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ADAPTIVE SIMULATION-BASED SERIOUS GAMES:

TAILORING CONCEPTUAL MODELS TO ACCOMMODATE

INDIVIDUAL LEARNING NEEDS

W. Osinga

Student Number: S2561263 w.osinga.1@student.rug.nl

MASTER THESIS

MSc Technology and Operations Management, University of Groningen, Faculty of Economics and Business

Supervisor University Dr. Ir. D.J. van der Zee

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ABSTRACT

Problem background: Students, workers, and managers are increasingly interested in lean

education. However, individual learning needs vary greatly, ranging from training their abilities in reducing product lead time to optimizing equipment and system utilization (Kumar & Labib, 2004; Appendix I). Unfortunately, these individual learning needs are sometimes unaddressed by current teaching methods like lecturing, training-on-the-job (Bellitto & Day, 2009; Deshpande & Huang, 2011), serious games, and simulation-based serious games (Adelsberger, Bick, Kraus, & Pawlowski, 1999; Belton & Elder, 1994).

Although simulation-based serious games developed so far show their merit in lean manufacturing education, they tend to be restricted to specific case settings targeting an a priori specified group of players, thereby assuming a specific educational background. Individual learning needs are not answered to in this way. Hence, cross functional and creative skills of workers may not be developed up to full potential.

Objectives: In response, serious games can be tailored, i.e. adapted, to individual learning

needs of the workers. Such an approach would enable individuals to fully participate in lean projects. Hence the need for adaptive simulation-based serious games.

Secondly, the potential of adaptive simulation-based serious games does not seem to couple with the availability of guidance for the game designer. Hence the need for extensions of an existing conceptual modeling framework for simulation-based serious games in order to make it fit for modeling adaptive simulation-based serious games.

Method: The sequence of research is as follows: (1) test the existing conceptual modeling

framework for simulation-based serious games, (2) identify the main shortcomings, and (3) suggest extensions, backed up by literature, to arrive at an extended conceptual modeling framework. These steps were executed by use of a case study. This case study concerns a serious game that is setup according to the mini-game concept on the lean design of an emergency department. A prototype was designed for Refaja Hospital, using Microsoft PowerPoint, in order to test whether it meets individual learning needs. The resulting single-player adaptive simulation-based serious game prototype can then be further developed into a real game.

Findings: The elements of adaptive simulation-based serious games, as proposed in this thesis,

consist of: (1) different levels of difficulty and (2) different learning styles. Those two elements provide a roadmap of mini-games that guides the individual player towards the learning objective.

Those two elements served as extensions to the conceptual modeling framework of Van Der Zee et al. (2012), which originally consisted of five activities: (1) understand the learning environment, (2a) determine the modeling objectives, (2b) determine the general project objectives, (3) identify the model outputs, (4) identify the model inputs, and (5) determine the model content.

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PREFACE

There are several people I would like to thank for their large contributions in helping me write this thesis. I would like to thank my supervisor Dr. Ir. van der Zee who introduced me to the topic, put me in touch with the key interviewees and experts of this thesis, read my thesis every two weeks, and organized meetings to provide constructive guidance on how tackle to the most relevant problems. This level of commitment is more than I could ask for from a supervisor, and has truly increased the overall quality of this thesis. I would also like to thank the company supervisor Ms. Marjo Smit who guided me with the game development, from coming up with design techniques all the way to conducting interviews at Refaja Hospital. Apart from her mix of creative and technical knowledge, she made the development process very fun. Her commitment was very motivating and pushed me even more to give my best effort.

Moreover, I would like to thank Mr. Martijn Veening and co-supervisor Dr. Riezebos who actively supported me with the game development during the wXp meetings. Mr. Martijn Veening helped me with brainstorming and fine-tuning game concepts and providing feedback from a game development perspective. Additionally, Dr. Riezebos guided me in making the challenging translation from lean concepts into an adaptive simulation-based serious game. Their contributions ensured the quality of the game concept and the lean aspect of the illustrated adaptive simulation-based serious game.

And finally, I would like to thank the managers of the Refaja Hospital’s emergency department, Ms. Jenny Noorman and Mr. Gert Hagenus. They made time for me during their inherently busy jobs on a voluntarily base, and always ensured that I had all the information to move forward. Their contributions has ensured quality of the medical aspect of the illustrated adaptive simulation-based serious game.

