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Original Research Article

Validating the ID-GAMING e-Training Toolkit for People with 
Intellectual Disabilities in Greece

Niki Pandria*, Anastasia Barboudi, Vasileia Petronikolou, Panagiotis Antoniou and Panagiotis D. Bamidis

Medical Physics & Digital Innovation Lab, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTH), 
Thessaloniki, Greece.

* Corresponding Author Email: npandria@gmail.com 

ABSTRACT

Intellectual disability (ID) is a neurodevelopmental disorder characterized by limitations in adaptive and intellectual functioning. 
Serious games (SGs) incorporate learning and educational strategies that are commonly used in special education, and they have 
been proposed as assistive tools for people with developmental difficulties. ID-GAMING e-training toolkit encloses an SG named 
“Qool City” available as a board and a digital game, a game catalogue, and training materials on cognitive functions and quality 
of life. In this manuscript, we focused on describing the methodology and the preliminary outcomes of the validation actions 
of the toolkit. A four-step methodology was formed to specify the interaction of participants with the toolkit and a qualitative 
validation tool was developed by the consortium to assess the participants’ performance during the session. The target groups 
were people with Intellectual Disabilities (PwID) (young adults and adults), professionals, and relatives. Twelve individuals 
participated of which seven were PwID, two educators, and three facilitators. However, two PwID withdrew from the activities 
performed in Steps 1 and 2, but one PwID joined the activities performed in Steps 3 and 4. The ID-GAMING e-training toolkit 
seems to lead to improvement in various cognitive functions of PwID including memory, attention, language, and spatial orienta-
tion. Components of quality of life such as wellbeing and independence were promoted. PwID remained engaged until the end of 
their interaction with the toolkit components while both PwID and educators were satisfied with the toolkit. Moreover, educa-
tors argued that the e-training toolkit helped them to be motivated and aware of the potential applications of SGs for improving 
cognitive functions as well as providing useful information about the quality of life, its improvement, and cognitive functions. 
In addition, collaborative and supportive skills were promoted along with digital skills. Indicators for participants’ experience 
and improvement were fulfilled. Therefore, the ID-GAMING e-training toolkit seems to be a valuable assistive tool for PwID and 
the people involved in their care that should be further validated using a larger sample size and standardized assessment tools. 

Keywords—Intellectual disability, Serious games, Validation actions, Cognitive functions, Quality of life.

Copyright © 2024. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY): Creative Commons - 
Attribution 4.0 International - CC BY 4.0. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright 
owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduc-
tion is permitted which does not comply with these terms.

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INTRODUCTION

Intellectual disability (ID) constitutes a neurodevel-
opmental disorder1 that is characterized by limitations 
in intellectual functioning and adaptive behavior.2 The 
difficulties are present at birth and their manifestation 
is shown during the developmental period before adult-
hood.1 The intellectual functioning refers to “the global 
ability to understand reality and interact with it” 2 and it 
is attributed to the concept of intelligence.2 It integrates 
different cognitive functions such as problem-solving, 
logical reasoning, abstract thinking, planning, ability in 
learning, and experiential learning which are all affected 
in ID.1,2 Adaptive behavior is conceptualized as a set of 
skills that provide competence in the social, practical, 
and conceptual domain.2 ID is characterized by deficits 
in adaptive behavior that lead to the inability to meet 
sociocultural and developmental standards for social 
responsibility and personal independence. Without 
ongoing support, deficits limit functioning to at least 
one daily activity and in multiple settings.1 ID can be 
accompanied by different co-morbidities such as other 
neurodevelopmental, neurological, or mental disorders 
as well as medical conditions.2

The treatment of ID should be multilevel, multidisci-
plinary, and tailored to patient needs and may include 
psychopharmacologic interventions, educational sup-
port, behavioral approaches, vocational training, and 
family education.2 Another interventional approach that 
was introduced as a tool to support people with ID was 
serious games (SGs). SGs are defined as the games that 
are designed with a primary purpose rather than pure 
entertainment3 and they have been applied in multiple 
fields such as education, healthcare, advertisement, and 
military among others.4 Although there are some examples 
of SGs that have been developed for mentally challenged 
people to support emotion recognition and expression5,6, 
dealing with real-life situations7 or mathematics8, the 
landscape of how to design, develop, and evaluate SGs is 
not adequately explored.9 However, it is clear that people 
with ID have special educational needs10 and therefore 
it is crucial to consider their abilities and needs while 
designing and evaluating an SG. Most of the SGs that 
have been evaluated were computer games, in the field of 

education and healthcare and questionnaires were used 
as an assessment method.11

