Videogames as "Edutainment“Enabling A New Form of Intervention

Barry G. Silverman, PhDAckoff Center for Advancement of

Systems Approaches (ACASA)University of Pennsylvania

www.acasa.upenn.edu

“I cut my class to beat the game”

-- a student in my lab(he didn’t beat it, only

got to next level)

Talk Overview

Teaching Challenges & Games

Issues in StoryTellingPrinciples for Game DesignCase StudyLessons Learned

Game-Based Learning

Learning & adaptation is now a lifelong function– there is a need for ubiquitous, JIT learning

Didactic teaching (talking head) is weak approach for learning, transfer, and retention – Not meta-cognitive (learning to learn)

Use games & characters to make learning fun:– We learn creativity through play (stealth learning)– We learn reasoning through puzzles and exercises

Retention in Learning Situations

10% of what they see20% of what they hear30% of what they see and hear70% of what they talk over with others80% of what they use and do in real life

• Or immersively in a videogame

95% of what they teach someone else to do• Or teach another agent in a videogame

» The Association of Libraries

Patient Behavior Change Theory

Each Villager You Teach is a Dialog Chain ~100 Decision Nodes

Attitudes

Intention(Dial 911)

Norms

Self-Efficacy Environment

Hindrances

Change inBehavior

Skills

SymptomRecognition

“People rarely succeed unless they have fun in what they’re doing”

-- Dale Carnegie

Who Plays Games?

34%

16%13% 12%

0%

10%

20%

30%

40%

Play PC &Video

Games

Watch TV SurfInternet

Go tomovies

What is the most popular entertainment activity in the USA?

IDC Research, Winter 2001

> 67% Male (but the female sector is growing fast)70% over 18, and 40% over 35 (mean = 31)Mean of US workforce = 39 (BLS, 1999)

“Adults, not kids, now dominate computer game market.”

-- Wall Street Journal, 2000

Wow, this should keep me busy all summer, Dad!

$40/game, 30-100 hours each (practice, practice)Expectation – better than last, not as good as nextWomen are big users of SIMS and SIM Exchange

Applications as Research Opportunities

(Improving Theory of Agents in Meta-Games/Systems)

Elements of Games1) Emotive, Smart Agents

2) Strong Story3) Challenge/Adventure

4)Feedback/Coach

ACASA Experiments1) Enterprise/Commerce(Business Sponsor - GM)

2) Health Behavior/Self-Care(NIH/NLM Sponsor)

3) Virtual Terrorist Generator(Pentagon Sponsor)

Human Mindset Sampling1) Individuals/Groups2) Worldview/Needs3) Context/Setting

4) PsychoSocial DifferencesSystemsThinkingGames

Validated MetricsPlay, Learn, Fun, Transfer

Lessons LearnedAbout Games

Talk Overview

Teaching Challenges & GamesIssues in StoryTelling

Principles for Game DesignCase StudyLessons Learned

Story Telling/Listening 2nd Oldest Profession

Be transported (immersed) into an ‘exciting’ worldEscape your own existenceFantasize/experience others’ experiencesPlay out a hero’s role in a safe environment

BEYOND ENTERTAINMENT: cathartic, educational, natural (to organization of our minds), learn while having fun.

There are only 2 or 3 human stories; and they go on fiercely repeating themselves as if they

had never been told before.

- W. Cather, O Pioneers

THE ACTION HERO TALE (Campbell) : Morphology of Countless Movies, Novels, Fairy Tales, etc1. ORDINARY WORLD2. CALL TO ADVENTURE3. REFUSAL OF THE CALL4. MENTOR5. 1ST THRESHOLD6. TESTS, ALLIES, ENEMIES7. APPROACH TO THE INMOST CAVE8. SUPREME ORDEAL9. REWARD (SEIZING THE SWORD)10. THE ROAD BACK11. RESURRECTION12. RETURN WITH THE ELIXIR

Patient Behavior Change Theory

Each Villager is a Dialog Chain ~100 Decision Nodes

Attitudes

Intention(Dial 911)

Norms

Self-Efficacy Environment

Hindrances

Change inBehavior

Skills

SymptomRecognition

Action Hero as Frame Story for Teaching Personas to Change Their Behavior

Ordinary world

Call to Action

Refusal of Call

SuperTech Aid (Magic)

Crossing Threshold

Villain Defeated/Victory

Crisis of Health Resolved

Ordinary World Transformed

Testing the Hero:Persona who can help defeat villainprovided player rescues them first(from themselves)

Twitch GameA

INE

SR

CasesInner Voyage

Plot Reversal Arose from Observing Phase I Players (Anticipate player moves)

Answering the Call(Earlier trauma =>Afraid to Practice)

Quests (To Save orNot to Save???)

Climax

Some Repetitive Stories across Disease Categories

Disease Category– Preventive– Chronic– Addictive

Storyline– Scare ->Behavior Change– “Days of Our Lives”– Skill Building w/Role

Playing Partners

Many (most) providers & consumers have their own stories to tell:•Could create their own games.

Talk Overview

Teaching Challenges & GamesIssues in StoryTellingPrinciples for Game Design

Case StudyLessons Learned

Base Needs To Create A Valuable Game

A good story to share– Interaction & Drama/Tension

Some knowledge engineering/scripting efforts– Goals (adventure, learning) & Rules– Outcomes & Feedback

Characters that players care about– Hero/Player’s Avatar– Personas to be taught

Psychological Stimulation to us of Events That Effect:

Self

Most intriguing

Least intriguing

Least intriguing

Friends

Strangers

Key Metaphor: Distance and (Psychological) Transport

Character Depth Creates Empathy(Literature, Movies, TV all know this)

Admirable Traits, Humanity Classic Weakness, Human FrailtyIdiosyncratic or Trademark MannerismsBehavior Consistency Throughout StoryDevelopment and Growth

Character Depth Quiz

Deepening Characters We Only Encounter Briefly

Each Line of Dialog Serves 3 Purposes:Advance Overall Plot/StorylineConvey Character Persona– its “storied” past (family, values, mores, desires, …)– its trademark mannerisms/idiosyncracies– its defining fear, weakness, human frailty

Setup Next Lines (humor, irony, conflict, etc.)

