Septris 2.0: a mixed-methods multinational evaluation of a gamified digital tool for sepsis education and quality improvement
Sonya Gupta, Ian Pottmeyer, Nathan Mischler, Estelle Moulin, Rokeena L Williams, Sylvain Meylan, Lisa ShiehBackground
Sepsis remains a leading cause of global mortality, yet persistent knowledge-to-practice gaps hinder timely recognition and evidence-based management. While gamified educational tools have shown promise, most lack rigorous evaluation, substantial international reach and alignment with current clinical guidelines.
Objectives
To evaluate the global reach, engagement and self-reported educational impact of Septris 2.0, a free, multilingual gamified sepsis simulation designed to address critical knowledge gaps in sepsis management.
Methods
Mixed-methods evaluation combining web analytics, game performance metrics and pre-post survey data. Implementation spanned 45 countries from July 2023 to September 2025.
Interventions
Septris 2.0 features 10 interactive multilingual case simulations with adaptive antibiotic resistance settings, alignment with current sepsis guidelines, real-time clinical decision feedback and gamified elements including leaderboards and pop quizzes.
Outcome measures
Primary: user engagement (website visits, gameplay initiation), game performance (patient survival, completion rates) and user-reported knowledge and confidence via 5-point Likert scale pre–post surveys. Secondary: user satisfaction and commitments-to-change data.
Results
Of 34, 208 visitors, 73.9% initiated gameplay across 45 countries; 19, 246 treated at least one virtual patient. Mean patient survival was 68.1% (10.8% saved all patients). Among 325 Continuing Medical Education (CME) participants (completion rate of 94.5%), statistically significant improvements occurred across all domains (p<0.001): sepsis definition understanding (+10.3%), evidence-based diagnostic practices (+12.0%) and treatment confidence (+10.8%). CME participants included medical students (36.2%), nurses (24.6%) and physicians (18.5%) from diverse clinical settings. Overall, 93.8% reported improved knowledge and 76.3% would recommend the tool.
Conclusions
Septris 2.0 achieved substantial global reach across 45 countries and was associated with measurable self-reported improvements in sepsis knowledge, confidence and intended practice behaviours, supporting the feasibility of scalable, multilingual gamified approaches for addressing critical gaps in sepsis education worldwide.