Serious Games as a Complementary Tool for Social Skill Development in Young People: A Systematic Review of the Literature

Abstract

Background

The use of games for social skill development in the classroom is accelerating at a tremendous rate. At the same time, the research surrounding games designed for teaching social skills remains fragmented. This systematic review summarizes the current existing literature on social skill serious games for young people ages 5 to 19 and is the first review of serious games to note the demographic and geographic component of these studies.

Method

This review included papers that: evaluated a game designed to teach social skills; included measurable, quantitative outcomes; have a translation or be published in English; were peer-reviewed; date from January 2010 to May 2020; and have a nonclinical study population between ages of 5 to 19. Keywords were obtained from the CASEL 5 framework.

Results

Our findings are mixed but suggest that serious games may improve social skills when used alongside in-person discussion. We also found potential effects of the length of time of gameplay, intervention, and follow-up on social skill serious game effectiveness. Although this review found promising research conducted in East Asian countries and with minority samples in the United States, the majority of social skill serious game research takes place in the United States and Australia, with unreported demographic information and white-majority samples.

Conclusions

Due to the limited number of published studies in this area and studies lacking methodological rigor, the effectiveness of using games to teach social skills and the impact of background on social skill learning require further discussion.

Keywords

social skills serious games review children adolescents

Background

In the past decade, there has been a boom in serious games, applications designed to improve learning and health and integrate knowledge with entertainment (Charsky, 2010; Gee, 2007; Sawyer & Smith, 2008). Serious games have been found to contribute to changes in brain plasticity and cognitive development, with long-lasting behavioral changes that extend to outside of the game environment (Anderson & Kirkorian, 2015; Anguera et al., 2013; Clark et al., 2016; Kühn et al., 2014; Li & Tsai, 2013). For a game to be considered serious, researchers need to show that it was designed with a learning or characterizing goal in mind, in addition to being entertaining (Dörner et al., 2016). For example, Pulse!!, designed to teach medical skills (Dunne & McDonald, 2010), and Trash Monsters, designed to teach waste separation (Trash Monsters, 2016), are considered serious games, while The Sims and Civilization are not, as they were not designed for achieving particular learning goals, even if players learn during gameplay (Becker & Gopin, 2016; Denny, 2019). While the goal of serious games often centers around knowledge acquisition (e.g., facts, details, and procedures) of a particular topic, they also target other aspects of learning, such as training and skills development (Bellotti et al., 2013; Blunt, 2009; Connolly et al., 2012).

Social Skills

Social skills, or more practically, having the ability to work with others, help children improve and manage relationships (Barthel et al., 2018; Collaborative for Academic, Social, and Emotional Learning (CASEL), 2017; Pinheiro Mota & Matos, 2013). These skills are valued in both personal and professional spheres (Deming, 2017; Gallup, 2013; Jones et al., 2015), as having social skills is often associated with increased engagement and motivation, and academic and workplace success (Chernyshenko et al., 2018; Chiteji, 2010; G. Duncan & Dunifon, 2012; Heckman & Kautz, 2012). In the long term, social skills buffer against conduct problems, emotional distress, and drug use, and promote emotional well-being and mental health (Campbell et al., 2010; Holopainen et al., 2012; Rose et al., 2014; Taylor et al., 2017). Given their importance in health and achievement, social skills such as collaboration and communication have been targeted frequently by interventions (Sheridan et al., 2019). Although social skills have been traditionally taught using curriculum (Corcoran et al., 2018; Taylor et al., 2017), in recent years serious games have been increasingly incorporated into social skill interventions worldwide. Serious games that target social skills, henceforth called social skill serious games in this paper, often use agents and scenarios in virtual environments to help engage learners (Gebhard et al., 2019; Grossard et al., 2017; Kahila et al., 2020; Qian & Clark, 2016; Romero et al., 2015). However, it remains unclear whether and how much these social skill serious games affect social skill development.

Serious Games and Social Skills

Games have often been regarded as lacking pedagogical and academic merit. However, “play is the work of children” (D. Cohen, 2007; Vygotsky, 1978; Whitebread et al., 2017). Social cognitive theory and sociocultural theory of learning posit that humans learn through interactions and experiences (Bandura, 1977; Vygotsky, 1978), which include play and leisure education (Daniau, 2016; Dattilo, 2015). Within a fictional world, players learn by doing (Aldrich, 2005; Passarelli & Kolb, 2011) by making decisions based on rules and receiving feedback (Brown, 2016; Gee, 2005; Leites, 2015; Rawitsch, 2017; Salen & Zimmerman, 2003). Furthermore, unlike the real world, which is often characterized by a no-fail culture (Miller, 2009; Plucker & Makel, 2010; Vallett & Annetta, 2014) games provide a non-threatening context in which players can practice social strategies (Bers & Kazakoff, 2013). Social skill serious games, in particular, may require players to follow social rules to advance in the game, see situations from multiple perspectives, and actively work with other players and in-game characters to solve problems (DeRosier & Thomas, 2019; Hilliard et al., 2018; Nieh & Wu, 2018; Shum et al., 2019).