I feel very lucky to have had help from so many fields of study for this thesis, which could not have been written without these people. This master thesis is the final step in my academic career and marks the end of my master program in Technology and Operations Management. It illustrates the concept of adaptive simulation-based serious games and distills the designer’s need for extensions of an existing conceptual modeling framework for simulation-based serious gaming in order to make it fit for modeling adaptive simulation-based serious games.

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CONTENTS

1 Introduction ... 1

2 Research Objectives and Design ... 3

2.1 Problem Background ... 3

2.2 Research Objectives ... 4

2.3 Research Design ... 4

3 Designing Adaptive Simulation-Based Serious Games – Definition and Design ... 6

3.1 Requirements to Stimulate Individual Learning of Lean Principles ... 6

3.2 Characterize Lean Adaptive Simulation-Based Serious Games – Proposed Format ... 9

3.3 Review an Existing Modeling Framework ... 13

4 An Adaptive Simulation-Based Serious Game – ED Process Improvement ... 18

4.1 Activity 1: Understand the learning environment ... 18

4.2 Activity 2a: Determine the modeling objectives ... 21

4.3 Activity 2b: Determine the general project objectives ... 22

4.4 Activity 3: Identify the model outputs ... 23

4.5 Activity 4: Identify the model inputs ... 24

4.6 Activity 5: Determine the model content ... 25

4.7 Testing The Adaptive Simulation-based Serious Game Prototype ... 31

5 Using the Extended Conceptual Modeling Framework ... 32

5.1 The Design Process - Using the Extended Conceptual Modeling Framework ... 32

5.2 Best Practices ... 35

6 Discussion ... 36

6.1 The Extended Framework Use: The Design Steps and the Best Practices ... 36

6.2 The Proposed Format for Adaptive Simulation-Based Serious Games ... 36

6.3 Limitations of the study ... 36

7 Conclusion ... 37

References ... 38

Appendix I: Specifications for lean manufacturing game design ... 40

Appendix II: Thesis Project Stakeholder Analysis ... 41

Appendix III: The Experimental Learning Process ... 42

Appendix IV: 5S - The Phases, descriptions, and activities ... 43

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Keywords: simulation, serious games, adaptive simulation-based serious games, operations

management, health care.

1 INTRODUCTION

For decades, lean principles have shown great potential for improving business processes by reducing waste. Yet, its implementation greatly depends on the cross functional skills of the workers (Bellitto & Day, 2009; Hopp & Spearman, 2011). These skills enable them to foster understanding of the bigger picture, increase idea generation, enhance their employability, and reduce boredom and fatigue (Hopp & Spearman, 2011). Moreover, they enable them to improve their own processes and improve their companies’ responsiveness to increasingly changing customer demands(Bell, Kanar, & Kozlowski, 2008; Bellitto & Day, 2009). Unfortunately, companies have difficulties in effectively training their workers this way (Bellitto & Day, 2009).

This learning problem is currently addressed with varying teaching solutions, including lecturing and training-on-the-job (Bellitto & Day, 2009; Deshpande & Huang, 2011). While these solutions have their merits, they have drawbacks. Lecturing lacks active involvement of trainees, the possibility to experience the bigger picture, and the suitability to convey system characteristics (Ben-Zvi, 2010; Faria & Wellington, 2004). Training-on-the-job lacks visibility, reproducibility, safety, economy, and system availability (Raser, 1969; Ruohomaki, 1995). Many of the aforementioned drawbacks are addressed by serious games.

Serious games are designed to teach workers, students, and managers to make better decisions through experimentation in a safe, but realistic, learning environment (Adelsberger et al., 1999; Belton & Elder, 1994). Note that the adjective “serious” stresses the learning objective underlying the game (Crookall, 2010). When these serious games are combined with a computer-based simulation model, it is called a ‘simulation-based serious games’. The term simulation is defined by Robinson (2014) as the “experimentation with a simplified imitation (on a computer) of an operations system as it progresses though time, for the purpose of better understanding an improving that system”. The resulting simulation-based serious games have already been successfully designed and implemented in multiple settings. Illustrative examples are the design and control of a manufacturing system (Battini, Faccio, Persona, & Sgarbossa, 2009), effective use of enterprise resource planning (Adelsberger et al., 1999), and operational supply chain management (Van Houten, Verbraeck, Boyson, & Corsi, 2005).

