**3. Research approach**

To investigate the possible threats resulting from gamification, an integrative literature review approach was implemented [11, 23]. This approach intends to gather relevant observations and findings of existing literature review studies enabling to deepen insights into the issues and trends likely to provide elements of answer to the research question. In particular the aim is identifying the unintended side effects, challenges and limitations of gamification detected and analysed in the included studies from which may be inferred the possible perils arising from gamification, and thus compensating the shortage of papers studying specifically the threats resulting from this tool.

The mentioned approach consists in three phases:

1.The choice of words for the search of studies was intended to be as broad as possible given the previously mentioned dearth of papers covering specifically the threats of gamification. Consequently, several words were used to refer to the possible adverse impacts of gamification. The terms chosen to search the studies in all used databases were: *literature review, gamification, risks, disadvantages, threats, negative impacts, unintended side effects*.

The four inclusion criteria were: 1) Published peer reviewed papers 2) Literature review studies 3) Written in English 4) Papers that examine, at least partially, the negative consequences and/or threats of gamification. Were excluded: 1) Posters

2) Non-published studies 3) Studies written in other languages than English. Literature review papers on empirical studies about gamification implementation pros and cons were privileged so as to increase the chances to identify frequent trends about the research question of this chapter.

**Included Literature Review Studies Identified Items/texts on Limitations,**

1. "Does gamification work? A literature review of empirical studies on gamification". J. Hamari, J.

2. "The dark side of gamification: How we should stop worrying and study also the negative impacts of bringing game design elements to everyone". S. Hyrynsalmi, J. Smed and K.

Number of examined studies included in this

3. "A systematic review of gamification in e-Health". L. Sardi, A. Idri and JL Fernandez-Aleman. Journal of Biomedical Informatics, 17

4. "Gamification of enterprise systems – A

Sunyaev A. (2019), [27]\*

review: 62

**27**

synthesis of mechanics, dynamics and risks". M. Schmidt-Kraepelin, S. Lins, S. Thiebes S. and

Number of examined studies included in this

Number of examined studies included in this

Koivisto and H. Sarsa (2014). [25]\* Number of examined studies included in this

*Threats Arising from Software Gamification DOI: http://dx.doi.org/10.5772/intechopen.95963*

review: 24

review: 26

(2017), [26]\*

review: 46

Kimppa (2017) [9]\*

**Challenges and Negative Unintended Side**

• Results of gamification may not be long term • Some users did not find gamification

• Users might be optimising the end-result game (ex. Position in leader boards) and not

• Some gamified solutions may be simplistic, childish and therefore demotivating • Some gamified solutions may encourage users to perform behaviour only when rewarded. • Gamified solutions may distract users from

• Risks of replacing intrinsic motivation with

• Ethical issues: ex. taking advantages of users,

• Lucrative gaming elements for one user can

• Effectiveness of the gamification solutions can lessen when relying on only one game

• There is no unified framework for evaluating gamification principles and outcomes. • Users might feel motivated and excited about the gamification elements, but the interest

• Gamification elements are sometimes perceived to be meaningless and not helpful in terms of the system's healthcare purposes • Gamification solutions are not users-centred as they overlook the traits and demographics

characteristics of potential users. • Some rewards were judged to be irrelevant or

• Gamified health solutions do not integrate health professionals in their development • Cheating may increase as users might work to achieve higher levels solely for their sake of

• There is a significant lack of control between the elements of gamification and thus various elements were viewed as a single one

• Quality of tasks might suffer if gamified elements distract from the main purpose of

• Low implementation quality of mechanics and dynamics which might lead to dysfunctional reward system or interaction concepts and may result in users'

• If underlying rules are not clearly defined, it enables cheating, which can lead to rejection of implemented game elements by other

• Gamification might not be effective in

**Effects of Gamification**

utilitarian contexts

the task at hand

the main purpose

element.

declines over time

exaggerated

rewards

the activity

demotivation.

employees

pursuit of extrinsic rewards

infringing their autonomy.

be detrimental to teamwork

engaging