Beyond the theoretical basis of learning social skills through serious games, practical factors such as game format (i.e., digital, in-person, blended) and gameplay and study duration may also influence how children learn from games. Games played digitally can create a more immersive world that stimulates motivation to learn and focus (Arnab et al., 2012; Connolly et al., 2012; Qian & Clark, 2016). However, guidance by trained facilitators may be needed for learners to understand the skills deeply (Mercer & Howe, 2012). Blended learning is a combination of face-to-face instruction with computer-based or online learning experiences (Garrison & Kanuka, 2004; Graham, 2006). It can combine the self-directed learning of digital games with scaffolding and explanation to help learners understand skills and apply them to their real life (Gentile et al., 2009; Greitemeyer & Osswald, 2010; Koo & Seider, 2010). Thus, games using blended learning may help players discover new social skills at their own pace and understand them with help from trained facilitators or teachers (Graham, 2006; Landers & Callan, 2011; Li & Tsai, 2013; Wendel & Konert, 2016).

Learning social skills through serious games may also be influenced by the duration of the game and study. Social skills have differences in complexity and may take different spans of time to understand and appear in assessment (Cox et al., 2012; Garton, 2004; Mikami etal., 2010). Longer games may offer increased opportunities for learning (Bers & Kazakoff, 2013; Brown, 2016) and result in better social skill learning outcomes. Furthermore, longer studies with follow-up procedures may be more accurate in determining how learning is maintained over the short- and long-term (Tüzün et al., 2009). Studies of serious games with longitudinal assessment beyond the actual gameplay may reveal potential sleeper effects of the serious game intervention on particular social skills (Mikami et al., 2010) along with potential fade-out effects for other social skills (Conduct Problems Prevention Research Group, 2011; see Protzko, 2015).

Games, Social Skills, and Demographics

Learning social skills and playing games are at some level dependent on social or cultural factors (Craig et al., 2015; DeRosier & Thomas, 2018; Jagers et al., 2018; Plass et al., 2015; Savina & Wan, 2017). Without enough consideration of participants’ backgrounds, findings on effective social skill games may be biased towards certain races or ethnicities (i.e. white-washed; see Hoffman, 2009; Mahfouz & Anthony-Stevens, 2020; Ford, 2020; Weaver Jr., 2020; Jagers et al., 2018). In social science research, many studies rely on Western undergraduates, specifically from the United States, to make broad generalities on human psychology and behavior. This use of WEIRD (Western, Educated, Industrialized, Rich, Democratic) samples may produce biased results not generalizable to other populations (Cheon et al., 2020; Roberts et al., 2020; Wigelsworth et al., 2016). In serious game research specifically, reviews have not taken into account participants’ demographics when discussing the findings (Corcoran et al., 2012; Qian & Clark, 2016; Romero et al., 2015). This gap in knowledge may obfuscate an important influence on social skill learning (Ado et al., 2017; Parrish & Linder-VanBerschot, 2010).

Given the potential of serious games to teach social skills and the largely absent discussion of demographics as a contributing factor to serious game effectiveness, we should better understand if and how games are effective as pedagogical tools for skills beyond knowledge acquisition (Boyle et al., 2012; Connolly et al., 2012; Noda et al., 2019). To the authors’ knowledge, there have not been reviews investigating how serious games may influence social skills in children and adolescents, nor any reviews of serious games that address the demographic component of the studies. Reviews of 21st century skills have covered two subtopics of communication and collaboration, but not social skills broadly (Qian & Clark, 2016; Romero et al., 2015). The current review aims to summarize research on serious games designed to improve social skills in children and adolescents, and note the study location and whether papers address the background of their participants.

Methods

Data Collection

Database Search

The electronic databases searched in this review were Web of Science, SCOPUS, and Google Scholar. Specific terms for social skills were selected from the social skills and competence components of the CASEL 5 framework (CASEL, 2020). Search terms included (“social skill” OR “interpersonal skill” OR “social competence” OR “perspective-taking” OR “empathy” OR “communication” OR “collaboration” OR “teamwork” OR “conflict” OR “negotiation” OR “leadership”) AND (“serious game” OR “game” OR “player” OR “game-based learning”). Reference lists of reviews and relevant articles were searched. Titles and abstracts were reviewed for eligibility and relevant articles were obtained in full and assessed against the inclusion criteria described below.

Selection of Papers for Inclusion in the Review

To be included in the review, papers needed to (a) evaluate a game designed to teach social skills; (b) include measurable, quantitative outcomes in the design and purpose of the study; (c) be published (or have a formal translation) in English; (d) be peer-reviewed; (e) date from January 2010 to May 2020; and (f) have a nonclinical study population between the ages of 5 and 19. We selected age 5 as the lower limit as games require certain knowledge of rules and literacy and age 19 as the upper limit as it is within the bounds of adolescence (McDonagh, 2018; World Health Organization (WHO), 2003).