ID-GAMING e-training toolkit was designed and devel-
oped in the context of the Erasmus+ ID-GAMING project 
and it is freely available on the project website (https://
id-gaming.inesc-id.pt/). It encloses an SG named “Qool 
City” that is provided in two versions as a board game 
and a digital game (Figure 1), a game catalogue, and 
training materials. The “Qool City” is a collaborative SG 
that incorporates a narrative adapted to the ID sector 
and to life settings and expectations of young adults and 
young adults with ID. The main purpose of the game is 
to promote quality of life improvement through training 
in cognitive functions and quality of life dimensions. The 
game catalogue is a collection of serious games, non-serious 
games, and platforms already tested by people with ID 
(PwID). Every game can be selected based on the cognitive 
function the user wants to train, and it is accompanied 
by a brief explanation of the training purpose, tips for a 
satisfying gaming experience, and relation, if any, with 
the dimensions of quality of life. Training materials were 
designed to familiarize PwID, professionals and caregivers 
with concepts that are involved in the “Qool City” game 
and further expand their knowledge on SGs and quality 
of life dimensions. More precisely, training materials were 
developed in five different themes that are dimensions of 
quality of life and cognitive functions, the impact of cog-
nitive training on quality of life, the definition of serious 
games and Information and Communications Technology 
(ICT) serious games, selection of ICT serious games to 
train cognitive functions for PwID, the role of supports 
in Easy-to-Read format. A methodological guide was also 
included to facilitate the interaction with the SG “Qool City”.

In this manuscript, we describe the validation actions 
of the Intellectual Outputs (IOs) of the ID-GAMING proj-
ect that are incorporated into the ID-GAMING e-training 
toolkit. The project had as Intellectual Outputs (IOs) the 
development of a Quality-of-Life Training Game so-called 
“QooL City”, a Training Toolkit, and an e-training Tool. The 
validation actions were focused on the evaluation of the 
quality of IOs and therefore the quality of ID-GAMING 
e-training toolkit, the assessment of possible improve-
ments in competencies of persons with ID, relatives, and 

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27 J Global Clinical Engineering Vol.6 Special Issue 6: 2024

FIGURE 2. Flowchart of the 4-step methodology applied to 
validation actions. 

 
and observer had to fill in the qualitative validation tool 
(Questionnaires A, B, C, D) developed by the consortium 
to assess participants’ performance during the session 
(see Appendix). Two different versions of each question-
naire were designed, the one to be filled by facilitators/
trainers after collecting PwID responses and the other 
addressed to relatives and professionals. Data collected 
through the questionnaires were anonymous. Addition-
ally, all sessions were accompanied by an attendance list, 
a checklist page and notes, and a satisfaction question-
naire. A number of indicators were set to assess the 
participants’ experience and improvement, listed below 
in Table 1. 
 
TABLE 1. Indicators to assess the participants’ experience 
and improvement.

No. Validation Indicator Target

1 Attendance to Validation 
Pilot Actions

100 participants
(30 in Portugal, Spain, and 

Italy, and 10 in Greece)

2
Target group awareness 
and motivation to use 

ICT SGs to improve QoL

≥ 70% target group is aware 
and motivated to use ICT SGs 

to improve QoL

3 Target group digital skills 
use improvement

≥ 70% target group 
experienced opportunities to 

use digital skills.

4
Target group cognitive 

functions use 
improvement

70% of the target group 
experienced opportunities to 
use their cognitive functions

5
Target group quality-

of-life dimensions 
improvement

70% of the target group 
experienced opportunities 
to improve quality-of-life 

dimensions

professionals, and the collection of feedback on “QooL 
City” for refinement purposes.    

FIGURE 1. Screenshots of the “Qool City” game available as a 
digital game (left) and a board game (right).

METHODS 

The validation actions were performed through face-
to-face sessions from May to July 2022 with a goal to 
involve at least 100 participants across countries (30 in 
Portugal, Spain, and Italy, and 10 in Greece). Our target 
groups were young adults and adults with intellectual 
disabilities, professionals, and relatives. 

