Fig. 1

The three main points to discuss during the development of a serious game. Firstly, users need to be motivated to play the serious game in order to access the learning content. Motivating serious games integrate the extrinsic motivation of the player for a specific outcome (e.g. practicing as a medical doctor) into the learning activity (e.g. a simulation game on the management of cardiac arrest), making this learning activity desirable (apparition of intrinsic motivation for the learning activity). This phenomenon was called “the convergence of motivations.” Secondly, the learning potential of serious games should be maximized. The “four pillars of learning,” a framework derived from cognitive science finding [12], may be useful for developers and educators to enhance the learning effectiveness of their games. Finally, serious game should be evaluated in order to progress towards evidence-based education