As pioneers in this field, our role in shaping the future of serious games in healthcare logistics is crucial. Digital media design significantly influences the quality of gaming simulation studies in healthcare. The leading challenge scholars face is introducing innovative and valuable features to university students. The data–simulation–gaming pyramid could serve as a blueprint for outlining how interactive simulations could be conducted. A participatory design process is important in serious game development. More recently, the literature has illustrated the contribution of extended reality. However, researchers have not explored this research framework in detail. This paper traces the participatory design process of serious games using an emergency logistics case study in Stockholm, Sweden. It underscores the importance of choosing the correct narratives and game mechanics to support the implementation of serious games using extended reality for the demonstration of non-technical skills. The research findings are threefold. (1) The participatory design process helps to place focus on the implementing philosophy that values health equality in networked hospitals. (2) Further analysis reveals that gamification could turn everyday tasks in the emergency department, which represents a stressful workplace in a hospital, into a spectrum of learning experiences for in-demand skills, including situational awareness, leadership, communication, and ethical thinking. (3) A closer inspection of the reality-changing methods shows new requirements to shorten patient queues before and after the (implementation of the) strengthened waiting time guarantee proposal in 2024. There is abundant room for principals in healthcare institutions to implement reality-changing methods to foster collaboration at the departmental, cross-departmental, and cross-institutional levels.