A four-step methodology (Figure 2) was formed including 
interaction with training materials in five different themes 
in Easy-to-Read format as described earlier (Step 1); Two 
complete turns of playing the board game “Qool City” as 
single players (Step 2); Two complete turns of playing 
the online game as single players (Step 3); interaction 
with the game catalogue and five ICT-Serious Games on 
training environment or at home (Step 4). At least one 
facilitator/trainer and observer participated during each 
validation session. The facilitator/trainer was a profes-
sional who was trained on “QooL City” contents, training 
methodology, and design and guided participants through 
the activities, while the observer was a professional who 
was responsible for collecting information about the 
validation experiences and facilitator support.

At the end of each validation session, the players com-
mented on their experience with support, if needed, from 
the facilitator and observer. Moreover, the facilitator

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6

Improvement of
 collaborative/

cooperative/teamwork 
skills

70% of the target group 
experienced opportunities 
to improve collaborative/

cooperative/teamwork skills

7 Target group opinion on 
“QooL City”

≥ 70% target group evidence 
satisfaction

RESULTS 

Twelve individuals took part in validation sessions of 
which seven were PwID, two educators, and three facili-
tators. However, two PwID withdrew from the activities 
performed in Steps 1 and 2, but one new participant with 
ID joined the activities performed in Steps 3 and 4. 

All educators agreed that training materials, both 
versions of “Qool City” game (board and online) and the 
game catalogue helped them to be aware of the use of SGs 
for improving cognitive functions, to be motivated about 
using SGs, to know more about quality of life, cognitive 
functions, and quality of life improvement. Moreover, 
they responded positively to questions about the differ-
ent components of ID-GAMING e-training toolkit and the 
use of supportive skills. More precisely, both versions of 
“Qool City” and the game catalogue facilitated the use of 
collaborative and supportive skills such as active listen-
ing, respect choices, teamwork, flexibility, as well as the 
balance between support and autonomy. Educators also 
agreed that the online version of “Qool City” and the game 
catalogue promoted the use of digital skills.

After interacting with training materials, six out of seven 
PwID showed improvement in their language, memory, and 
attention skills. PwID were able to practice their language 
skills to share their thoughts and opinions regarding the 
training material themes and discuss with each other 
and the facilitators. Through discussions, they had the 
opportunity to learn the meaning of some new words 
and phrases. They could also recall moments from their 
personal experiences related to the quality-of-life dimen-
sions and they were able to remain focused throughout 
the whole session. Generally, it was observed that most 
of the players were motivated and actively participated 
in the discussion especially on topics related to material 
wellbeing. Six out of seven PwID completed all cognitive 

challenges of the board game “Qool City” with little or 
no help. Similar findings were revealed in five out of six 
PwID when playing the online game “Qool City”. Evaluat-
ing the game catalogue experience, four out of six showed 
an improvement in their memory skills, while five out of 
six in attention to detail and spatial orientation skills, as 
they were able to focus on each game to find the match-
ing pairs, or the right position and the new elements 
added to the scene. Moreover, it was observed that half 
participants strengthened their skills in calculation and 
emotional wellbeing, as they could do calculations with 
money (i.e., addition and subtraction) and correctly rec-
ognize different emotional expressions. 

Six out of seven PwID were aware and motivated about 
the use of ICT-SGs for improving cognitive functions and 
therefore their quality of life after their interaction with 
the board version of “Qool City”. Similar findings were 
observed in all participants (6 out of 6) after interacting 
with the online game “Qool City” and the game catalogue. 
This was emphasized by the fact that they enjoyed playing 
the “Qool City” by trying to fall into challenge boxes and 
they remained motivated and engaged until the end of 
the game. All PwID (6 out of 6) were familiar with playing 
digital games and interested in playing the five ICT-SGs. 
They remained engaged until the end of the session and 
it was noticed that some of them continued playing even 
though they had successfully completed the games. Six 
out of seven PwID actively participated throughout the 
game, and they took part in every challenge they had to 
accomplish in their turn. Moreover, participants tended to 
prefer challenges related to physical activity and socializa-
tion. Similar findings were shown in all participants (6 out 
of 6) after interacting with the online game “Qool City”. 

Moreover, six out of five out of six improved their 
wellbeing competence after playing the board and the 
online game respectively. Evaluating the independence 
competence, five out of seven and five out of six PwID were 
autonomous in completing the challenges of the board 
and the online game respectively. Some of them (4 out of 
7 for the board game and 3 out of 7 for the online game) 
needed help to understand the challenges’ instructions 
because they did not have the ability to read. It was also 
observed that they could decide for themselves on those 
challenges that offered several options. Interacting with 

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29 J Global Clinical Engineering Vol.6 Special Issue 6: 2024

FIGURE 4. The overall participants’ satisfaction after inter-
acting with the board game “Qool City” (Step 2).

