Learning Digital Skils for Elderly People by using Touch Screen

Technology and Learning Games: A Case Study

Borka Jerman Blažič, Primož Cigoj and Andrej Jerman Blažič

Institut Jožef Stefan, Jamova 39, Ljubljana, Slovenia

Keywords: Elderly People, Game based Learning, Touch Screen Table, Case Study.

Abstract: The problem of learning digital skills among elderly addressed in this paper is focused on an approach focused

to overcome the barriers in adoption of touch screen digital technology faced by older adults, by using the

game based learning approach. The paper provides an overview of some early results and findings from an

exploratory study based on use of an alternative learning approach with games enabled to facilitate the digital

literacy and digital skills adoption by elderly people. The learning was carried out with designed games

offered on big tablets with touch screen technology. The study results presented in the paper were collected

within the project GIRDA – Gameplay foR Inspiring Digital Adoption from the European ERASMUS+

program. The paper describes the research setting, the experiments and the results that are accompanied by

discussion and conclusion.

1 INTRODUCTION

The place of Europe in the future of the ICT will

depend on its ability to work and to manage the digital

innovation brought by the new technology for benefit

of all in the continent. In June 2016, a new Skill

Agenda was launched by the EU Commission with

digital skills as a key component of the European

development. The Agenda presents a number of

actions and initiatives that seek to improve the digital

skills at all levels and among all citizens with a

specific attention to elderly people. The problem of

learning digital skills among elderly addressed in this

paper is focused on the overcoming the barriers in

adoption of touch screen digital technology faced by

older adults, by using the game based learning

approach. The elderly European citizens may either

be in retirement or in middle age and they often have

no digital skills required for use of the services

offered on modern phone or similar devices with

touch screen interfaces. Increasingly, digital skills are

required for performing instrumental tasks such as

searching for contacts, medical help, measuring

medical indicators in an e-health service, paying

bills, and taking part in democratic processes. Access

to cultural resources, social connectedness and

emotional well-being are also activities related to the

adoption of digital technology skills among the

elderly people.

Several barriers for learning digital concepts

among older adults were identified relatively early

(Tang et al., 2006). These barriers partly appear

because the learning of digital skills is different in its

fundamental nature from what these people have

previously experienced. It was also found that

acquisition of digital concepts occur more easily

through hands-on trials and with use of the error-

based learning principles developed by some

researchers (Damodaran and Sandhu, 2016). Hands-

on exploration approach used by the learners was

found to be more effective than using secondary

assistance such as manuals or procedural descriptions

of concepts. This becomes typical approach for the

way in which these devices are learned in the last ten

years (

Häikiö et al., 2007). However, this is type of

learning is not familiar to many older citizens because

its use involves a number of problems in approaching

them. One of the barriers is the sense that le learning

is too difficult task, and is discomforting or

potentially stigmatizing prospect for the elderly due

to the lower physical ability and more difficult

understanding of the digital concept. In addition,

many older people are also not comfortable to learn

something that they perceive to be a 'classroom '

setting by trying to pick up concepts and skills

through a third party. Also, many of them have not

222

Jerman Blaži

c, B., Cigoj, P. and Jerman Blaži

c, A.

Learning Digital Skils for Elderly People by using Touch Screen Technology and Learning Games: A Case Study.

DOI: 10.5220/0006682002220229

In Proceedings of the 10th International Conference on Computer Supported Education (CSEDU 2018), pages 222-229

ISBN: 978-989-758-291-2

been in touch with the digital technology and rely for

their digital based service need on visits to public day

centres for use it where help can be expected.

Sometimes, additional concern appears among them

when a mentor is present without specific knowledge

for elderly learning.

A game concept for elderly was designed to foster

social interaction and physical activity. This was

investigated in several case studies (Gerling, Schulte

and Masuch, 2011). One of the studies has found that

playing brain training games on a portable game

console had a positive correlation with the reported

fun and the learning within an elderly age group.

Similar studies has recognized some cognitive

challenges that are aimed to provide a satisfying

gameplay mechanics for the elderly (Al Mahmud et

al. (2008) and consequently better learning. Finally,

the Elder Games project by Gamberini et al. (2008)

proposed gaming solution specifically designed to

test and train cognitive abilities of elderly persons.