Robinson (2004) Although simulation-based serious games developed so far certainly show their merit in lean manufacturing education, they tend to be restricted to specific case settings targeting an a priori specified group of players, thereby assuming a specific educational background. Individual learning needs are not answered to in this way. Hence, cross functional and creative skills of workers may not be developed up to full potential.

In response, this thesis aims to tailor serious games to individual learning needs of the workers, by providing game designers with a conceptual modeling framework for “adaptive simulation-based serious games”. Note, the adjective “adaptive” relates to the game’s ability to accommodate individual learning needs. These needs can be identified from the worker’s backgrounds or the operations system detail (Van der Zee & Sloot, 2014). Once identified, they can be used to design targeted mini-games, which game operators can parameterize and sequence to accommodate individual learning needs (Smit & Van der Zee, 2014).

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modeling frameworks have proven to be essential tools for designers to meet budget, resource, and time targets (Robinson, 2008). Therefore, the thesis builds upon an existing conceptual modeling framework for generic games (cf. Van Der Zee et al., 2012) and extend it into a conceptual modeling framework for adaptive simulation-based serious games.

Thus, the objectives of the thesis project are: (1) to illustrate the adaptive simulation-based serious game concept, and (2) to distill the need for extensions of an existing conceptual modeling framework for simulation-based serious gaming in order to make it fit for modeling adaptive simulation-based serious games.

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2 RESEARCH OBJECTIVES AND DESIGN

This chapter consists of the problem background (section 2.1) and the research objectives (section 2.2). Next, this chapter answers how the objectives are going to be studied, described in research design (section 2.3).

2.1 Problem Background

Students, workers, and managers are increasingly interested in lean education. However, individual learning needs vary greatly, ranging from training their abilities in reducing product lead time, to optimizing equipment and system utilization (Kumar & Labib, 2004; Appendix I). These individual learning needs are sometimes unaddressed by current teaching methods. Such teaching methods include lecturing and training-on-the-job (Bellitto & Day, 2009; Deshpande & Huang, 2011). While these solutions have their merits, they have drawbacks. Lecturing lacks active involvement of trainees, the possibility to experience the bigger picture, and the suitability to convey system characteristics (Ben-Zvi, 2010; Faria & Wellington, 2004). Training-on-the-job lacks visibility, reproducibility, safety, economy, and system availability (Raser, 1969; Ruohomaki, 1995).

Many of the aforementioned drawbacks are addressed by serious games and simulation-based serious games (Adelsberger et al., 1999; Belton & Elder, 1994). Although simulation-based serious games developed so far certainly show their merit in lean manufacturing education, they tend to be restricted to specific case settings targeting an a priori specified group of players, thereby assuming a specific educational background. Individual learning needs are not answered to in this way. Hence, cross functional and creative skills of workers may not be developed up to full potential.

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2.2 Research Objectives

The objectives of the thesis project are:

1. To illustrate the adaptive simulation-based serious game concept.

2. To distill the need for extensions of an existing conceptual modeling framework for based serious gaming in order to make it fit for modeling adaptive simulation-based serious games.

These research objectives will be addressed using the following research design.

2.3 Research Design

These research objectives are addressed using the regulative cycle (van Strien, 1997): Table 2.1 Research design

Stage (van Strien, 1997)

Steps Research

method

Chapter Design problem 1. Define need for adaptive simulation-based

serious games.

Literature review

2.1 System description 2. Review an existing conceptual modeling

framework.

3.2 Analysis 3. Propose a format for adaptive simulation-based

serious games.

3.1 Game design 4. Illustrate the adaptive simulation-based serious

game.

Case study 4 5. Describe the adaptive simulation-based serious

game design process.

5 Testing 6. Evaluate existing conceptual modeling

framework use – suggest extensions.

Note: the adaptive simulation-based serious game was created first (step 4), and its practical experience was used to suggest extensions to an existing conceptual modeling framework (step 6). This resulting extended conceptual modeling framework can be used by designers as a tool to create adaptive simulation-based serious games.

Thus, the research design consists of 6 steps, which are elaborated below: Step 1. Define need for adaptive simulation-based serious games

The problem background (section 2.1) defined the need for adaptive simulation-based serious games, using a literature review. The aim was to evaluate how lean manufacturing education can benefit from the concept of adaptive simulation-based serious games. Firstly, it showed the need of individual training in lean education. Secondly, it discussed different training modes, such as training-on-the-job, lecturing, and simulation-based serious games. And thirdly, it highlighted the need for the adaptive simulation-based serious game concept, and a stepwise approach to design these adaptive simulation-based serious games.

