Trauma Center. Ever heard that name mentioned in the context of serious games? Probably not, but it is not your fault because it is not a traditional serious game. It is an actual commercial game developed for the Nintendo DS portable console (a wonderful platform that sacrifices graphics and power for new forms of gameplay via its touch screen). The main objective of the game is to entertain, not to teach, but it is deserves some study from a Game-based Learning perspective.
The game puts you in the role of a young doctor just emerged from the haze of being an intern. You finally made it and you are ready to perform operations on your patients, although your distracted and overconfident attitude may soon get you into trouble. As you perform different operations, a fantastic story unfolds around you.
Gameplay itself is actually quite simple. You are presented with the interior of the patient and a set of tools is at your disposal. You use them by selecting the appropriate tool and making specific gestures. For example, you excise a tumor by selecting the scalpel and cutting along a dotted line around the tumor, or you apply stitches to a wound by selecting the needle and swinging your stylus in a zig-zag motion for the length of the wound.
The game is fun because the operations are not about being calmed, precise and thoughtful. Actually, they are a frenzy, with the clock ticking against you, problems emerging inside the patient and the patient’s condition decreasing at different rates. A mid-level operation will require you to keep under control several steadily growing aneurisms with a nasty tendency to explode, while keeping an eye in the blood that needs to be drained and having to continuously inject substances to to keep the patient’s condition high enough. Bottom-line is: operations are not easy. This is not about making the player comfortable with the procedures, but about pressing to the limit of his skill (some consider they overdid it a bit… indeed, some of the operations are a real nightmare).
In addition to the operations, the story itself also works in the line of providing fun. Soon you see yourself immersed in a bio-terrorist plot and enlist in a counter-terrorist agency of elite surgeons, where you eventually discover your dormant powers that allow you to slow time down if you concentrate enough. And you will certainly need them, for the terrorist bio-attacks grow more and more sophisticated: you will find tiny creatures eating your patients from the inside, rapidly moving tumors, intelligent cells that disguise themselves and so on.
And this is where the criticism may emerge: “It is not realistic!” “The doctors will not learn the proper lessons!” “This can’t substitute a regular class!” Those assertions are correct, although naïve. They miss the point and don’t see the potential. This is a game. It is meant to entertain and its creators never wanted it to be a learning tool. But this doesn’t mean that it doesn’t have good learning principles into it.
When challenged with an operation in Trauma Center, I will repeat it many times, devising new strategies, changing the order in which I treat the different problems and trying to figure out the most efficient procedure. While I am trying to master one of these science-fiction procedures, I am repeating to the point of automating several simple tasks such as always disinfecting before cutting, not using certain tools near sensible organs, or performing the eight-step tumor removal procedure without missing a step and in the right order. In addition, I am always being guided by my assistant, who instructs me on the procedures and teaches me about obscure medical terms and treatment names.
The game as it is right now, is just a game. But some slight modifications would turn it into a suitable learning product. And if you are thinking “well, if we remove the oversimplification of the procedures, the magic powers and the terrorist plot, we have a learning game”, I’m sorry, but I think you are wrong. Those should stay, or the game would no longer be fun and there would be no point in playing it.
Leave in the twitch speed, the terrorists, the magic powers, and the potential romance with the assistant. Just modify it so that complex real procedures with lots of steps that must be performed in a specific order are included. The assistant can always guide you through those procedures, but soon you will have to be able to do them correctly and in the right order by yourself. The game doesn’t give you enough time to read what the assistant says if you want to succeed.
And suddenly, the true and often elusive magic of game-based learning, might appear. Medicine students would still understand the procedures as usual: lectures and practical exercises with “real” patients (well, donated corpses). But the step of careful memorization of the steps of the procedures is substituted by the game. If (and only if) you didn’t kill the fun of the game with the modifications, the students will enjoy the game, play on their free time, while in the subway, at night, on the weekend, etc (as I do, and I’m not into medicine). They (we) don’t play it to learn. The objective is to beat the game, to get the highest score on each operation. And in doing so, those procedures are being memorized far more deeply than with any study session.
And this is precisely what would define a good example of game-based learning. Fun. If it is not fun, it is not a game. If it is not a game, it is not game-based learning. If it is not game-based learning, it is just another bunch of boring multimedia content.
Research
educational games, reflections, serious games