Previous research in this area tried to address

mainly (Gerling, Schulte and Masuch, 2011) the

digital game design for elderly persons from different

perspectives, by focusing on the creation of enjoyable

gaming experience for seniors, while trying to

motivate them to engage in healthy behaviour through

engagement in playing.

The work presented in this paper is to provide

another aspect in elderly learning by focusing the

research work to the development of digital skills in

an attempt to make the elderly people capable of

using modern digital devices with touch screen

interfaces. This paper provides an overview of some

early results and findings from an exploratory study

based on the use of an alternative learning approach

with games that facilitate the digital literacy and

digital skills adoption by elderly people by gaming

and socializing. The learning was carried out with

designed games offered on big tablets with touch

screen technology. The study results presented in the

paper were collected within the project GIRDA –

Gameplay foR Inspiring Digital Adoption from the

European ERASMUS+ program by the partner from

Slovenia. The paper introduces the research setting,

the experiments and the results that are accompanied

by discussion and conclusion.

2 DIGITAL SKILLS LEARNING

AND TOUCH SCREEN

TABLETS

Contemporary digital skill training for older citizens

usually reflects a 'behaviourist' metaphor of teaching

and learning. Typically, learners are tutored and

thought with basic manipulations for specific key

tasks offered over the e-services such as filling claim

forms. Frequently reported problems in building these

skills with that approach include difficulties in

acquiring and retaining the skills as fear appears

among the learners that errors will be made. General

reluctance to explore the technics or the technology is

present in the part of many elderly participants. Those

acting in mentoring role are often not highly skilled

or trained teachers, and many of them have only

recently acquired digital skills themselves. Therefore,

being placed in a 'teacher-like' role for such tasks is

something that can be discomforting for the mentors

as well. This interpretation of the roles of teacher and

learner is often also problematic for learners,

particularly if they had bad previous experience of

formal learning in classical classrooms setting. By

contrast the approach taken in the study presented in

this paper reflects constructivist and socio-cultural

methods that encourage learners to develop

confidence and skill through hands-exploration and

discovery in a supportive environment that includes

mentorship and collaborators from their own

environment. In such environment mentors are

expected to easily interact with learners, to observe

them and to demonstrate the tasks through action,

and by providing direct support rather than being put

under pressure to 'teach' the class in the traditional

sense.

The approach taken in the study explicitly

separates learning from any specified instrumental

context by using games generally available on big

tablets. In doing so the approach the intention is the

learning process “to be hidden” from the users. The

attractiveness and low-pressure nature of the selected

games in the experiment addresses the affective and

culturally-situated barriers to learning. Academic

studies (Haikio et al., 2007) of novice older users

playing touch table games have suggested that older

users are capable to rapidly acquire manipulation

skills and that they exhibit a willingness to explore

the new tool in a way that naturally develops

cognitive and motor skills. This suggests that

effectively 'hiding' the learning of digital concepts in

games that are also carried out in socializing

environment allows users to acquire the skills and the

Learning Digital Skils for Elderly People by using Touch Screen Technology and Learning Games: A Case Study

223

confidence to progress towards full digital literacy.

Furthermore the 'reality-based interaction' of touch

screens is also very likely capable to transfer the

adopted skills in the use of key modern carriers such

as the mobile smart phones, a non-avoidable tool for

many e-health and other e-services.

In setting the research in the GIRDA project all

interrelated areas for this type of learning were taken

into consideration. Serious games have increasingly

attracted the attention of professional trainers and

educators’ due to the empirical evidence, notably

from the 2014 PISA project that surveyed the

relationship between the ICT technology used and

learning outcomes evaluated through scores achieved

by the students in 17 European countries. The authors

of the PISA report, Biagi and Loi (2013) found that

the relationship between the domain-specific PISA

test scores and the measure of the intensity of the

student's gaming activity (playing any game) is the

only information technology indicator that had a clear

positive correlation with the achieved subject scores,

such as mathematics, science and the language of

instruction in the majority of the surveyed European

countries. All the other IT-activities measures in the

same study indicated only negative correlations with

the scores. The positive association between the

intensive use of gaming and the test scores indicates

that gaming during learning positively stimulates the

development of the necessary skills, competences and

abilities, such as problem solving, strategic thinking,

memory, fantasy, interaction and adaptation to the

learning subject, which are elements well captured by

the standardized tests in particular subjects, such as

those used in the PISA survey. Earlier findings by

Wilson et al (2008) on 'Relationships between Game

Attributes and Learning outcomes contributed to the

accepted assessment of the “game based learning

value.” This type of learning was supposed also to be

re-enforced and easier with the abilities offered by

touch screen tablets.

