Face-the-Case

1. Face-the-Case Achieving health literacy through game play

2. Overview • Face-the-Case is a quest in which the player collects the health literacy skills and uses them to solve a large set of realistic health and human services case studies • It is a role-playing game similar to A Tale in the Desert • Contains elements similar to elements in Final Fantasy X and Age of Empires • Teaches undergraduate nursing and social work students health literary skills in a role-playing environment that is engaging, challenging and visually interesting

3. Game World • Skill shops (3) • Collaboration Café • Case room • Bling boutique • High score board

5. Game Elements • Player avatar • Skills objects (three types) • Case studies • Companion collaborators • Skill dollars (for buying skills) • Bling bucks (for accessorizing avatar) • PDA (contains inventory, displays status info)

6. Skills Information Communication Cultural Competency Summarizes main concept Convey instructions Recognizes own belief system Applies criteria to variety of information sources Self identifies ethnic group Body language Eye contact Expresses biases Synthesizes information to create new concept Touch Seeks other's beliefs Posture Identifies most major languages in service area Compares new knowledge with prior knowledge Comforting Identifies most major languages in service area Validates understanding of information through discourse Communicate with angry person Communicate with confused person Knows of community support services Find information Communicate with anxious person Chooses appropriate methods of information retrieval Ability to assess client's health literacy Language barrier Hearing impairment Effectively searches for information Intubated person Retrieves information online Aphasic Retrieves information in person Language specific fluency Refines search strategy Create patient instructions Manages information Compose letters, memos and notes

7. Case Studies in Health & Human Services • Mr. Lonely Heart is unable to drive and stuck at home. He needs transportation and diet advice. • Mrs. Bedraggin is a Spanish speaking mother of four young children, husband works two jobs, needs help getting children ready to attend public school, relief from stress associated with child care, immigration, etc. • Miss Hungry is a young single college student with active eating disorder, escalating health problems are beginning to affect school, social life. She needs nutritional counseling, help with seeking health services, etc. • Mr. All Alone is a recently widowed elderly man who is unable to read all but most basic signage, needs to renew driver's license, and needs help with legal matters associated with wife's death. • Other cases will include topics like husband's in-laws, a bad diagnosis, foster children, job loss, temporary disability, substance abuse, child abuse, relocation, nursing home placement, minor injury, bullying at school, poor school performance, no health insurance

8. Companion Collaborators • Each collaborator will have a predefined set of skills relevant to game • Collaborators will include a lawyer, Spanish speaker, pediatrician, psychiatrist, dietician, exercise therapist, librarian, social security clerk, ESL tutor, Russian speaker, communication specialist, physical therapist, occupational therapist, respiratory therapist, baby sitter, driver, Arabic speaker, and job counselor

9. PDA • Holds inventory and status information • Inventory consists of skill objects • Status includes • Case history (solved and unsolved) • Skill dollar count • Bling buck count

10. Game Activities & Events • Player creates profile and avatar (one time activity) • Game presents one randomly selected case study to player • Player reviews case study • Player (optionally) acquires skills • Buy skills in skill shops • Successfully complete mini-games to earn new skills • Player (optionally) chooses one companion collaborator • Player “faces the case” • Selects cluster of skills needed to solve active • Applies skill cluster to active case • Receives rewards for solving case or feedback/hints in the event that case is not solved successfully • Player (optionally) buys bling to accessorize avatar

11. Mini-Games • In addition to buying skills, players will be able to play mini-games within the larger game to earn new skills • Examples of what a player will accomplish in a mini-game: • Identify outward manifestations of beliefs (i.e. clothes, jewelry, food, etc) • Identify characteristics of healthcare need (i.e. Native American, disabled, educated, wealthy) • Speak a foreign language • Identify biased statements • Recognize relationship among concepts (i.e. broader, narrower, contradictory, complementary, etc.) • Identify agreement/disagreement between concepts • Pick out evaluation criteria from a list

