Bill Kapralos

Priyamvada Tripathi, Bill Kapralos

Serious games are widely used for learning and training across domains such as healthcare, defense, and education. Persistent challenges remain, however, including static scenario design, authoring bottlenecks, limited learner modeling, and difficulty implementing meaningful real-time instructional adaptation. Recent advances in artificial intelligence (AI) introduce novel capabilities such as dynamic scenario variation, contextual feedback, adaptive pacing, and learner-state modeling that may help address some of these limitations. At the same time, integrating AI into serious games raises important questions related to validity, transparency, system control, and learner trust. This chapter examines how contemporary AI approaches may support real-time instructional adaptation in serious games. It distinguishes between instructional intelligence, defined as a system's capacity to infer learner knowledge and reason about pedagogically appropriate responses, and adaptivity, defined as the ability to modify instructional actions during interaction. A historical synthesis of adaptive learning systems is presented, tracing developments from early computer-assisted instruction through intelligent tutoring systems (ITS), dynamic difficulty adjustment (DDA), authoring platforms, learning analytics, and recent AI-enabled architectures. Building on this perspective, the chapter discusses how large language models (LLMs), reinforcement learning (RL), and agent-based architectures may contribute to more integrated forms of intelligence and adaptivity in serious games. It also highlights practical and research challenges associated with AI-enabled systems, including explainability, validation, computational cost, and the limited empirical evidence regarding long-term learning outcomes in AI-enabled serious games.

Karisa Parkington, Bazen G. Teferra, Marianne Rouleau-Tang et al. · utoronto

Thematic analysis provides valuable insights into participants' experiences through coding and theme development, but its resource-intensive nature limits its use in large healthcare studies. Large language models (LLMs) can analyze text at scale and identify key content automatically, potentially addressing these challenges. However, their application in mental health interviews needs comparison with traditional human analysis. This study evaluates out-of-the-box and knowledge-base LLM-based thematic analysis against traditional methods using transcripts from a stress-reduction trial with healthcare workers. OpenAI's GPT-4o model was used along with the Role, Instructions, Steps, End-Goal, Narrowing (RISEN) prompt engineering framework and compared to human analysis in Dedoose. Each approach developed codes, noted saturation points, applied codes to excerpts for a subset of participants (n = 20), and synthesized data into themes. Outputs and performance metrics were compared directly. LLMs using the RISEN framework developed deductive parent codes similar to human codes, but humans excelled in inductive child code development and theme synthesis. Knowledge-based LLMs reached coding saturation with fewer transcripts (10-15) than the out-of-the-box model (15-20) and humans (90-99). The out-of-the-box LLM identified a comparable number of excerpts to human researchers, showing strong inter-rater reliability (K = 0.84), though the knowledge-based LLM produced fewer excerpts. Human excerpts were longer and involved multiple codes per excerpt, while LLMs typically applied one code. Overall, LLM-based thematic analysis proved more cost-effective but lacked the depth of human analysis. LLMs can transform qualitative analysis in mental healthcare and clinical research when combined with human oversight to balance participant perspectives and research resources.