3 STUDY DESIGN

3.1 General Approach

The main objective of the Gameplay for Inspiring

Digital Adoption study was to use games as a learning

tool to develop and practice skills critical for using

touchscreen technology such as tap, drag and rotate n

objects on the screen. Our initial criteria for selection

of the games included familiarity from the ‘real

world’, such as card games, crossword puzzles and

jigsaw puzzles, chess and backgammon. Regarding

the previous knowledge of the participants was

decided to select participants for the study without

any skills in playing games. The selection of games

was based on that decision.

The study was designed as two-player gaming on

a touch-table device (basically a giant tablet e.g. the

Lenovo table) to introduce older learners to

touchscreen functionality, in a low pressure

immersive environment where the fact that

participants are learning was ‘hidden’. The Lenovo

touch table used in the study offers a selection of

preinstalled games that can support up from one to

four people playing simultaneously. However we

decided the game playing to be performed by a pair

of elderly people composed by the same gender or

mixed. Exploring the diverse range of game

categories available on a Windows touchscreen

device presented certain challenges - which might be

off-putting for new users trying to find their way in

using the screen functionality. The main property of

the game to be selected was the game to create non-

stressful and enjoyable paths to learning cognitive

motor skills. This implied such type games that avoid

placing o cognitive burden on the learner that

distracts unduly from the skill learning process. The

same applies for games that apply complex set of

rules that may burden the working memory. The

featured ‘popular’ games were generally overly

sophisticated; ‘educational’ games were clearly

aimed at pre-school and primary school age children,

while ‘adult games’ were found to be x-rated. More

useful were the genres which included puzzles, board

games and casual games. It was decided the first

game to introduce a basic drag action as an

introductory lessons for using touch screen device.

The selection was not very difficult as there are a

number of games that introduce dragging in a variety

of ways. The drawing game was selected as most

appropriate for users that have not been in touch

previously with touch screen technology and

computer games. The simple drawing tool in our

repertoire of games was sort of introductory element

so that our participants were enabled to have a first

experience of just touching the tablet and getting an

immediate visual result – be it a fingerprint sized dot,

a line, a house or a ship. The game enabled also using

the tablets key for change of the colour. The second

game was decided to introduce the rotate action and

to enable learning of object moving on the screen.

Koala puzzle was selected as second game. Puzzles

are games that are popular as entertaining games and

it was supposed that not much explanation will be

needed for explanation of the game. However, this

game enabled learning other skills, moving, rotating

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in dragging objects to come in right position. The

third game was selected from the list of games with a

matter of in-situ judgment, so the very popular heavy

traffic Cross road game was selected. The player is

moving an object over very busy roads and is trying

the object to not crash under the fast moving vehicles.

If the crash happens before the object reach the other

side of the last road the game closes and start again.

This game is focused on coordination of the

vision/recognition and motor activity of the fingers.

The three selected games proved useful in identifying

how key variations and their pros and cons in learning

how to act on touch tablet scree can be identified.

Figures 6-8 (see Appendix) present the screenshots

from the video record of all three games.

The participants were recruited from three nursing

homes in Ljubljana, Slovenia (Bokalce, Črnuče and

Kolezija). The home care employee selected the

participants that had no experiences in novel technical

solutions and had never used touch screen device. The

age of the participants ranged from 65 to 85. And

most of them had no previous experiences with digital

technology as we requested novices to form the

group. The level of education ranged from high

school up to master degree. Most of the participants

had weaknesses in some of their motor based

capabilities and this governed the way data were

collected after each of the carried sessions. The

learners have worked in pairs. They were expected to

collaborate in helping each other which was

considered as a socializing effect enriched with the

other members of the particular group. The witness

presence is usually considered as a key dynamic of

co-learning. Participants take cues from watching the

partner interacting with the system and the

consequent system response. One of the study tasks

was to observe how people interacted with each other

as well as with the technology, and how the choice of

game or activity influenced to the changes of these

interactions.