Using these conditions 12 papers met the criteria and were identified as relevant to the current review. We report our review process using the PRISMA statement to ensure transparent and complete reporting in this review (Page et al., 2021) and characteristics of the studies using the STROBE guidelines to facilitate critical appraisal and interpretation of results (da Costa et al., 2011). Studies identified as eligible at the full-text level progressed to full-study coding, in which information about the studies, games, and participants were independently extracted and examined by two of the authors. Discrepancies in the coding were resolved by discussion.

Data Analysis

We coded game and study factors based on coding from past reviews of game-based learning (Abdul Jabbar & Felicia, 2015; Arnab et al., 2012; Clark et al., 2016; Connolly et al., 2012; Hromek & Roffey, 2009; January et al., 2011; Qian & Clark, 2016; Wendel & Konert, 2016). Papers were coded in terms of: name of authors and date published; game format; the main aims of study; the individual social skills outcomes; study design, follow-up, and duration; details of participants, their mean age, age range, grade level, gender split, ethnicity breakdown; presence of facilitator; game creator involvement. This study also examined the statistical and practical significance (i.e., effect size) of the game on outcome variables to determine the impact of corresponding change (J. Cohen, 1988; Miles & Shevlin, 2001).

Results

The number of studies at each stage of the review is reported in the PRISMA flow chart (Fig. 1), with reasons for exclusion of studies listed in Table S1. The strengths and weaknesses of the studies are reported in the STROBE Statement (Table S2). Study characteristics are included in Table 1.

Figure 1.

PRISMA flow chart of the study selection process.

Table 1.

Characteristics of studies included in literature review (N=12).

	N	%
Type of study
RCT	9	75
Waitlist control	3	-
Single control	4	-
SC + 2 exp. cond.	2	-
Quasi-experimental	3	25
Single control	3	-
Game type
Digital only	6	50
In-person only	3	25
Blended	3	25
Collaborative	3	25
Measure format
Survey	12	100
Task assessment	2	16.7
Reporter (survey)
Self-report	11	91.7
Parent report	3	25
Facilitator present	5	41.7
Creator as author	9	75
Follow-up conducted	5	41.7
Participant age
Elementary school	5	41.7
Middle school	3	25
High school	2	16.7
Mixed	2	16.7
Continent
North America	8	66.7
Asia	2	16.7
Oceania	2	16.7
Gender
0-45% girls	5	41.7
45-55% girls	3	25
55-100% girls	1	8.3
Not reported	3	25
Mention sample demographics
Yes, no breakdown	2	16.7
Yes, breakdown	3	25
No	3	25
Assumed	4	33.3

Note. Studies included multiple measures and assessments; hence, Measure format and Reporter results do not sum up to 12. Under Mention sample demographics, no breakdown indicates broad statements of demographics (e.g., 28% were racial or ethnic minority), breakdown indicates specific percentage of specific ethnic or racial groups, and assumed was based on study location and/or language spoken at home.

We found a total of 12 studies that fit the criteria, resulting in 27 outcomes. These outcomes included empathy (Bachen et al., 2012; Boduszek et al., 2019; Craig et al., 2016; Kral et al., 2018; Nieh & Wu, 2018; Shum et al., 2019), social self-efficacy (Craig et al., 2016; Norris et al., 2013), peer relatedness (McMahon & Hanrahan, 2020), interpersonal strength (DeRosier & Thomas, 2019), interpersonal relations (DeRosier & Thomas, 2019), communication (Craig et al., 2016), cooperation (Craig et al., 2016), collaboration (K. Duncan, 2020), social initiation (Craig et al., 2016), assertiveness skills (Craig et al., 2016), social satisfaction (Craig et al., 2016), social problems (DeRosier & Thomas, 2019), prosocial and helping behavior (Hilliard et al., 2018; Nieh & Wu, 2018), positive youth development (e.g., competence, confidence, character, caring; Hilliard et al., 2018), and social skills and competence (Beaumont et al., 2019).

Half of the studies (n=6) used digital-only interventions, and the remaining half was evenly divided into in-person (n=3) and blended interventions (n=3). A majority of the studies (n=9) used a game designed specifically for the purposes of the study, while only three studies used games designed previously (REAL LIVES, Bachen et al., 2012; BOEDU, K. Duncan, 2020; Quandary, Hilliard et al., 2018). Studies typically used surveys (n=12), were co-authored by the game creator (n=9), did not include a follow-up (n=7), and took place in the United States and Australia (n=10). Study length was typically around six weeks, and the amount of time spent playing games during the experiment was around six hours.

