

• Interest: intensity of attention attracted to the story

• Identification: a feeling of unity with the characters

• Transportation: a cognitive or emotional shift in the state of consciousness.

• Increases acceptance of the knowledge embedded in the story

• Increases willingness to practice the modeled behaviors

• Increases memorability of the experience.

• Game content - Teaching cases (realism)

• Game content - Diagnostic cases (interest)

• Game content - Resuscitation cases (interest, transportation)

• Game content - flashbacks, mystery, in-game relationships (interest, identification, transportation)

• Game mechanics (e.g. tap to act) (interest, transportation)

• Game design (e.g. music) (transportation)

• Game graphics (e.g. color of text bubbles) (interest, transportation)