FIGURE 5. The overall satisfaction of participants after inter-
acting with the online version of the “Qool City” game (Step 3).

FIGURE 6. Evaluation of the game catalogue experience (Step 4). 

the online game “Qool City”, all players gradually improved 
their digital skills. More specifically, they got familiar with 
the use of the computer mouse, and they learned how to 
use the “zoom” function in the pictures. Some of them 
(3 out of 6) were able to use the keyboard to name their 
avatar. In this direction, most of the participants (5 out 
of 6) improved their ability to use the keyboard and the 
computer mouse to follow the game rules and advance 
to the next level after interacting with the five ICT-SGs. 

During both versions of “Qool City” game, all PwID 
had the opportunity to enhance their teamwork skills. A 
friendly and cooperative environment was fostered during 
the game where participants encouraged each other to 
perform the challenges. It should also be noted that every 
player was willing to patiently wait for his/her turn to 
play. Assessing whether the “QooL City” game is playable, 
fun, educational, accessible, usable, and having an impact 
on their cognitive functions and quality of life, six out of 
seven PwID after playing the board game reported that 
they had fun and they liked using the physical elements 
of the game like rolling the dice and moving their pawns. 
They also thought that the game was useful for learning 
new things and practicing new skills. Likewise, all PwID 
had fun during the online game which was also considered 
useful. However, the board game was preferred compared 
to the online game as they enjoyed the interaction with 
the physical elements of the board game. 

The overall satisfaction of participants in different 
steps and the global satisfaction are presented in Figures 
3–6 as well as in Figure 7 respectively. 

FIGURE 3. Evaluation of participants’ experience after 
interacting with training materials (Step 1). 

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FIGURE 7. Evaluation of the global participants’ satisfaction 
after interacting with the ID-GAMING e-training toolkit. 

All indicators defined to assess the participants’ 
experience and improvement were fulfilled in PwID as 
displayed in Table 2. 

TABLE 2. Results of participants’ experience and improve-
ment indicators in PwID. 

No. Validation Indicator Results

1 Attendance to Validation Pilot Actions 12 participants

2 Target group awareness and motivation 
to use ICT SGs to improve QoL 95.2%

3 Target group digital skills use improvement 91.7%

4 Target group cognitive functions use 
improvement. 78.6%

5 Target group quality-of-life dimensions 
improvement 84.9%

6 Improvement of collaborative/cooperative/
teamwork skills 91.7%

7 Target group opinion on QooL City 92.9%

DISCUSSION 

Serious games incorporate learning and educational 
strategies that are commonly used in special education 
such as repetition, narrative, simulation of real-world 
conditions, as well as coherent and immediate feed-
back.12 Repetition is an important learning component 
of SGs as it highly enhances memory retention13 which 
is affected in persons with developmental disabilities.14 
Memory retention is further enhanced by incorporating 
information into context15 that can be achieved through 
a narrative. Embedding a narrative into an SG facilitates 
cognitive load reduction16, motivation, problem-solving17, 
and efficiency.18 Simulation of real-world settings inher-
ent to SGs seems to promote better transition to everyday 
life tasks.19 The transition from learning environment 
to real-life setting is challenging for PwID as they face 
difficulties in generalizing the acquired knowledge to 
different conditions or applying it to daily activities.4 The 
coherent and immediate feedback provided by SGs has 
been observed to enhance motivation20, independent 
learning21, and retention of acquired knowledge22 while 
reducing errors.21 

As SGs constitute an appropriate learning method for 
people with developmental difficulties such as PwID, they 
have been incorporated into the ID-GAMING e-training 
toolkit, leading to beneficial outcomes on different 
cognitive skills such as attention, spatial orientation, 
and memory skills. Similar benefits of SGs in attention, 
spatial orientation skills and memory were reported in 
children with Attention Deficit Hyperactivity Disorder 
(ADHD)23, 24, while improvement in cognitive and adap-
tive functioning was found in children with intellectual 
disability and/or autism spectrum disorder in a recent 
meta-analysis.25  Training materials, integrated into the 
ID-GAMING e-training toolkit, were found to promote 
language skills. A similar conclusion was reached by a 
recent study9 which argued that SGs could have positive 
outcomes in vocabulary and language learning.