Details of all studies, games, measures, and social skill improvements are summarized in Tables 2 (digital-only), 3 (in-person only), and 4 (blended). Outcome characteristics by effect at post-test are included in Table S3. Outcomes that improved throughout the intervention included empathy (Bachen et al., 2012; Craig et al., 2016; Nieh & Wu, 2018; Shum et al., 2019), social self-efficacy (Craig et al., 2016; Norris et al., 2013), peer relatedness (McMahon & Hanrahan, 2020), interpersonal strength (DeRosier & Thomas, 2019), social initiation (Craig et al., 2016), assertiveness skills (Craig et al., 2016), social satisfaction (Craig et al., 2016), and social skills and competence (Beaumont et al., 2019). Empathy was the outcome most commonly measured across studies, with six studies including it as an outcome measure. Outcome characteristics classified by effect at post-test are included in Table S2. At post-test, out of the 27 outcomes, half (n=15) reported no significant differences from the intervention and half (n=12) reported significant improvement from the intervention. Ten of those twelve significant outcomes reported effect sizes, with an average small effect size (η_p²) of .22. Studies that used wait list controls had an average effect size (η_p²) of .29, while studies that had curriculum or task controls had an average effect size (η_p²) of .11. While a slight majority of outcomes came from samples that included more boys (n=16), it is unclear whether the sample composition influenced the effect of the game.

Table 2.

Digital-only Intervention Study Details (n=6).

Author (year)	Game Description	Participants	Design	Outcome measure(s)	Findings
Bachen et al. (2012) REAL LIVESStudents experience life as someone living in a different country, to foster cognitive, affective, and communicative components of global empathy Commercially available	REAL LIVES is an online simulation game that allows students to live the life of a person from a different country, with the goal of developing students' empathy and interest in others. Players make decisions in multiple domains of life, including education, employment, and marriage.	• 301 high school participants in United States Ethnicity: 43.5% racial or ethnic minority group (breakdown included) Gender: not reported	• Quasi-experimental Curriculum task control No follow-up Single- and multi-player formats Teachers present, but not active facilitators	Self-report empathy Measure: Global Empathy Scale (Wang et al., 2003; Validated)	Improved (η_p²=.02)
Boduszek et al. (2019) JesseProsocial role-playing video game designed to influence players’ empathetic responses to victims of domestic violence Commercially available (created for this study)	Jesse is a prosocial video game designed to increase players' prosocial behavior, especially toward victims of intimate partner violence. Players participate in a point-and-click role-playing game where they assume the role of characters involved in violence within a family context. Through five levels, players meet and interact with Jesse, who has experienced physical violence, and attempt to understand and provide support for Jesse.	172 mixed-grade participants in Barbados Ethnicity: assumed Gender: 48% girls	RCT Curriculum task control Follow-up 1 week after post Single-player No facilitation	Self-report empathy (affective) Measure: None in Three Victim Responsiveness Assessment (under review)	Improved (η_p²= .17), sustained at follow-up
				Self-report empathy (cognitive)Measure: None in Three Victim Responsiveness Assessment (under review)	No significant differences found
Craig et al. (2016) Zoo UChildren interact with virtual teachers and classmates to take care of animals. Aims to improve children’s social behavior with peers, social literacy, social self-efficacy, and peer relations Commercially available (created for this study)	Zoo U is designed to assess and build children's prosocial skills via a computer game where they interact with virtual teachers and classmates to learn about and take care of animals. Children receive feedback about their performance and gameplay, including personalized information about why their choices in the zoo were or were not successful.	• 47 mixed-grade participants in United States Ethnicity: 28% racial or ethnic minority group (no breakdown) Gender: 41% girls	• RCT Waitlist control No follow-up Single-player No facilitator	Parent-report communication Measure: Social Skills Behavior Inventory (DeRosier, 2011; Validated)	No significant differences found
				Parent-report cooperation-Measure: Social Skills Behavior Inventory (DeRosier, 2011; Validated)	No significant differences found
				Parent-report social initiation Measure: Social Skills Behavior Inventory (DeRosier, 2011; Validated)	Improved (η_p²_W =.10)
				Parent-report empathy Measure: Social Skills Behavior Inventory (DeRosier, 2011; Validated)	No significant differences found
				Parent-report assertiveness skillsMeasure: Social Skills Behavior Inventory (DeRosier, 2011; Validated)	Improved (η_p²_W =.09)
				Self-report social self-efficacy Measure: Self_efficacy Scale; (Ollendick and Schmidt, 1987; Validated)	Improved (η_p²_W =.09)
				Self-report social satisfactionMeasure: Loneliness and Social Dissatisfaction Scale (Cassidy and Asher, 1992; Validated)	Improved (η_p²_W =.16)
DeRosier & Thomas (2019) Hall of HeroesYouth navigate a school-like word, engage with other characters, and solve social problem-solving tasks. Aims to improve impulse control, communication, cooperation, social initiation, empathy, and emotion regulation Commercially available (created for this study)	Hall of Heroes is a digital game aimed to provide youth with traditional social skills training. Players participate in an online point-and-click adventure game where they navigate a school-like world, engage with other characters, and solve social problem-solving skills.	26 mixed-grade participants in United States Ethnicity: 31% racial or ethnic minority group (no breakdown) Gender: 24% girls	RCT Waitlist control No follow-up Single-player No facilitator	Parent-report interpersonal strengthMeasure: The Behavioral and Emotional Rating Scale (Epstein, 2004; Validated)	Improved (η_p²_W =.43)
				Parent-report interpersonal relationsMeasure: Youth Outcomes Questionnaire, Second Edition (Burlingame et al., 2005)	No significant differences found
				Parent-report social problemsMeasure: Youth Outcomes Questionnaire, Second Edition (Burlingame et al., 2005)	No significant differences found
Kral et al. (2018) Crystals of KaydorStory-based game with empathy training mechanics. Aims to help players recognize and respond to basic emotions Commercially available (created for this study)	Crystals of Kaydor is a story-based empathy training video game aimed to teach players to recognize six basic emotions by recognizing avatars' facial expressions and head movements. Players receive feedback and can replay the game. Once players have mastered the emotion identification skills, they can respond to the avatar and receive more feedback.	• 74 middle school participants in United States Ethnicity: not reported Gender: 36% girls	RCT Comparable game control No follow-up Single-player No facilitator	Self-report empathy (concern)Measure: Interpersonal Reactivity Index (Davis, 1983)	No significant differences found
				Behavioral assessment - empathy (accuracy)Measure: developed by authors (Kral, 2017)	No significant differences found
Norris et al. (2013) Drama-RamaAvatar-based virtual reality game designed to supplement a traditional abstinence plus school sex education program for Hispanic girls Not commercially available (created for this study)	DRAMA-RAMA is a peer resistance skill building game that uses human-based digital puppetry to create verbal and non-verbal behavior for digital avatars. The game includes audio interaction and video observation of the participant interacting with the puppeteer. Players earn points by verbally and non-verbally resisting peer pressure, and can earn more points based on how they utilize their social skills in each given situation.	• 45 mixed-grade participants in United States Ethnicity: 100% racial or ethnic minority group (breakdown included) Gender: 100% girls	• RCT Comparable game control Follow-up two months after post Single-player No facilitator	Self-report peer resistance self-efficacy Measure: developed for study; pretested but unvalidated	Improved at post (no effect size) but not at follow-up

