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Developing persuasive games about human error and blame culture

Key points

  • Well-designed ‘persuasive’ games can be powerful awareness raising tools. We organised a game design competition challenging university students to create a persuasive game that raised awareness about human error in healthcare.
  • We developed a way to evaluate the games based on the reflection that they led to.
  • All the games are freely available from the Errordiary Discovery Zone (www.errordiary.org/) so that anyone can play them.

Persuasive games are games designed to make you think. We have used them as an interactive way to make young people think about the issues arising from healthcare-based human error research, and in particular encourage players to reflect on blame culture, where individuals are blamed for errors even when the wider system may be at fault.

A competition
We organised a game design competition challenging teams of university students to create a persuasive game that raised awareness about human error and related topics within the context of healthcare. 27 students from four universities across eight subject areas attended a kick-off day, giving information about the competition themes, allowing them to ask the experts questions and kick starting the design process. Talks introduced the students to human error, blame culture, healthcare, game design including games for serious purposes, and user-centred design concepts such as rapid prototyping and testing with players. We also held a Q&A panel, a game design workshop and a networking session.

Four games were submitted: Nurse’s Dilemma, St.Error Hospital, Patient Panic and Medical Student Errors. We used a combination of expert judging, play-testing with a group of players and following up game-play with a brief set of email questions to choose the game most likely to lead to reflection on human error in healthcare. This method for evaluating the games led to a paper at a major international conference that received an honourable mention, awarded to the top 5% of submissions.

Prizes were awarded at a final showcase. Nurse’s Dilemma won first prize. The game puts the player in the role of a nurse who is trying to get to the drug cabinet to get her patient his medication. On her way she is constantly interrupted by others who really need her help. Should she stop and help the man who has fallen in the corridor or keep going to the drug cabinet so that her patient does not have to wait any longer? We thought that it was a great example of how a simple yet compelling gameplay experience can lead to reflection on assumptions about responsibility and blame in healthcare that are taken for granted. All four entries are freely available for anyone to play in the DIscovery Zone of Errordiary (www.errordiary.org/).

Since hosting the games online, the game pages have been viewed over 1000 times. Nurse’s Dilemma has also been used as a preparatory activity for a nurse training workshop in Hong Kong. Students who attended the kick-off day were very positive about the event, reporting high levels of learning from the sessions and that they were also enjoyable.

See also…
Promoting human factors to young people
Blame to learning culture

Publications/further reading
Iacovides, I. & Cox, A.L. (2015). Moving Beyond Fun: Evaluating Serious Experience in Digital Games. In the Proceedings of the SIGCHI Conference on Human Factors in Computing Systems, pp. 2245-2254. New York, NY, USA, ACM. (Honourable mention).

Iacovides, I. & Cox, A.L. (2014). Designing persuasive games through competition. Paper presented at the Workshop on “Participatory Design for Serious Game Design: Truth and Lies” at CHI Play 2014, Toronto, Canada, October 2014.

Iacovides, I., Cox, A. L., Furniss, D., & Myketiak, C. (2014). Exploring empathy through sobering persuasive technologies: “No breaks! Where are you going missy?” Demonstration presented at the 2014 BCS Conference on Human-Computer Interaction (BCS-HCI 2014), Southport, UK, September 2014.

Key people
Jo Iacovides, Anna Cox, Katarzyna Stawarz, Dominic Furniss, Chrystie Myketiak, Sarah Wiseman
Charlene Jennett, Margaret Gold & Brian Fuchs (Citizen Cyberlab)

Special thanks to all those attended the Persuasive Game Workshop at Melton Mowbray, where we first started to think about how we could use games as part of the CHI+MED public engagement activities.