We also observed that emotional recognition skills were 
strengthened after interacting with the e-training toolkit. 
This finding was also supported by the study of Kokol et 
al.26 PwID showed improvement in wellbeing competence, 

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31 J Global Clinical Engineering Vol.6 Special Issue 6: 2024

CONCLUSION

This paper describes the summary of preliminary re-
search on the effects of ID-GAMING e-training toolkit on 
cognitive functions and quality of life. The toolkit seems 
to lead to improvement in various cognitive functions of 
PwID including memory, attention, language, and spatial 
orientation. Components of quality of life were promoted 
such as wellbeing and independence. Teamwork and digital 
skills were enhanced, while the PwID remained engaged 
until the end of their interaction with the toolkit. Both 
PwID and educators were satisfied with the toolkit. More-
over, educators argued that ID-GAMING e-training toolkit 
helped them to be motivated and aware of the potential 
applications of SGs for improving cognitive functions as 
well as providing useful information about the quality of 
life, its improvement, and cognitive functions. In addition, 
collaborative and supportive skills were promoted along 
with digital skills. Indicators for participants’ experience 
and improvement were fulfilled. Therefore, the ID-GAMING 
e-training toolkit seems to be a valuable assistive tool for 
PwID and the people involved in their care that should be 
further validated using a larger sample size and standard-
ized assessment tools. 

GRANT SUPPORT

This work has been partially funded by the “DEVELOP-
MENT OF A TRAINING PROGRAM FOR THE IMPROVEMENT 
OF QUALITY OF LIFE OF PERSONS WITH INTELLECTUAL 
DISABILITIES THROUGH ‘SERIOUS GAMES’” (ID-GAMING) 
project, co-funded by the Erasmus+ Programme of the 
European Union (2020-1-PT01-KA204-078873). 

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https://doi.org/10.2174/1573396315666190808115238
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J Global Clinical Engineering Vol.6 Special Issue 6: 2024 34

36. Sterkenburg, P.S. and Vacaru, V.S. The effectiveness of 
a serious game to enhance empathy for care workers 
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https://doi.org/10.3390/s20040966
https://doi.org/10.3390/s20040966


35 J Global Clinical Engineering Vol.6 Special Issue 6: 2024

A detailed description of the indicators defined to assess the participants’ experience and improvement is pre-
sented in the following table (Table 3).   

TABLE 3. Detailed description of the indicators defined to evaluate the experience and performance of participants.

APPENDIX

No. Indicator Definition Measurement Method Target
Instrument 

Used to Collect 
Evidence

1
Attendance to 
Validation Pilot 
Actions

Number of persons 
belonging to the Target 
Group who participated in 
the Validation Pilot Actions.

List of attendants identifying the specific 
target group (PwID, relative, professional)

100 participants
(30 in Portugal, 
Spain, and Italy 
and 10 in Greece)

Attendance list

2

Target group 
awareness and 
motivation to 
use ICT SGs to 
improve QoL

Number of trainees/
players (PwID, Relatives 
and Professionals) who are 
aware and motivated about 
the use of ICT-Serious 
Games for improving the 
cognitive functions of PwID 
and therefore their Quality 
of Life.

PwID: guided interviews for collecting their 
opinions.
Relatives and professionals: Self-Assessment 
questionnaire about their experience after 
each Step.

≥ 70% target 
group aware and 
motivated to 
use ICT SGs to 
improve QoL

Questionnaires 
A, B, C and D

3
Target group 
digital skills use 
improvement

Number of trainees/players 
(PwID, Relatives and 
Professionals) that showed 
an improvement of Digital 
Skills use.

PwID (qualitative): Trainers’ assessment 
through direct observation and guided 
interviews about their experience on Steps 
2 and 3.
PwID (quantitative): Trainers and supports 
assessment on questionnaire B and C. 
Supports: Self-assessment questionnaires 
after the validation actions.

≥ 70% 
target group 
experienced 
opportunities to 
use digital skills.

Questionnaires B 
and C

4

Target group 
cognitive 
functions use 
improvement

Number of trainees/
players (PwID) that 
showed an improvement 
of cognitive functions 
(Language, Calculus & 
Problem Solving; Memory 
& Attention to Detail; 
Spatial Orientation; Social 
& Emotional) use. 
Number of Supports that 
showed an improvement 
in supporting skills, while 
playing.