The role of a mentor was appointed to a person

that was paid as a tutor or as a volunteer, or simply

someone with a little more experience in ICT. The

mentor was expected to be capable to guide the less

experienced player and, in the process, improve their

own skills, both as a touchscreen user and as an

informal teacher. However, he/she was not allowed to

intervene on the screen during the session, only in

case a restarting of the game was required.

3.2 The Applied Study Protocol

The applied protocol of the experiments included

several tasks. However, the approach of using hard

protocol’ with strictly controlled variables appeared

to not be a useful approach for GIRDA’s objectives.

Therefore, we stated some parameters for study set-

up that allow for local adjustments. The nature of the

study was based on the spirit of Grounded Theory

(Martin and Turner, 1986), where exploratory studies

may resolve questions but equally importantly

generate issues and questions for the ongoing

investigation. Our guidance for generation and

analysis of data reflects this. As digital adoption

‘landscape’ is different in each environment, it was

allowed the selection criteria to be affected by local

sensitivities in GIRDA participating countries. In

Slovenia, we found that there are elderly in the

nursing home who have had no exposure to digital

technology at all, but more common were those who

have had just a small degree of exposure connected

to their working environment before they retired. In

selecting the participants, as was already agreed

elderly with no prior experience of digital technology

at all or very limited experience and balanced genders

(as far as possible) were asked to be invited to the

experiment . In targeting recruitment pairs were asked

to be formed from both genders as sociality was one

of the key elements of the strategy in learning. It was

also supposed that the participants know each other.

We asked the maintaining personnel in the nursing

home to propose pairs by presenting them the action

as “playing of games” and that as a major part of the

experiments. The action was illustrated additionally

as a ‘gift-based’ incentive. The gifts were provided at

the end of each experiment.

3.3 Conducting the Session

Session began with welcoming the participants with

brief introductions to the people involved and purpose

of the study. Then the participants signed the consent

form and agreement to take part and to the fact that

they will be video recorded but without disclosure of

their identity. The camera was focussed on the screen

and their hands. The session started with an

introduction of the first activity in a form of drawing

game accompanied with the drag action on the screen.

In the introduction an encouragement to touch the

Lenovo table was provided. . The mentor was asked

to inform the participants that his engagement or

struggling to work actions out was not allowed,

however prompting the participants by making

suggestions was recommended. One of the mentor

tasks was to ensure both participants to take a turn, to

discuss progress and to express the first impressions.

The time for drawing was not limited. After drawing

the second activity was introduced, the Game with

Learning Digital Skils for Elderly People by using Touch Screen Technology and Learning Games: A Case Study

225

Rotate and moving objects activity. Giving

encouragement to touch and move pieces to complete

the puzzle was done but in same time it was allowed

the participants to explore first the rotation

unprompted unless stuck. The mentor was supposed

to encourage less active partner to try actions. The

third activity within the third game was more

demanding and it was introduced with an explanation

from the mentor regarding the game gestures and the

goals of the game e.g. crossing successfully several

roads with heavy traffic. Again, the time for playing

was not limited strictly. Each session lasted from one

hour to two and after the gaming was ended post-test

open questions were passed to the participants. These

open questions were intended to give participants

their own opportunity to comment, and reflect on

their experience. The questionnaires (2 of them) were

prepared in advance, each of them with several

questions. They are presented in the Appendix.