Note. Effect sizes of studies without comparable control group (e.g., waitlist) are noted as η_p²_W.

Table 3.

In-Person-only Interventions Study Details (n=3).

Author (year)	Game description	Participants	Design	Outcome measure(s)	Findings
Duncan (2020) Breakout EDUGame-based learning strategy aimed to increase students’ engagement and motivation in Grade 3 while developing collaboration, communication, creativity, and critical thinking Commercially available	Breakout EDU is a small-group escape room game designed to increase students' engagement and motivation while developing collaboration and communication skills as they solve the problems. The content of the games correlated with the subject content in the classroom curriculum.	• 74 elementary school (3^rd grade) participants in United States Ethnicity: assumed (71% speak language other than English at home) Gender: not reported	• Quasi-experimentalCurriculum task controlNo follow-upMulti-player (small group design)No facilitator	Self-report collaborationMeasure: Century Learning and Innovation Skills survey (Boyaci & Atalay, 2016; Validated)	No significant differences found
McMahon & Hanrahan (2020) LifeMattersLife skills program designed for disadvantaged youth. Aims to meet or support participants’ needs of relatedness, autonomy, and competence Commercially available (created for this study)	LifeMatters is a multisession life skills program that combines physically active games with mental skills training, and each session contains games, discussions, and takeaway tasks for participants to complete.	• 40 high school participants in Australia Ethnicity: not reported Gender: 13% girls	• RCT Curriculum task control No follow-up Multi-player (group design) Led by trained facilitators	Self-report peer relatednessMeasure: Basic Measure of Psychological Needs (Sheldon & Hilpert, 2012; Validated)	Improved (η_p²=.14)
Nieh & Wu (2018) Galaxy RescuersA collaborative board game aimed to educate students about bullying and identify productive responses to bullying situations Commercially available (created for this study)	Galaxy Rescuers is a collaborative board game in which characters attend a training school to become rescuers in the “Galaxy”. Players earn points by answering questions about bullying, matching characters (e.g., victim) to their roles in bullying incidents, and working together with other players to complete the training tasks.	• 328 elementary school participants (5^th grade) in Taiwan Ethnicity: assumed Gender: 48% girls	• RCT Curriculum task control with 2 experimental conditions: game and game with debriefing Follow-up 2 weeks after post Multi-player Led by trained facilitators	Self-report empathyMeasure: Not specified	Improved at post (no effect size) but effects faded at follow-up

Table 4.

Blended (digital and in-person) Interventions Study Details (n=3).