PwID (Qualitative): Trainers’ assessment 
through direct observation and guided 
interviews (questionnaires A, B and C) with 
PwID about their experience on validation 
Step 1, 2 and Step 3.
PwID (Quantitative): Trainers and supports 
assessment through a questionnaire 
assessing PwID’s cognitive functions use 
during validation Step 1, 2 and Step 3.
Supports: Self-assessment questionnaires 
after the validation actions assessing 
supporting skills (respect, collaboration, 
teamwork, trust, etc.).

70% of the 
target group 
experienced 
opportunities 
to use their 
cognitive 
functions

Questionnaires 
A, B and C  

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J Global Clinical Engineering Vol.6 Special Issue 6: 2024 36

5

Target group 
quality-of-life 
dimensions 
improvement

Number of trainees 
(PwID) that showed an 
improvement of Quality-
of-Life Dimensions (self-
determination, social 
inclusion, rights, personal 
development, personal 
relationships, material 
wellbeing, emotional 
wellbeing and physical 
wellbeing).
Number of Supports that 
showed an improvement 
in supporting skills, while 
playing.

PwID (Qualitative): Trainers’ assessment 
through direct observation and 
guided interviews with PwID (to fill 
in questionnaire A and B) about their 
experience on validation Step 1 and Step 2.
PwID (Quantitative): Trainers and supports 
assessment through a questionnaire 
assessing quality of life dimensions of 
PwID.
Supports: Self-assessment questionnaires 
after the validation actions assessing 
supporting skills (respect, collaboration, 
teamwork, trust, etc.).

70% of the 
target group 
experienced 
opportunities to 
improve quality-
of-life dimensions

Questionnaires A 
and B 

6

Improvement of
 collaborative/
cooperative/
teamwork skills

Number of trainees (PwID 
and Supports) that showed 
an improvement on 
collaborative/Cooperative/
Teamwork skills.

PwID and supports. (Qualitative): Trainers’ 
assessment through direct observation and 
guided interviews with PwID about their 
experience on validation Step 1 and Step 2. 
PwID and supports (Quantitative): Cross 
Assessment between PwID and Supports 
about their experience on validation Step 1 
and Step 2.

70% of the 
target group 
experienced 
opportunities 
to improve 
collaborative/
Cooperative/
Teamwork skills

Questionnaires A 
and B 

7
Target group 
opinion on 
“QooL City”

Number of trainees (PwID 
and Supports) who thought 
that the QoL Game is 
playable, fun, educational, 
accessible, and usable 
and with impact in their 
cognitive functions and 
quality of life.

PwID and supports. (Quantitative)
≥ 70% target 
group evidence 
satisfaction

Satisfaction 
questionnaire

Questionnaire A | Applied to PwID
After having read all Easy-to-Read training materials, please present below your opinion and conclusions about the 
most significant improvements.

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37 J Global Clinical Engineering Vol.6 Special Issue 6: 2024

Step 1—Training Materials Experience Evaluation

[Indicator 4]

How many players in this validation group have improved cognitive functions use?

Qualitative opinion and conclusions:

Other comments:
 

Questionnaire B | Applied to PwID
After playing Qool City board game please present below your opinion and conclusions about most significant improvements.
 

Step 2—QooL City board game Experience Evaluation

[Indicator 2]

How many players in this validation group are aware and motivated about the use of ICT-Serious Games for improving 
cognitive functions and therefore their Quality of Life?

Qualitative opinion and conclusions:

[Indicator 5]

How many players in this validation group have improved their participation’s competence after playing QooL City 
game?

Qualitative opinion and conclusions:

How many players in this validation group have improved their wellbeing’s competence after playing QooL City game?

Qualitative opinion and conclusions:

How many players in this validation group have improved their self-determination’s competence after playing QooL 
City game?

Qualitative opinion and conclusions:

 Questionnaire C | Applied to PwID
After playing Qool City online game please present below your opinion and conclusions about most significant improvements. Thanks.

Step 3—Qool City online game Experience Evaluation

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J Global Clinical Engineering Vol.6 Special Issue 6: 2024 38

[Indicator 2]

How many players in this validation group are aware and motivated about the use of ICT-Serious Games for 
improving cognitive functions and therefore their Quality of Life?

Qualitative opinion and conclusions:

[Indicator 5]

How many players in this validation group have improved their participation’s competence after playing QooL City 
game?

Qualitative opinion and conclusions:

How many players in this validation group have improved their wellbeing’s competence after playing QooL City 
game?

Qualitative opinion and conclusions:

How many players in this validation group have improved their self-determination’s competence after playing QooL 
City game?