4 RESULTS

We have collected data from 30 participants from

three nursing homes aged between 65 and 85 in

collaborative performances on touch-screen devices

over two months. After each session, the participants

were asked one by one to take part in an interview

with several open questions. They were also asked to

fill the template with answers that contained closed

number of questions. The collected data were

analysed with an intention to reveal how elderly

people react and accept the new digital technology

with touch screen, what are their attitudes towards

learning with it, do they accept the way for learning

new skills, do they experienced some difficulties in

development of the motoric skills necessary to act on

the screen, how big was the players immersion with

the games (obtained by observation of the mentor), if

collaboration among the pairs was present and was

observed as a support in solving the game e.g. in the

puzzle game and if the participants within the group

that accompanied the players provided support

during the learning with instructions how to play a

game or with instruction for the move on the tablet

Selections of the processed data are presented as

Figures 1-5 bellow.



Figure 1: Question №1.



Figure 2: Question №2.

Figure 3: Question №3.

Figure 4: Question №4.

Strongly

disagree

Disagree Neutral Agree Strongly

agree

Participants

Ienjoyedplayingthegames

Strongly

disagree

Disagree Neutral Agree Strongly

agree

Ilikedplayingthegameswithothers

Strongly

disagree

Disagree Neutral Agree Strongly

agree

Participants

Iwouldbeinterestedinplayingmoregames

Strongly

disagree

Disagree Neutral Agree Strongly

agree

Participants

IfeelIhavelearnedsomethingnewabout

usingatouchscreen

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Figure 5: Question №5.

Most of the participants (82%) described the

action as pleasant and full of fun, however 18 %

found the action tiresome. The most enjoyed game

was the puzzle followed by the drawing game. Crossy

road from some of them was somehow tiresome and

maybe demanding regarding the required speed of

action and coordination of the vision and the motor

skills required for successful playing. . Most of them

(75%) have declared that they did not found the use

of touch screen difficult, the other part (25%) have

declared that they have encountered some difficulties

especially in the Crossy road game. It was important

finding that majority of them (95% did not

experienced any physical discomfort in using their

fingers for playing the games. The same results were

obtained about the experienced novelty of the

technology used and the attraction of playing games

on a touch screen table. Most of the participants did

not found that playing of games was difficult (80%)

and the assessment of the attractiveness of the

approach was also assessed as high (90%). The

participants declared that they would describe this

experience to others as fun. The collaboration –

playing as pair and with group support was also

accepted positively by the majority of the

participants, The same results was obtained during

the interviews about existence or nonexistence of

fear in using the technology or learning with this type

of digital technology. No fear was reported. Overall

the whole experiment was assessed as very positive

experience. Some participants asked if there will be a

second session with the same technology and the

same mentors.

5 DISCUSSION

In most cases, the foundations of being a good user -

developing trust self-efficacy and perceived value is

growing slowly and steadily without anyone giving

the matter much thought, often well before someone

e.g. a child in particular case start learning. By the

time person is seventeen, he/she can easily

understand the benefit of learning to drive a car as this

enable better mobility. The person is also well aware

of the risks of driving, but also knows how they can

be mitigated. It is well known that lots of people learn

and apply the skills without too much difficulty.

