Air Medic Sky 1

A biofeedback game to train young resident doctors in Stress Management and Patient Safety skills

Air Medic Sky One (AMS-1) is a groundbreaking, serious game that teaches young doctors in the early stages of their clinical careers life-saving patient safety and self-management techniques. AMS-1 was designed by Visionshift Studios in collaboration with the University Medical Center Utrecht, the Netherlands.

The game utilizes an international team of patient safety experts delivering crucial training in combination with biofeedback controls that allows players to gain insight into their own physiological functions and how they affect their performance. AMS-1 trains young doctors how to regulate stress and manage complex organizational and situational contexts.

AMS-1 Teaching goals:

Effective teamwork and communication

  • The importance of using ‘readback’ and ‘hearback’ when ordering drugs and tests
  • Working effectively in a team: using all resources
  • Communicating effectively (careful listening) with nurses and family
  • Recognizing red flags in clinical situations that may lead to adverse incidents and avoidable complications when not addressed
  • How to ‘speak up’ when recognizing one or more red flags, in particular how to make an assertive statement to a superior who may be irritated or distracted


  • How to recognize and deal with the signs of sleep deprivation in oneself and in colleagues
  • How to recognize and deal with signs of sleep depression in oneself and in colleagues
  • Discovering the power of simple and easy breathing exercises to focus before an important task or to deal with the stress of the work environment
  • Skills that train each player to remain focused and sufficiently calm in order to initiate such critical tasks in hectic situations. This is implemented in the game by allowing the player to score game points by making effective use of biofeedback to let things happen in the game, for example: inserting an iv cannula, suturing a wound or making a blurry drug label readable.

Game concept

‘Air Medic Sky One’ is a state of the art flying hospital built into a very large quad rotor aircraft, that can take-off and land almost anywhere in the world. It is operated by an international organization providing worldwide emergency medical relief where and when needed.

Regardless of background and previous medical training, every candidate must first perfect his/her ‘non-technical’ skills in the AMS-1 training center, the ‘Biodome’.

Here the player gets acquainted with the biofeedback devices and performs exercises that may be called upon later while on mission. This is also the place to learn about teamwork and patient safety by watching brief video clips of patient safety experts who explain some important teamwork and self-management concepts. Once the basic ‘bootcamp’ training in the Biodome is complete, the player is invited to fly missions, such as ‘Forest fires in California’ or ‘Earthquake in Italy’.

While on a mission, the goal is to treat patients needing care, either by administering the correct treatment or referring them to another specialist. While managing patients it is important to pick up clues from the nurse, the patient and sometimes the families. The player is encouraged to ask a supervisor for help when they are uncertain about how to proceed -- there is no deduction in the game’s scoring, as studies have shown that this behavior leads to more positive outcomes in real-life scenarios. The supervisor will, however, send subtle but clear signals when the call for help is unnecessary.

Scalability and future expansion

From its inception AMS-1 was designed to be expandable, by allowing the easy addition of game content by medical experts, patient safety experts and medical educators. Video content (nurses, supervisors, patients or family) can be created and incorporated in the scenarios. New safety related lectures can easily be added.

Air Medic Sky

Project Details

VisionShift Studios wishes to thank the producers of ASM-1 from the University Medical Center Utrecht for their invaluable collaboration.

The three main medical advisors whose participation was critical to the quality and success of the project were:

  • Cor Kalkman , Ph.D. (Professor of Anesthesiology, UMC Utrecht)
  • Ian Leistikow , Ph.D. (Director of Patient Safety, UMC Utrecht)
  • Pam Kato, Ed.M., Ph.D. (Harvard- and Stanford-trained psychologist who developed the Re-Mission video game for young cancer patients)

VisionShift Studios interviewed and filmed the top Patient Safety experts in the world for the AMS1.

Patient Safety Experts