Author (year)	Game description	Participants	Design	Outcome measure(s)	Findings
Beaumont et al. (2019) Secret Agent SocietyMulti-level computer game and in-person meetings where children play spy-themed games and activities. Aimed to boost children’s confidence and engage with peers in social environments Commercially available (created for this study)	Secret Agent Society is a multi-level computer game designed to teach children social skills and emotion regulation. For this study, children also participated in nine weekly meetings with other youth, which included spy-themed games and "missions" that allowed children to practice the skills they learned in the computer component.	27 mixed-grade participants in Australia Ethnicity: not reported Gender: 26% girls	• RCT Waitlist control Follow-up 6 weeks after post Single-player Led by trained facilitators	Parent-report social skillsMeasure: Spence’s Social Skills Questionnaire (Spence, 1995; Validated)	Improved (η_p²_W =.46)
				Parent-report social competenceMeasure: Social Competence with Peers Questionnaire (Spence, 1995; Validated)	Improved (η_p²_W = .58)
				Self-report social skills Measure: Social Skills Questionnaire (Spence, 1995; Validated)	No significant differences found
Hilliard et al. (2018) QuandaryVideo game designed to promote ethical thinking and moral considerations for decision-making Commercially available	Quandary is an online video game designed to promote ethical thinking and moral considerations for decision-making. It uses engaging storylines and characters to challenge youth to make difficult ethical decisions that require players to consider the perspectives of others.	• 131 middle school participants in United States Ethnicity: 57.14% racial or ethnic minority group (breakdown included) Gender: 52% girls	• RCT Comparable game control with 2 experimental conditions: game only and game with facilitation No follow-up Single-player Facilitation condition led by trained facilitator	Self-report positive youth development (competence, confidence, character, caring) Measure: Five Cs of PYD (modified from Geldhof et al., 2014; Not Validated)	For all 3 outcomes, no significant differences from game play, but game play group showed greater depth of response to interview questions
				Self-report prosocial behavior Measure: Composite measure of Empathic concern (Davis 1980), Perspective taking (Davis, 1980), Interpersonal generosity (Smith & Hill, 2009), and Commitment to moral action (Barriga et al., 2001)
				Behavioral assessment of helping behavior (Cyberball) Measure: Cyberball task (Williams et al., 2000; Validated)
Shum et al. (2019) DoReMiFaMix of digital game and school-based mental health intervention. Aimed to elevate the knowledge of mental health and promote perspective-taking Commercially available (created for this study)	The Adventures of DoReMiFa is a game where students help 4 monsters from another planet to look for a hidden book that would help improve the mental health of their fellow citizens. In addition to the in-game challenges and tasks, in this study, students also participated in classroom lessons to discuss what they learned and consolidate the students' learning.	• 459 primary school participants in China Ethnicity: assumed Gender: not reported	• Quasi-experimental Curriculum task control Follow-up 6 months after post Single-player Teacher-led facilitation	Self-report empathyMeasure: Interpersonal Reactivity Index (adapted for Chinese students in Siu & Shek, 2016; Validated)	Improved at follow-up (no effect size) but not at post

Note. Effect sizes of studies without comparable control group (e.g., waitlist) are noted as η_p²_W.

Characteristics Associated with Improved Outcome at Post-test

Of those with significant improvements at post-test (n=12), most were from randomly controlled trials (RCTs) (n=11) with wait list controls (n=7) and were based in the United States or Australia (n=11). Eleven outcomes were from studies where co-authors were involved in the creation of the game. Eight were from studies that used only digital games (with no in-person components). Compared to nonsignificant outcomes at post-test, significant post-test outcomes were part of interventions that included longer gameplay (7.7 hours vs 4.9 hours). However, nine outcomes did not report gameplay length.

Characteristics Associated with Improved Outcome at Follow-up

There was follow-up for nine outcomes by the studies, including empathy (Boduszek et al., 2019; Nieh & Wu, 2018; Shum et al., 2019), social self-efficacy (Norris et al., 2013), prosocial and helping behavior (Nieh & Wu, 2018), and social skills and competence (Beaumont et al., 2019). Four saw significant improvements at follow-up (Beaumont et al., 2019; Boduszek et al., 2019; Shum et al., 2019). Two were from one study with wait list control, while the other two were from studies with single control groups. Two were based in Australia, one in Barbados, and one in China. All four outcomes were from studies where co-authors were involved in the creation of the game. One was from digital-only intervention (with no in-person component) while three were from blended interventions, and none were from studies with collaborative game components. Compared to outcomes that did not see improvements at follow-up (n=5), those with significant improvements were part of studies with longer follow-up (9.3 weeks vs 3.8 weeks), longer intervention (6.3 weeks vs 4 weeks), and longer gameplay (4 hours vs 2.3 hours).

Discussion

In this review, we summarize the current existing literature on social skill serious games. We found significant social skill improvements in studies that targeted empathy, social self-efficacy, peer relatedness, interpersonal strength, social initiation, assertiveness skills, social satisfaction, and social skills and competence. Empathy was the most popular social skill outcome, with six of the twelve studies including it as a social skill outcome. However, overall few studies have been conducted and peer-reviewed in the literature.

