Video Games in Health Care: Closing the Gap Pamela M. Kato University Medical Center Utrecht Although a great deal of media attention has been given to the negative effects of playing video games, relatively less attention has been paid to the positive effects of engaging in this activity. Video games in health care provide ample examples of innovative ways to use existing commercial games for health improvement or surgical training. Tailor-made games help patients be more adherent to treatment regimens and train doctors how to manage patients in different clinical situations. In this review, examples in the scientific literature of commercially available and tailor-made games used for education and training with patients and medical students and doctors are summarized. There is a history of using video games with patients from the early days of gaming in the 1980s, and this has evolved into a focus on making tailor-made games for different disease groups, which have been evaluated in scientific trials more recently. Commercial video games have been of interest regarding their impact on surgical skill. More recently, some basic computer games have been developed and evaluated that train doctors in clinical skills. The studies presented in this article represent a body of work outlining positive effects of playing video games in the area of health care. Keywords: video games, interventions, technology, health Despite the existence of effective medicines, advanced medical technology, and hospitals staffed by highly trained and educated health care professionals, human beings do not always behave in ways that take advantage of what health care has to offer. A majority of patients do not comply with the treatment regimes that could save their lives (Partridge, Kato, & DeMichele, 2009). Similarly, doctors make mistakes to such an extent that medical errors can be counted among the leading causes of death in the United States (Institute of Medicine, 2001; Kohn, Corrigan, & Donaldson, 1999). The solutions to these problems are clearly complex, yet psychological and behavioral factors play a prominent role. An innovative tool that is being used more and more to address the psychological and behavioral barriers to optimal health care is the video game. Most people think of video games as entertainment. There is a growing interest, however, in video games as a means to educate and train people (Durkin, 2010). Serious games is a term that has been used to describe video games that have been designed specifically for training and education (Annetta, 2010). The field of medicine has a history of embracing games as a means to engage patients behaviorally to improve their health outcomes. There are early reports of case studies using video games with patients experiencing diseases or physical disabilities (Krichevets, Sirotkina, Yevsevecheva, & Zeldin, 1994; Szer, 1983). We are now seeing more video games evaluated in the literature that are developed and used explicitly for health education and training. Games are now being evaluated in randomized trials with the scientific rigor applied to pharmaceutical therapies (Kato, Cole, Bradlyn, & Pollock, 2008). It is interesting that examples of video game applications in health care consist not only of serious games that are designed specifically training and education purposes, but also of commercially available off-the-shelf games that are repurposed to meet certain behavioral goals in health care. As deduced from the review that follows, the use of video games to train medical professionals is only in its infancy compared with the depth to which the medium has been explored with patients. This use of games has grown out of the tradition of training physicians with simulations. It has gone from a focus on learning with cadavers and mannequins to the use of computer-generated 3-D interactive software to teach technical skills in medicine. This is the first review to evaluate the state-of-the-art research on video games and their impact on health by evaluating the effect they have had on training medical professionals to provide high-quality health care as well as their impact on patient health. In this review, psychological theories of play that may explain the effectiveness of games in health care are explored. A history of video games and health is also described, with a focus on studies of video games aimed at improving the health of patients and then on video games that are used to train and educate medical students and doctors. The use of commercial games and tailor-made games for behavioral health or medical training is reviewed. Only games that have been described and evaluated in peer-reviewed publications are presented in this article. Theories and Mechanisms Video games have been used strategically to affect a number of issues in health among patients. The main mechanism for action often cited is their ability to