Where’s the Fun in Serious Games?: Keys to Developing an Effective and Engaging Game with Planned Positive Impact - Dr. Bradley Tanner
SERIOUS GAMES -> East Coast Games Conference 04/19/17 Wed @ 1130 am - 1230 pm - ROOM - 305A

“Serious games” and “games for health” often fail. Instead of the fun, challenging, and engaging experience seen in first-person, strategy, MOBA, MMO RPG, or cooperative games, players of “serious” games are expected to accomplish a “real” goal, say an educational or health outcome. The experiences are often lonely, passive, and isolating single-player experiences. They often deploy a “gamification” strategy focused on earning points, badges, and ranking on a leader board. Players quickly see the difference between a gamified education experience (“you ate the right food, you got 5 points!”) vs. a real immersive multi-player game – and reject it or complete it only because it is required. Academic support for the effectiveness of “serious” games has been unimpressive and enthusiasm for developing such a game is fading.
This either/or state of affairs (fun vs. useful) is misguided. Outside of games we engage in a plethora of enjoyable activities which are also good for us. The list of activities from playing sports, to brainstorming new ideas, to cooking, to pottery, to running goes on an on. And that list also includes playing “fun” games which have been shown to impact memory, attention, connectedness, mood, and skills related to 3D modeling, collaboration, planning, and more.
Instead of the above “education first” strategy, the designer of a game with planned positive impact should first imagine a game WITHOUT an education, health or other serious objective. As the game design evolves the team identifies opportunities to inject meaningful impact into the experience. For example, since games already have objectives and goals; the goal can be aligned with acquiring a specific (and useful) skill or a healthy behavior.
As the design process proceeds, standard game design and development strategies are followed including user experience, and opportunities for choice, exploration, self-expression, and creativity. As design standards require, the game emphasizes a flow state matching challenge with skills, rapid feedback, and expansion of social connections through communication with other players. There is no reason a planned positive impact should interfere; instead, it should give the game focus. In the design, multi-player is essential for the game to tap the ability of multi-player to enhance enthusiasm and engagement, reinforce skills, engage emotions, and provide coaching and support.
Continuing the example, imagine a game with planned positive impact of health improvement through lifestyle change. Players practice lifestyle change by counteracting and replacing lifestyle choices contributing to excessive weight and poor cardiovascular health; specifically inactivity, decreased exercise, and nutritional choices. As the game avatar takes on challenges the real-world player is test driving difficult yet necessary lifestyle changes.
In the game, players succeed by practicing skills and countering unhealthy habits: They
1. navigate through the challenges to lifestyle change,
2. recognize food, environment, social situation cues, and npcs that challenge their avatar,
3. counteract those cues in themselves by rejecting some choices,
4. identify and implement changes in lifestyle to offset current lifestyle choices.
5. provide and receive advice and motivation as they collaborate with real life co-players.


Are games the solution for medical training of millennials (and everyone else)

Sat Apr 22, 2017, 4:17 PM - 5:02 PM, Plenary Hall, Medicine ​X  | ​Ed, Li Ka Shing Center, Stanford University


The panel highlights concepts and examples related to the potential of challenging and engaging game experiences to aid medical and health skills development. The talk reviews evidence that well designed games can confer problem solving skills and effect change in knowledge, attitude, confidence, and skills. Successful games borrow established design and development standards from the entertainment game industry as seen in first-person shooter games, mystery games, or a find-and-seek (e.g., Pokeman Go) games. Successful game design and development strategies focus on user experience, choice, exploration, self-expression, creativity, matching challenge with skills, receiving feedback, and expanding social connections through communication with other players. 

A multi-player, exploratory, and immersive game is a format familiar to the audience of Millennials. Health professional or lay students expect game-based learning to be a similarly personalized experience that rewards cooperation, improvement, and group success. They want an immersive and motivating experience that depends on intrinsic reward rather than extrinsic motivation. Such enthusiasm and engagement can arise from standard multi-player game elements: narrative, mechanics, environment, an avatar with health/strength elements, co-players (real and computer-generated), choice and quick/medium/slow decision-making, feedback, levels of improvement, and the thrill of success. 

Sophisticated learning games where learners investigate history and findings, establish diagnoses, and determine treatment in rich game environment offer an opportunity to rethink how we establish and refine medical and health-related skills. In a medical game, instead of building a civilization, causing mayhem, or working with a team of players to destroy the other team, the end goal is the acquisition of skills and understanding necessary to navigate the complicated science and psychological principles of health care. These well designed games can help medicine navigate the radical changes happening as we move from older models of health care to models emphasizing patient empowerment, easier data access, team models of treatment, and most importantly prevention vs. treatment of disease. Since ongoing change is inevitable, game frameworks must be flexibly designed to allow for easy upgrades, revisions, and repurposing for novel topics. 

Pedagogy based on immersive games can become the standard by which training is based and overtake older lecture/didactic models, “gamification” of existing approaches, and resource intensive solutions including problem-based learning, team learning, and simulated/standardized patient-based training. Existing and future games offer stakeholders in the ever expanding field of medicine a unique way to master knowledge and skills.


 Bradley Tanner, MD, President, Clinical Associate Professor Psychiatry , Clinical Tools Inc., University of North Carolina, Chapel Hill, and Board Certified in Psychiatry and in Obesity Medicine​

 Debra Lieberman, PhD, Director, Center for Digital Games Research University of California, Santa Barbara