Instruction and Discussion as Potential Influences on Game Outcomes

Games that were used to prepare for in-person instruction, facilitated by trained personnel and teachers, had significant intervention outcomes. Among those that reported significant effects at follow-up, Adventures of DoReMiFa was used to prepare for classroom lessons (Shum et al., 2019), while Secret Agent Society was played digitally prior to small group programs (Beaumont et al., 2019). Among studies without follow-up, such as Quandary (Hilliard et al., 2018) and Life Matters (McMahon & Hanrahan, 2020), by using games to support classroom discussion, players reported greater depth of response to interview questions and increases in peer relatedness. On the other hand, digital games that were played without in-person instruction did not significantly improve at intervention end (DeRosier & Thomas, 2018; Kral et al., 2018; Norris et al., 2013).

Games may be effective as tools that educators can use to support the learning process (Landers & Callan, 2011; Li & Tsai, 2013; Wendel & Konert, 2016). Even though games can help young people practice social skills in a fictional, low-stakes environment (Bers & Kazakoff, 2013; Vallett & Annetta, 2014; Verenikina et al., 2003), players may still need guidance for why certain behaviors are applicable to social interactions. Reflective discussions in a real environment can re-engage that player with the social skill, further develop their understanding of the skills, and help them retain the knowledge (Mercer & Howe, 2012). These discussions are important for any transfer from game to reality (Crookall, 2010), as the scaffolding and explanation can help learners better understand the skill and connect positive game behaviors with real-life consequences (Gentile et al., 2009; Greitemeyer & Osswald, 2010; Koo & Seider, 2010). When these discussions are skipped, the programs may work for some better than others, but with less efficacy or consistency (Hawkes-Robinson, 2021).

Time as Potential Influence on Game Outcomes

In our review, only five studies (producing nine outcomes) conducted follow-up procedures, which may contribute to the mixed findings on social skill serious game effectiveness. Two studies, targeting empathy and peer resistance self-efficacy, found significant effects of the intervention at post-test but the positive effects faded at follow-up (2 and 8 weeks after post-test, respectively) (Nieh & Wu, 2018; Norris et al., 2013). On the other hand, a third study, which examined the perspective-taking component of empathy, did not find a significant effect at post-test but did at follow-up six months later (Shum et al., 2019).

Social skills have differences in complexity and may take different spans of time to understand and appear in assessment (Cox et al., 2012; Garton, 2004; Mikami et al., 2010). Skills that have a short processing time but suffer from fade-out may incorrectly lead researchers to assume the effect lasts when instead the effect disappears over time (Conduct Problems Prevention Research Group, 2011; see Protzko, 2015). On the other hand, games that teach skills with a longer delay in learning and improvement may be misconstrued as having no effect on the outcome (e.g. sleeper effect; Mikami et al., 2010). It may be that improvement in certain skills appear at varying times and assessing at different times may clarify the game and implementation factors that influence social skill learning. However, these findings are preliminary, given that only one-third of total outcomes included follow-up procedures and one-third did not report total gameplay time.

Studies Lack Comparable Control Groups

Similar to reviews of serious games for knowledge acquisition (Boyle et al., 2012; Connolly et al., 2012), in our review of social skill serious games, we also found that many of the RCT studies used non-comparable controls (Bachen et al., 2012; Beaumont et al., 2019; Boduszek et al., 2019; Craig et al., 2016; DeRosier & Thomas, 2019; McMahon & Hanrahan, 2020; Shum et al., 2019). The use of curriculum or wait list controls potentially weakens the significance of the effects, as parents or children may report a placebo effect (Abdul Jabbar & Felicia, 2015; Boyle et al., 2016; Connolly et al., 2012). However, comparisons to curriculum are still important, given that most interventions are conducted with curriculum (Corcoran et al., 2018; Taylor et al., 2017). If serious games can produce social skill learning similar to those of traditional intervention curricula, it may suggest that games can be used alongside or as an alternative. We did not find significant differences in two studies that used comparable game controls (i.e., commercial games) (Hilliard et al., 2018; Kral et al., 2018). While initially disappointing, this also suggests that commercial, non-serious digital games may have the potential to promote development of social skills despite not being specifically designed for the task (Barr, 2017, 2018; Greitemeyer & Osswald, 2010).

Studies Lack Demographic Information and Consideration

Without addressing participants’ backgrounds, findings from interventions may be biased towards certain races or ethnicities and result in games that are ineffective or detrimental (Bambra, 2018; Dimidjian & Hollon, 2010; Haskell, 2020; Hoffman, 2009; Love, 2019; Mahfouz & Anthony-Stevens, 2020). As the first review of serious games to address sample demographics, we found that most studies (n=10) took place within WEIRD countries (more specifically, United States and Australia). Of those, three studies did not mention demographic information at all while two studies did not give a specific breakdown, only stating that a certain percentage were “racial or ethnic [minority] group”. Furthermore, only three of the 12 studies mentioned demographics or culture in the discussion section as a potential influence on game implementation or use, or limitation to the generalizability of the findings. We were unable to find a particular association between study location or demographics association and study outcome, although those with significant improvement at follow-up were not located in the United States. While the evidence is not enough to suggest a significant impact of location and demographics, noting and addressing the study sample are crucial first steps in understanding the differences in how children and adolescents respond to social skill learning through games (Ado et al., 2017; Parrish & Linder-VanBerschot, 2010).