Step 2. Review an existing conceptual modeling framework.

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modeling. Besides, it links levels by deciding on: (1) whether to emulate the operations system, (2) whether to use computer support, (3) the choice of simulation tool, and (4) the choice of scenario.

Step 3. Propose format for adaptive simulation-based serious games.

Before designing the adaptive simulation-based serious game, it needs to have a clear game format. Literature does not yet provide a clear concept of adaptive simulation-based serious games. Instead, characteristics of adaptive simulation-based serious games are spread in literature. Firstly, a checklist was made of the characteristics of adaptive simulation-based serious games (section 3.2.1). Secondly, this checklist was input for a brainstorm interview with experts on simulation-based serious gaming and lean training, which led to a proposed format of adaptive simulation-based serious games (section 3.2.2).

Step 4. Illustrate the adaptive simulation-based serious game.

The adaptive simulation-based serious game was illustrated (chapter 4) using the proposed format of adaptive simulation-based serious games (step 3), using the existing conceptual modeling framework (step 2), and using the case study with Refaja Hospital (Appendix V). This adaptive simulation-based serious game concerns the lean design of an emergency department. A prototype was presented to Refaja Hospital, using Microsoft PowerPoint, in order to test whether it meets individual learning needs. The resulting adaptive simulation-based serious game prototype can then be further developed into a real game.

Step 5. Describe the adaptive simulation-based serious game design process.

All steps in the design process of the adaptive simulation-based serious game are documented in parallel to the game setup of step 4. These steps were then tailored to the existing conceptual modeling framework (chapter 5).

Step 6. Evaluate existing conceptual modeling framework use – suggest extensions.

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3 DESIGNING ADAPTIVE SIMULATION-BASED SERIOUS GAMES

DEFINITION AND DESIGN

This chapter first reviews the requirements to stimulate individual learning of process improvement, in the context of lean principles (section 3.1). Secondly, it reviews the characteristics of adaptive simulation-based serious games, and proposes a game format (section 3.2). Thirdly, it assesses to what extend these characteristics are addressed by an existing conceptual modeling framework, in order to uncover its main shortcomings (section 3.3).

3.1 Requirements to Stimulate Individual Learning of Lean Principles

This section reviews the requirements to stimulate individual learning of process improvement, in the context of lean principles.

3.1.1 Worker Skills in Lean Manufacturing

There is a growing interest in lean education among students, workers, and managers. This group of learners are interested in a wide variety of skills. A survey among this group has indicated the interest for training on the following top 5 of worker skills (Kumar & Labib, 2004; Appendix I):

Table 3.1 Worker skills, in descending order of importance Rank Worker skills

1 Reduce product lead time 2 Optimize operating cost

3 Equipment and system utilization 4 Equipment modularity

5 Reduce set-up of equipment

This large variety of concepts leads to a problem in group training, when individuals have different learning needs (Wan, Compeau, & Haggerty, 2012). For instance, some individuals may already have adequate knowledge on reducing product lead time. In this case, a group training on product lead time would not be very beneficial to them, as they have different learning needs. If these individual learning needs are not addressed, their cross functional skills may not be developed up to full potential. As a result, there is a need for individual training.

3.1.2 Training modes

Current training modes include lecturing, training-on-the-job, and simulation-based serious games (Bellitto & Day, 2009; Deshpande & Huang, 2011). While these solutions have their merits, they have drawbacks.

Table 3.2 Worker skills, in descending order of importance Training

mode

Description Merit Drawback

Lecturing A fairly common teaching method, in which organizations teach their workers in a class room setting about lean principles, lean methodologies, and company objectives. Elements of such courses include safety, IPCA-610

It offers great visibility of learning outcomes (e.g. by means of grades), safety (classroom setting), cost

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one-to-7 overview, and Kanban (Bellitto & Day, 2009).

effectiveness (no large investments). Furthermore, the social environment of the classroom can have motivational aspects (Wan et al., 2012). one. Additionally, lecturing lacks experimental learning, such as active involvement of trainees, the possibility to experience the bigger picture, and the suitability to convey system characteristics (Ben-Zvi, 2010; Faria & Wellington, 2004).

Training-on-the-job

A teaching method that allows workers to shift between work areas as demand dictates (Bellitto & Day, 2009). This way, worker can learn skills and tacit knowledge with hands-on experience. An example is job rotation (Kumar & Labib, 2004) It offers great experimental learning stemming from hands-on experience. Additionally, this hands-on environment stimulates the motivational aspects (Wan et al., 2012).