Qualitative opinion and conclusions:

Questionnaire D | Applied to PwID
After using game catalogue in the ID-GAMING e-training toolkit and have played five (5) different ICT - serious games (ICT-SGs) 
online game, please present below your opinion and conclusions about most significant improvements.

Step 4—Game catalogue Experience Evaluation

[Indicator 2]

How many players in this validation group are aware and motivated about the use of ICT-Serious Games for improving 
cognitive functions and therefore their Quality of Life?

Qualitative opinion and conclusions:

[Indicator 3]

How many players in this validation group that show an improvement of digital skills use?

Qualitative opinion and conclusions:

[Indicator 4]

How many players in this validation group have improved cognitive functions use?

Qualitative opinion and conclusions:

Other comments:

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39 J Global Clinical Engineering Vol.6 Special Issue 6: 2024

Questionnaire A | Applied to Relatives and Professionals
After having read all Easy-to-Read training materials, mark with an X your chosen option using “Yes”, “No”, or “Don’t Know”.

Step 1—Training Materials Experience Evaluation

[Indicator 2]

Training Materials helped you to be aware of the use of Serious Games for 
improving cognitive functions

Training Materials helped you to know more about quality of life

Training Materials helped you to be motivated about using Serious Games

Training Materials helped you to know about cognitive functions improvement 
and quality of life improvement

Other comments: 

Questionnaire B | Applied to Relatives and Professionals
After playing Qool City board game mark with an X your chosen option using “Yes”, “No”, or “Don’t Know”.

Step 2—Qool City board game Experience Evaluation

[Indicator 2]

Qool City board game helped you to be aware of the use of Serious Games for 
improving cognitive functions

Qool City board game helped you to know more about quality of life

Qool City board game helped you to be motivated about using Serious Games

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J Global Clinical Engineering Vol.6 Special Issue 6: 2024 40

Qool City board game helped you to know about cognitive functions improvement 
and quality of life improvement

[Indicator 4, 5]

Qool City board game made you to use supportive skills such as active listening 
and respect choices 

Qool City board game made you to use supportive skills such as teamwork and 
being flexible

Qool City board game made you to use supportive skills such as balance between 
support and autonomy

[Indicator 6]

Qool City board game helped to use more collaborative skills

Other comments: 

Questionnaire C | Applied to Relatives and Professionals
After playing Qool City online game mark with an X your chosen option using “Yes”, “No”, or “Don’t Know”.

Step 3—Qool City online game Experience Evaluation

[Indicator 2]

Qool City online game helped you to be aware of the use of Serious Games for 
improving cognitive functions

Qool City online game helped you to know more about quality of life

Qool City online game helped you to be motivated about using Serious Games

Qool City online game helped you to know about cognitive functions 
improvement and quality of life improvement

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41 J Global Clinical Engineering Vol.6 Special Issue 6: 2024

[Indicator 3]

Qool City online game promoted digital skills acquisition

Qool City online game promoted digital skills improvement

[Indicators 4, 5]

Qool City board game made you to use supportive skills such as active listening 
and respect choices

Qool City board game made you to use supportive skills such as teamwork and 
being flexible

Qool City board game made you to use supportive skills such as balance between 
support and autonomy

[Indicator 6]

Qool City online game helped to use more collaborative skills

Other comments: 

Questionnaire D | Applied to Relatives and Professionals
After using game catalogue in the ID-GAMING e-training toolkit and have played five (5) different ICT - serious games 
(ICT-SGs), mark with an X your chosen option using “Yes”, “No”, “Don’t Know”.

Step 4—Game catalogue Experience Evaluation

[Indicator 2]

Game catalogue helped you to be aware of the use of Serious Games for improving 
cognitive functions

Game catalogue helped you to know more about quality of life

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J Global Clinical Engineering Vol.6 Special Issue 6: 2024 42

Game catalogue helped you to be motivated about using Serious Games

Game catalogue helped you to know about cognitive functions improvement and 
quality of life improvement

[Indicator 3]

Game catalogue promoted digital skills acquisition

Game catalogue promoted digital skills improvement

[Indicator 4]

Game catalogue made you to use supportive skills such as active listening and 
respect choices

Game catalogue made you to use supportive skills such as teamwork and being 
flexible

Game catalogue made you to use supportive skills such as balance between 
support and autonomy

[Indicator 6]

Game catalogue helped to use more collaborative skills

Other comments: 

Satisfaction Questionnaire 
Please answer the next questions using “Yes”, “No”, or “Don’t Know”. Please mark with an X your chosen option.