However, these learning foundations are often

absent when it comes to non-users of digital

technology, as it was proved to be very hard to teach

them through the general system ‘show and tell’. The

first step - going from being a complete non-user to

an engaged newbie - is the steepest. The challenge for

digital inclusion practitioners is ensuring that training

provision for new users should be based on fun, social

and risk-free, while still building vital interface skills,

and encouraging experimentation and adopting self-

guided learning. Research shows that these factors are

especially important for older learners, for whom the

opportunity to play with digital technology, helps to

capture interest and build confidence. These findings

were confirmed in our study as well. The learning was

“hidden” and the adoption of self-learning was

present and proven All points towards the importance

of game-based learning for digital inclusion have

shown to be true even in a group of elderly people

with some physical or mental weaknesses. It was

shown by majority of our participants that using

games to learn is taken as a fun, but it’s also low-risk,

and the players were able to run through situations

again and again e.g. in the drawing game and in the

Crossy road game They explored during the game

playing how different actions have different results by

the changing the colour in the drawing and assessing

when to cross the road. The big difference with

classical teaching of skills for digital inclusion by

learning by gaming is that the games can be

completely familiar, or incredibly easy to learn. In

fact, the more familiar and easier are they, it is better

for the learner, at least to begin with. The rules for

learning for this type of games are not the rules of the

game, but the rules of how to interact with a digital

device. In our sessions, all participants adopted the

touch interaction method easily regardless of their

motor skills. Most of them understood the games

easily and some outperformed the others especially in

playing the second game - Koala puzzle. All of them

were capable to draw figure on the tablet and to

change colours; however, several trials were

necessary to touch the right place on the screen. The

differences in flow observed among the participants

might be attributed to the fact that the players with

some motor weaknesses seemed to encounter more

Strongly

disagree

Disagree Neutral Agree Strongly

agree

Participants

Inowfeelmorepositiveaboutusingdigital

systems(e.g.touch‐tables,tablets,iPadsand

similardevices)

Learning Digital Skils for Elderly People by using Touch Screen Technology and Learning Games: A Case Study

227

problems when interacting with Crossy road game.

Immersion in the game was present as well

collaboration among the players either from the

partner in the pair or from the group that gave loud

advices how to act on the tablet. Some of the partners

were first watching before they entered actively in the

game. Observation during the sessions suggested that

the cognitive load of managing the session required

more than one mentor sometimes. Altogether these

findings appeared through participant’s observation

but as well from the data collected in the interviews

and the closed questionnaire. Despite age related

cognitive and physical changes, all of the participants

were able to understand and answer all questions in

the questionnaire. Yet, further research regarding the

test criteria like reliability and internal consistency of

such shortened first version of GIRDA exploratory

study is necessary.

6 CONCLUDING REMARKS

To become a proficient user - of anything some

absolute essentials are needed. Each person needs an

easy and regular access to the thing/device to be used,

and skills are needed for effective use of it. But

having that access, and learning those skills, are not

much useful if there is no trust in the things that are

used, and the if the user does not have faith in his/her

abilities to use it, or simply does not see the point. Just

like skills, these internal conditions are not innate,

and there are lots of factors that influence the degree

to which someone has them and like with the skills,

they can be nurtured and grown with the right kind of

support.

The first study carried in GIRDA - Gameplay for

Inspiring Digital Adoption project has shown that

most these aspects in learning were considered during

the study. Elderly people need to know how to use

modern devices like smart phone in order to stay

socialized and to accept the benefits of modern

technology specially designed to help them in aging

or staying at home as long as possible. Many e-health

applications are developed for elderly but their use

and the benefits they bring depends on the user digital

skills and understanding of the offered service.

Playing games on touch screen table is obviously one

of the methods to help them in acquiring these skills

more easily and on a friendly manner. Learning

without knowing that person learn is simply more

acceptable as it is an easy way to adopt what is need

in the current and future digital world. GIRDA will

continue with similar experiments and studies in the

future within the environments from the participating

countries and future reports and findings will be

prepared and published. Comparison among the

results will be provided as well. The future rounds of

data collection and analysis will help the GIRDA

team to understand the optimum setup for this kind of

peer-to-peer learning, and what kind of games yield

the best results. We hope that in future there will be

opportunities to use this evidence to create tailor-

made games that can build the interface skills and

help older learners to overcome the lack of

confidence and a feeling that using touch screen

computers is risky and impossibly complicated.

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APPENDIX

The post session open questions carried out as an

interview. These open questions were intended to

give participants an opportunity to comment, and

reflect their experience and to discuss the experiment

with the mentors and with the nursing team.

a. Which game did you enjoy the most (and why?)

b. Was there anything that struck you as novel or

surprising?

c. How would you describe these actions to someone

else?

d. Was there anything you found particularly difficult

about using a touch screen?

e. Did you experience any physical discomfort?

Closed Elicitation in a questionnaire with Likert

scale.

a. I enjoyed playing the games.

b. I liked playing the games with others.

c. I would be interested in playing more Games.

d. I feel I have learned something new about using a

touch screen.

e. I now feel more positive about using digital

systems (e.g. touch-tables, tablets, iPads etc).

Figure 6: Screenshot from the video – drawing game.

Figure 7: Screenshot from the video – puzzle game.

Figure 8: Screenshot from the video – crossy game.

Two edited short videos of the experiments can be

found on the following address:

https://dbox.si/index.php/s/hDv1r3IR8rPdRc0

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