It lacks the ability to reproduce content, which leads to a low score on content variety and individualized learning pace. In addition, it lacks time flexibility, visibility, and safety (Raser, 1969; Ruohomaki, 1995). Simulation-based serious games

Serious games are designed to teach workers, students, and managers to make better decisions through experimentation in a safe, but realistic, learning environment (Adelsberger et al., 1999; Belton & Elder, 1994). Note that the adjective “serious” stresses the learning objective underlying the game (Crookall, 2010). This learning is classified by Kumar & Labib (2004) as ‘learning by doing’ (see Appendix III for a scientific explanation of ‘learning by doing’). The three characteristics of serious games are (Forssén-Nyberg & Hakamäki, 1998): (1) always reflecting reality, (2) embodying in the form of social communication, and (3) requiring evaluation of reality together with self-evaluation and reflection.

When these serious games are combined with a computer-based simulation model, it is called a ‘simulation-based serious games’. These games use discrete event simulation to model operations systems (Law, 2009). These games have already been successfully designed and implemented in multiple settings. Illustrative examples are the design and control of a manufacturing system (Battini et al., 2009), effective use of enterprise resource planning (Adelsberger et al., 1999), and operational supply chain management (Van Houten et al., 2005).

It overcomes many of the drawbacks of training-on-the-job and lecturing. It has an advantage over lecturing in terms of experimental

learning, such as the active involvement of trainees, the possibility to experience the topic as a whole, and its suitability to convey system characteristics (Greenblat, 1988). Additionally, it has an advantage over training-on-the-job in terms of visibility, content variety, safety, cost effectiveness, and time flexibility (Raser, 1969; Ruohomaki, 1995).

If it does not include a social element, such as seeking peer assistance and social comparison, it may lack a motivational aspect (Wan et al., 2012). Additionally, currently available simulation-based serious games tend to be restricted to specific case settings targeting an a priori specified group of players, with a specific educational background. Individual learning needs are not answered to in this way. Hence, there are areas of improvement in terms of content variety and individual learning pace.

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and drawbacks provide insight into the requirements for individual training, as is discussed in the next section.

3.1.3 Defining Individual Training Requirements

The previous section provided the merits and drawbacks of each training mode. These merits and drawbacks provide insight into the requirements of individual training. Moreover, the third column discusses whether these requirements are especially applicable for individual training, or generally applicable to individual and group settings.

Table 3.3 Requirements of Individual Training Requirements

of Individual Training

Details Applicability (individual/generally)

Visibility It must provide visibility of the learning outcomes of the workers (Raser, 1969; Ruohomaki, 1995).

Generally. Providing visibility of learning outcomes is applicable for both group- and individual training.

Safety It must provide a safe learning experience (Raser, 1969; Ruohomaki, 1995).

Generally. Providing a safe learning environment is applicable for both group- and individual training.

Cost

effectiveness

It must contain costs while deriving value from training expenditures (Wan et al., 2012).

Generally. Providing a cost effectiveness is applicable for both group- and individual training. However, for individual training this might be more challenging, since it is generally more economical to teach in a group setting.

Content variety It must satisfy a variety of individual learning requests and competency levels (Wan et al., 2012).

Individual. Satisfying a variety of individual learning requests and competency levels is more applicable for individual training. In group settings this may be much more challenging too incorporate because of the different learning needs.

Individualized learning pace

It must be able to reproduce content at an approachable but manageable level of challenge - not too hard to cope with but not so easy as to yield completely to the existing repertoire (Salomon & Perkins, 1998).

Individual. Reproducing content at a manageable level of challenge is more applicable for individual training. In group settings this may be much more challenging too incorporate because of the different learning paces.

Motivational It must provide the conditions that sustain motivation and energy, such as encouragements, entertainment, appropriate level of challenge, friendly interfaces (Salomon & Perkins, 1998).

Generally. Providing the conditions that sustain motivation is applicable for both group- and individual training. However, Salomon & Perkins (1998) warn that this is especially true for individual training, because it lacks the social element, which is inherently available in group training, and which positively correlates with the student’s motivation.

Experimental learning

It must encourage the active involvement of trainees, and the possibility to experience the bigger picture (Ben-Zvi, 2010; Faria & Wellington, 2004).