Story-in-Game To Date:Opportunity Unconquered

Great Action with Shell of Story & No Character Depth– state of practice today (Mario, Golden Eye, RolePlayers)

Forgetting to Use a Visible Player “Avatar”– first person games (Doom, Myst, Racing Games)– loss of empathy for hero, no character development

Great Story with Side Games at Stop Points (F.Fantasy)– destroys story transport/char. integrity during games– loss of player control during story

Highly Branching, Non-Linear Story– loss of author control/character definition (The SIMS)

Story in EdutainmentGames may or may not ultimately adopt story– Sega’s ‘Gran Tourismo’ Developer (Story belongs in pub

after game is over)– TV & Movies not broken – don’t want interactivity – Fun/Work Ratio (eg., couch potato effect)

Edutainment has no choice– Flight simulators can avoid – but this is equipment training– People skills & social behavior training require

story/character

Edutainment Revisited

Videogames•Great action•Replayability

Movies/TV•Great stories•Deep characters

Education•Great knowledge•Skills transfer

Trainingsimulators Documentaries

BranchingFictions

Roleplaylearning

Talk Overview

Teaching Challenges & GamesIssues in StoryTellingPrinciples for Game DesignCase Study

Lessons Learned

(Can a Game) Reduce Morbidity and Mortality from the Number 1 Killer in the USA?

Case Study: Heart Sense Game Ph.I

NIH/National Heart Attack Alert Program

Delay After Heart Attack Leads to Adverse Effects

0 1 2 3 4 5 6 7 8 9 10 11 12

Hours till arrival at ER

ActualArrivals

IdealTime

Probabilityof FullRecovery

10% of people

Current Approach is Making Little Headway

Didactic Videos and Training Groups (trainees soon forget)Hardcopy training documents (sits unopened on shelf)Complex Websites (overwhelming, pull not push)Calling Doctor, Asking Spouse

Barriers/Access to Care

Symptom Mis-recognitionDenial (I’m too young, too macho)Perceived Acceptability of ERPoor advice (spouse, relative)Peer pressure Procedural (referral, HMO policy)Cost & lack of insurance

Rationale for Game

Work through all your delay issues in a virtual world

Have no Delay Issues when a heart attack actually occurs

Get to ER in 1st hour!!!

Phase I Prototype – One Villager’s Delay(No avatar, no hero’s tale)

Answering the Call(Earlier trauma =>Afraid to Practice)

Quests (To Save orNot to Save???)

Climax

Modules of the Phase 1 Prototype Heart Sense Game

ENGAGE TRAIN REHEARSEIMMERSE LEARN TEACH OTHERS

Talk Overview

Teaching Challenges & GamesIssues in StoryTellingPrinciples for Game DesignCase StudyLessons Learned

Test Results of 18 Users of Ph.1 Heart Sense Game

0

20

40

60

80

100

120

MultimediaDidactic/Text

HS Case Study Conclusions

Cardiovascular Disease is #1 Killer– Mortality & Morbidity need to be reduced– Pre-Hospital Delay is the issue

Game Appears to Reduce Delay– Major Intention Shifts (every version)– Multimedia, Interactive Agent Version Preferred

Caregivers Have Interesting Stories to Share

Advisory and Focus Groups

End users (middle-aged and elders) - Focus Groups– 11 of 12 Physicians & Cardiologists Would Disseminate As Is– 100% of patients in waiting room said they’d play a videogame– 75% of them have tried computer games – 32% of them play computer games at least 1x/week

Health & delay cause advisors (AHA, ACPM, ACFM, ACC, etc.)– AHA scientific approval, website invite

Phase I – Prototype Issues(Reason for Phase II)

Only One Episode to rehearse know-how and convince a recalcitrant persona – need more casesDrama: little story, no action hero, no frame storyPlaying Delayed to End: all learning in middle moduleCharacters -- loved by some, drove others to attempt “evil” (anticipate and surprise your players)Cartoons, not video

Lessons from all 3 Cases

Game-based learning is not just a youth phenomenon– Promise in all age groups (seniors too), across all sectors– Particularly appropriate for meta-learning and transfer– Rehearse new behaviors in context/teach others

Need today is:– Seed the World with Good Intervention Games– Interactive Animated Fiction Generator– Many Spinoff Applications (and an online exchange site)– Better, Validated Instruments (game evaluation)

Some Repetitive Stories across Disease Categories

Disease Category– Preventive– Chronic (Diabetes)– Addictive

Storyline– Scare ->Behavior Change– “Days of Our Lives”– Skill Building w/Role

Playing Partners

Many (most) providers & consumers have their own stories to tell:•Could create their own games.

“Days of Our Lives”

Focus is on Day-by-Day Care & Relationship to Long Term OutcomesSimilar Interactive Fiction Ingredients to HS Game– Strong drama/deep characters who need help– Hero with weakness/idiosyncrasies– Solving a crime while teaching characters to manage their day– See health impacts of neglecting diabetes over time

Exchange Site/Story Generator– People may have a need to share their stories

Research may show gamers are right

Videogames are good for you!