Step 1—Training Material Experience Evaluation

Training materials were easy to navigate and use.

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43 J Global Clinical Engineering Vol.6 Special Issue 6: 2024

Training materials helped me learn more about Serious Games and their benefits.

I liked to read the training materials.

Step 2—Qool City board game Experience Evaluation

Qool City board game is involving.t

I was able to be attentive.

I was motivated. 

I had fun.

Qool City board game rules are simple.

Qool City board game history is relevant to me.

Qool City board game playing pace was appropriate.

I like the QooL City board game. 

Step 3—Qool City Online Experience Evaluation

Qool City online game is involving.

I was able to be attentive.

I was motivated.

I had fun.

Qool City online game rules are simple.

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Qool City online game history is relevant to me.

Qool City online game playing pace was appropriate.

I like the QooL City online game.

Step 4—Game catalogue Evaluation

Game catalogue is easy to navigate and use. 

Game catalogue’s games helped me to learn.

I liked to use the Game catalogue. 

Global satisfaction 

Trainers have been friendly and supportive.

The training space has been comfortable.

I liked to participate in the sessions.

I want to continue to use the Qool City game.

I’ll recommend the ID-GAMING e-training toolkit to others 

Other comments: 

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	Editor’s Corner
	Biomedical Technology and Clinical Engineering in Greece after the Pandemic: Highlighted Works from the Panhellenic Conference of Biomedical Technology
	Aris Dermitzakis1,2,*, Vasiliki Zilidou1,3, Eleftheria Vellidou1,4, Alkinoos Athanasiou1,3

	Digital Transformation Management in Health Services: Health Professionals Perceptions as an Implementation Factor
	Theodoros S. Tanis*, Chryssoula Chatzigeorgiou, Ioanna Simeli, and Evangelia Stalika

	Validating the ID-GAMING e-Training Toolkit for People with Intellectual Disabilities in Greece
	Niki Pandria*, Anastasia Barboudi, Vasileia Petronikolou, Panagiotis Antoniou and Panagiotis D. Bamidis

	Novel Functional Electrical Stimulation Parameter Optimization for Neurorehabilitation Using Both Conventional and AI Techniques 
	Arsenios Arsenidis1, Alexandros Moraitopoulos2, Alkinoos Athanasiou2, Alexandros Vildiridis3, Panagiotis Bamidis2, Petros Stefaneas4 and Alexandros Astaras5 

	Leveraging Web Scraping and API Integration for Efficient Medical Device Data Management 
	Agapi Konstantina Liontou1,*, Spilios Zisimopoulos2 and Aris Dermitzakis1 

	Human Muscle State Machine Using Electromyography Classification with Machine Learning 
	George Lyssas1,*, Konstantinos Mitsopoulos1, Dimitris Zantzas2, Anestis Kalfas2, Panagiotis D. Bamidis1 

	Kinematic and Dynamic Analysis of Lower Limb Movement: Towards the Design of a Wearable Rehabilitation Assistant Device 
	Filippos Margaritis1,*, Konstantinos Mitsopoulos1, Kostas Nizamis2, Alkinoos Athanasiou1 and Panagiotis D. Bamidis1 

	A Novel Dermatological Diagnosis Support Device Based on Electrical Impedance Spectroscopy 
	Alexandros Moraitopoulos1,*, Konstantinos Mitsopoulos1, Christina Kemanetzi2, Panagiotis Bamidis1 and Alexandros Astaras3

	Software Skills Identification: A Multi-Class Classification on Source Code Using Machine Learning
	Dimitris Bamidis, Ilias Kalouptsoglou, Apostolos Ampatzoglou, Alexandros Chatzigeorgiou*

	Improvement of Aortic Valve Stenosis Classification in Patients Through Computational Fluid Dynamics Model
	Ioannis Makropoulos, Dimitris Zantzas, Vasilis Gkoutzamanis, Anestis Kalfas*

	Kinematic and Dynamic Analysis of the Human Hand’s Articulation for Wearable Soft-Robotic Device Applications
	Paschalina-Danai Sarra, Vasiliki Fiska, Konstantinos Mitsopoulos, Diamanto Mylopoulou, and Panagiotis D. Bamidis*

	Deep Learning Classification of Epileptic Magnetoencephalogram 
	Andreas Stylianou1, Lefteris Koumakis2, Maria Hadjinicolaou3, Adam Adamopoulos1,* and Alkinoos Athanasiou4


