The Midwife Who Wouldn’t

Written by David Chandross

Early in my gamification work at Ryerson University in 2002, no one had really heard of the idea and when we took role playing games modeled after Dr. Richard Bartle’s famous dungeon crawler concept and used them in the classroom, we were in unfamiliar waters. Bartle is a key name in the history of video games, he designed the first “dungeon maps”, where you adventured in a complex network of passages, encountering monsters and treasures. Bartle also came up with the four “player types”, the different needs that players fulfilled in game play, achievers, socializers, explorers and competitors. These were the early days of video games, long before we had advanced graphics, the imagination was 90% of the experience.

We didn’t know much about player types at the time, as game-based learning was entirely new. I was working in isolation. In one course where I taught midwifery students basic medical science using gamification, we had one group who immediately stated that they “hated games”. The entire group was female and at the time, gaming had a rather adolescent male aura surrounding it, competition, nerds, geeks, guys who could not get a date, and lots of killing monsters. So naturally when this group of women interested in holistic medicine and natural child birth encountered the game, they did not embrace it. The leader of the group, who I will call Nora, said plainly that she did not want to be a part of this and it was a childish waste of time.

The game was based on medical simulations, so I responded; “then just forget about the game entirely, just save babies”. That reaction took her by surprise, now she was in control, the game was not. She could do what she came to university to do, save infants and mothers from distress. The game was an immersive real-time simulation where the students could take on easy cases, medium cases or hard cases, all ranked by difficulty and probability of a bad prognosis and hence more unlikely to be treated successfully. By integrating the difficulty of the medical cases and linking it to outcomes based on game-based learning (solving cases in as short a time as possible and gaining “points” for doing so), players were permitted to forget the game and just immerse themselves in an experience of exploration, testing their limits, expanding knowledge, finding a decision path and seeking a resolution. The game did not force them to adapt to it, they made the game serve them. As the founder of modern karate, Gichin Funakoshi said, “the art should serve the man, and not the man the art”.

At the end of the term the final winners of the game were announced and given some real world prizes, such as body shop products and other cosmetics or bath luxuries. The winning team was the group of midwifery students who were lead by Nora, who had been the most vocal about detesting games. They won by a comfortable margin, having forgotten the “game” and immersed themselves in the “game world”. A good game should do this, it should be able to disappear, it should become a part of the person’s actions and perception. One plays without really playing. The rule set is designed so that the awareness of actually playing a game disperses.

In this way, the midwife who would not play became the best player in the game. Seamless integration of game mechanics, content and evaluation are essential and are the hallmarks of solid training game design. During this course, the team of midwives saved nearly 30 “virtual babies” from illness or death, by using the game mechanics to develop their knowledge and analytic capacity. I cannot help but feel that as these students entered their careers, the gamification experience not only prepared them, but “primed” them for future learning. By the end of the first term of the first year of their program, these students were functioning like physicians. What they lacked in overall knowledge of the many fields of medicine, they made up for in being able to identify the gap between what they know and what they must learn. A good game becomes no game at all. Very Eastern philosophical, if you think about it.

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