12. Narrative Structure • The narrative structure fits nicely into Campbell’s1 three-part “hero’s journey” metaphor : • The Departure: The hero (i.e. the player) is presented with a case study, which is a call for help • The Initiation: The hero goes about collecting the skills and choosing a companion collaborator that will assist him in solving the problem presented in the case study • The Return: The hero chooses the skill he thinks will help him solve the case and then applies this skill cluster to the case. If successful, he is rewarded with bling bucks. If not successful, he receives hints that will help him when he returns to this case • The player repeats this journey over and over, solving new cases and revisiting old cases that he was initially unable to solve. As the journey is repeated, skills (and the knowledge of how to apply those skills) accumulate and cases become easier to solve 1. J. Campbell, The Hero with a Thousand Faces. Princeton University Press. (1972)

13. Game Play Sequence Info Emporium Culture Bazaar Login ReviewCase Study Communications Market Face the Case Collaboration Cafe Buy Bling

14. Sample Game Play – Steps 1 & 2 • Step 1: Player logs into game through a web browser • Step 2: If first time in game, player creates an avatar

15. Sample Game Play – Step 3 • Step 3: Game presents player with a randomly selected case study Mr. All Alone is a recently widowed elderly man who is unable to read all but most basic signage, needs to renew his driver's license, and needs help with legal matters associated with wife's death.

16. Sample Game Play – Step 4 • Step 4: Player enters the Information Emporium and buys two skills Validates understanding of information through discourse Chooses appropriate methods of information retrieval Knows of community support services

17. Sample Game Play – Step 5 • Step 5: Player enters the Culture Bazaar and buys two skills Knows of community support services Create patient instructions

18. Sample Game Play – Step 6 • Step 6: Player enters the Communications Market and buys one skill Able to compose letters, memos and notes

19. Lawyer Sample Game Play – Step 7 • Step 7: Player enters the Collaboration Café and chooses a companion

20. Mr. All Alone is a recently widowed elderly man who is unable to read all but most basic signage, needs to renew his driver's license, and needs help with legal matters associated with wife's death. Sample Game Play – Steps 8 & 9 • Select a cluster of skills from inventory and apply to active case

21. Sample Game Play – Steps 10 & 11 • Player receives feedback • If case is successfully solved, player receives reward (bling bucks) • If case is not successfully solved, player receives hints/instruction on how to solve the case • Player optionally enters Bling Boutique and buys accessories for his avatar

22. Audience • 1,200 undergraduate allied health students (e.g. future nurses and social workers) • Game is aimed at a population of pre-professionals whose course of study is preparing them for careers in which they will interact with a diverse population of patients/clients who have complex and diverse health and human services needs

23. The Production Team • Content specialist: Librarian, faculty from Institute for Innovation in Health and Human Services • Learning specialist: JMU instructional technologist • Production manager: JMU software developer • Graphic artist: outsourced, JMU students • Animation specialist: outsourced, JMU students • Sound: JMU’s Center for Instructional Technology • Narrative: JMU Health Literacy faculty • Programing: JMU software developer, JMU computer science majors • Play testers: JMU nursing students • Assessment: Faculty from JMU’s Center for Assessment & Research

24. Technologies • Macromedia Flash object running in a web browser (graphical game interface) • SQL Server 2005 Express (database for storing user profiles and history, skill sets, case histories, etc.) • .NET Web Services (communication between Flash object and database) • .NET Web Application for managing database content (adding new skills, case studies, etc.)

25. Expected Outcome • Expected outcome: Game players will demonstrate increasingly high levels of cultural awareness, improved communication skills, and improved information literacy skills within a variety of settings • Assessment: To be determined. • Challenge: Build fun into the game so that students are motivated to play • Game must be visually engaging • Skill mechanics must be further developed so that game does not rely to a large extent on “buying skills” • Solving cases should involve combining skills in interesting and challenging ways

26. Is it Fun? 3 Faculty meeting 1 Tooth extraction 5 Day at the water park 2 Airport security 4 Potluck lunch