Gamified Educational Learning Path on HIV/AIDS Stigma and Discrimination (REDXIR): Design, Development and Pilot Study.

Background: HIV/AIDS-related stigma and discrimination are among the main barriers to controlling the HIV epidemic. Discriminatory behavior in healthcare settings deprives people of accessing high-quality health services.

Methods: This study presents the design, development, and pilot study of a novel web-based application ("REDXIR"), which is designed based on behavioral and gamification principles and aims to eliminate HIV/AIDS-related discriminatory behavior among health professions students. REDXIR storyline is set in an imaginary world where the students' journey is like a 10-level game, in which each level consists of several missions with a certain amount of score. The participants have to accomplish the mission to reach the minimum amount of score to pass each level. Finally, each becomes an individual who has not only the knowledge but also the competency to educate and advocate appropriately in the field.

Results: The pilot was done in six medical sciences universities in Tehran, Iran. The feasibility of the instructional design, specifically gamification strategies in the field of HIV education, and the executive functions to run the program on a bigger scale were evaluated. In total, 241 students were included and performed 1952 missions. The program evaluation showed a mean satisfaction score of 4.16 (from 1, the lowest, to 5, the highest) and participants considered their learning practical and gamification method appropriate for HIV education.

Conclusion: A meaningful gamification design for an online medical education program could be a suitable, functional, and applicable learning model to reduce HIV/AIDS stigma and discrimination among health professions students.