Limitations

The current review has a number of limitations. Due to the aim to analyze both statistical and practical significance of empirical findings, quantitative instead of qualitative research on the effectiveness of social skill serious games was selected. Second, due to limited data and the different interventions and constructs measured, our synthesis of data was unsuitable for meta-analysis. While we considered possible methodological solutions, we believe that combining outcomes that are too diverse may obscure genuine differences. Third, all studies relied on survey assessments, of which a majority were self-report. This may reflect only a partial perspective on the change that occurs as a result of the social skill serious game (Beaumont et al., 2019; Gresham et al., 2010; Spence, 1995). Fourth, while most of the tools used to measure the outcomes were previously validated, the tools used for seven outcomes were not validated or specified. Thus, the results obtained from these potentially invalid and unreliable measures may not reflect the true intervention effects. Fifth, most studies did not report technological restrictions, variations in gaming and technological skill, and material and teacher preparation costs, factors that could impact the use of serious games (Egenfeldt-Nielsen, 2006; Kirriemuir & McFarlane, 2004). Given that studies conducted in-person and without technology were more likely to be used for at-risk populations (K. Duncan, 2020; McMahon & Hanrahan, 2020), familiarity with and use of technology may be a confound for participants who use digital versus in-person only games, contributing to mixed findings. Finally, nine out of twelve studies used games designed and created by one or more of the authors, which may cause these games to be implemented more effectively and evaluated more positively (Backlund & Hendrix, 2013; Fowler & Pusch, 2010; Wigelsworth et al., 2016).

There is much room for improvement in the social skill serious game literature. Intervention design can be improved by using comparable controls; varying gameplay, intervention, and follow-up times; sampling from non-WEIRD populations; and reporting demographics. In addition, future research may also benefit from investigating how multi-method assessment, levels of resources and technology-related knowledge, and third-party game evaluation influence learning of social skills through games, both quantitatively and qualitatively. By addressing these game and study design changes, we can better understand how serious games can be used broadly as a potential tool to help teach social skills (Chu et al., 2017).

Conclusion

Learning benefits from the development of tools that can interest students in new ways and complement traditional curriculum (Kitchenham, 2008; Poling, 2013). By using the gaming medium to teach social skills, we may improve upon the standard lecture model, which is limited by time constraints of the traditional class period and student disengagement (DeRosier & Thomas, 2018; Merrell & Gimpel, 2014; Read & Shortell, 2011; Sancassiani et al., 2015). However, despite the engaging and motivating aspect of games (Kahila et al., 2020), educators and researchers should refrain from being caught up in the excitement of innovation. Scaling these programs for larger groups has remained a challenge and research on serious games’ use for educational purposes is still limited (Boduszek et al., 2019; Poling, 2013; Williamson, 2009)

In this review, we find that serious games may be effective as tools to support social skill learning, particularly when paired with discussions. However, this finding is preliminary, due to the lack of empirical studies, methodological limitations of published studies, and use of WEIRD samples. It is still an open question whether games are effective for the development of social skills and for whom. Regardless, this overview has implications for social skill serious game development and intervention study design, and is an important first step in exploring how serious educational games can be used for purposes beyond knowledge acquisition.

Supplemental Material

Supplemental material for this article is available online.

Supplemental Material for Serious Games as a Complementary Tool for Social Skill Development in Young People: A Systematic Review of the Literature by Lucy R. Zheng, Catherine M. Oberle, W. A. Hawkes-Robinson and Stéphane Daniau, in Simulation & Gaming

Footnotes

Acknowledgements

The authors would like to thank Tenelle J. Porter for her suggestions and comments during the writing process.

Declaration of Conflicting Interests

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Lucy R. Zheng

Author Biographies

Lucy R. Zheng, (PhD, University of California, Davis) is at the University of Gothenburg, Sweden. She is a developmental psychologist with interests in applied research, lifespan development, curriculum and game design, and education and public policy.

Contact: lrzheng@ucdavis.edu

W. A. Hawkes-Robinson, (RT(R), Washington State Department of Health) is at RPG Research, Eastern Washington University (EWU), and associated research at Washington State University (WSU). He is a recreational therapist and educator with additional background in music and therapeutic recreation, neuroscience, research psychology, and computer science, and has been involved with RPGs since 1977 and researching their effects since 1983.

Contact: rpgresearcher@gmail.com

Stéphane Daniau, (PhD, Université Montpellier III) started to play tabletop role-playing game in the mid-1980s and to study its transformative potential in 2000. His research interests cover areas such as innovative and collaborative approaches in adult education, transformative learning, personal development, and basic training.

Contact: daniau.stephane@uqam.ca

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