provided, and the player can advance the patient across the board to a number of locations for a mammography, ultrasound, or other procedure (biopsy, fine needle aspiration, etc.). Players may continue until they feel prepared to make a management decision. They have a choice of five decisions to make. If they make the correct decision, the patient is considered successfully managed and removed from the board. If they make an incorrect decision, they lose a turn. The goal of the game is to be the first to successfully manage all four patients. The 33 students who played the game showed significant improvement from pre- to posttest on a 10-item true–false test on breast problem management. They also gave the game favorable ratings for usefulness and appeal (Mann et al., 2002). The Oncology Game and the game for breast health may be quite simple in their approach and design, but they are remarkable in medical education because they openly combine play with learning. The findings are intriguing and promising, but controlled outcomes studies are needed to more fully determine the causal role that this approach to educating doctors has on learning and ultimately on clinical practice. Simulations. There are reports of other games to teach clinical skills in the literature, but they are only descriptive reports of these games. They are mentioned here because they show strong promise and potential for affecting health outcomes. Both of these games are simulation-based, and it is unclear from their descriptions what, if any, game mechanics they use to engage the player in the scenarios depicted. Burn Center is a training module simulation that teaches triage and resuscitation in a simulated mass casualty disaster scenario with 40 patients (Kurenov, Cance, Noel, & Mozingo, 2009). Pulse!! is simulation software that replicates the National Naval Medical Center at Bethesda, Maryland. It is aimed at both civilian and military medical students and professionals. A report in the medical literature says that it offers an “epistemic framework for optimizing cognitive and psychomotor skills in clinical practices” (Johnston & Whatley, 2006, p. 240). Despite the apparent sophistication of these games and their aims, no evaluation of the efficacy of these tools to affect clinical practice exists in the literature. Evaluating the efficacy of games such as Burn Center and Pulse!! presents a rich opportunity for future research, and the findings will further our knowledge about what video games can do to improve clinical skills. Discussion The research evaluated and reviewed here demonstrates that video games can positively affect health behaviors and outcomes. The use of commercial and tailor-made games to improve the health of patients shows that a great deal of innovation and creativity has gone into making this medium work in effective ways for patients. On the other hand, the use of games for medical education is just in its infancy, and the full potential of serious game applications in this area has yet to be seen. Overall, however, the findings outlined here suggest that video game design and video game technologies have important applications beyond entertainment. The efficacy of games to change important health behaviors and improve knowledge suggests that the strengths of these tools should be seriously considered when designing interventions in health care. The findings also suggest that play and entertainment can be effective foundations for serious interventions in health care. The work outlined in this article shows that games can have indirect clinical implication because they can promote quality in care through improving surgical skills of doctors and their clinical skills involved in patient care. They have direct clinical implications because video games can help improve patient participation in important diagnostic tasks, enhance patient knowledge about their disease, and increase patient adherence to aversive yet lifesaving treatments. One thing to keep in mind when considering the overview of studies presented in this article is the possibility that there was a bias to publish studies with positive results, otherwise known as the “file drawer problem” (Rosenthal, 1979). In general, the file drawer problem is a bias to focus on the positive results over negative or inconclusive results. Thus, some writers may have failed to submit their studies with negative or inconclusive results of the effects of video games on health. Similarly, editors and reviewers may have had a tendency to publish evaluations of video games for health that show positive results and not publish studies with negative or inconclusive results. This bias should be kept in mind, although it may be less of a concern with video game studies given that there is a strong interest in general to focus on the negative effects of video games on outcomes (Ferguson, 2007, 2010). One other drawback is that I did not a review of all the games that have been developed for health, only the games for health that have been described in the scientific literature. As is apparent from general searches on the Internet, other games for health do exist. These games for health may not appear in the scientific literature because of the file drawer problem, lack of funds or expertise available to conduct an evaluation, or purely a commercial interest in developing the games. Whatever the