Generally. Encouraging active involvement of trainees is applicable for both group- and individual training.

Time flexibility It must deliver training at convenient times to a large number of employees in different locations (Salomon & Perkins, 1998).

Individual. Delivering training at convenient times is more applicable for individual learning. It is challenging to incorporate time flexibility in training-on-the-job and lecturing.

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content variety, individualized learning pace, motivational, experimental learning, and time flexibility. Moreover, the third column discusses that content variety, individualized learning pace, and time flexibility are especially applicable for individual training. These requirements allow for a more rigorous assessment of simulation-based serious games the following section.

3.1.4 Assessing Simulation-Based Serious Games

The comparison between training modes illustrates the great potential of simulation-based serious games, and how they outperform the other training modes in the mentioned training requirements. However, currently available simulation-based serious games tend to be restricted to specific case settings targeting an a priori specified group of players, with a specific educational background. Individual learning needs are not answered to in this way. Hence, there are areas of improvement, if simulation-based serious games were to be tailored to individual learning needs (Van Der Zee et al., 2012).

3.1.5 A Need for Adaptive Simulation-Based Serious Games

In response, this thesis aims to provide a new concept: adaptive simulation-based serious games. These games aim to tailor serious games to individual learning needs of the workers. Hence, the adjective “adaptive” relates to the game’s ability to relate to individual learning needs. These needs can be identified from the worker’s backgrounds or the operations system detail (Van der Zee & Sloot, 2014). Once identified, they can be used to design targeted mini-games, which players can parameterize and sequence by choice of their individual learning needs (Smit & Van der Zee, 2014).

Adaptive simulation-based serious games should be able to address individual learning these drawbacks and thus lead to improvements in terms of content variety and individual learning pace. In addition, the differences between individual working paces can be recorded and provide insight on the strengths and weaknesses of worker’s skill levels which may provide greater visibility.

3.2 Characterize Lean Adaptive Simulation-Based Serious Games – Proposed Format

Before designing the adaptive simulation-based serious game, it needs to have a clear game format. Unfortunately literature does not yet provide a clear concept. Instead, characteristics of adaptive simulation-based serious games are spread in literature. In order to obtain a clear game format, the following steps were taken:

1. Section 3.2.1: A checklist was made of the characteristics of adaptive simulation-based serious games.

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3.2.1 A Checklist of Characteristics of Adaptive Simulation-Based Serious Games

Various authors on simulation-based serious games have proposed directions for future research on how to make simulation-based serious games more adaptive. These papers were scanned, using the software Mendeley Desktop version 1.13.5, by searching through a database of simulation literature for related keywords, also checking their references and respective articles. This resulted in the following checklist of characteristics of adaptive simulation-based serious games:

Table 3.4 Checklist of Characteristics of Adaptive Simulation-Based Serious Games Characteristics of

adaptive simulation-based serious games

Detail (Salomon & Perkins, 1998)

Roadmap It must provide a roadmap to stage the learner’s progress. Adding a chart feature that indicates the learners’ training progress as they go can promote skills in self-evaluation (Wan et al., 2012).

Goal orientation It must frame the activity as either a performance or a mastery activity, where the former is associated with flawless performance and the latter is associated with developing capability (Wan et al., 2012).

Scenario sequencing It must enable game operators to parameterize and sequence targeted mini-games by choice of their individual learning needs (Smit & Van der Zee, 2014). This can be based on worker’s backgrounds or the operations system detail (Van der Zee & Sloot, 2014).

Experimentation It must provide the opportunity to generate and select among alternative representations or behaviors, or refine one or combine them.

Guidance It must provide guidance, which can be in the form of instruction, demonstrations, hints,lecturing, question and answer sessions, books.

Feedback It must provide informative feedback about what was right or wrong and what to do instead.

Double-loop feedback It must provide the ability to ‘learn to learn’; i.e. developing understanding of their own memories and how to manage memory.

Multi-lingual It must allow individual gaming in multi-lingual environments (Deshpande & Huang, 2011).

Object oriented principles of reuse and inheritance

It must use object oriented principles of reuse and inheritance in order to constantly adjust itself to the dynamic changes in the industry, myriad of new research avenues, and the latest technology platforms (Deshpande & Huang, 2011).

Holistic understanding It must be a virtually integrated and comprehensive simulation game applications that will enable holistic understanding of a subject where the students can interrelate various concepts, understand the tradeoff involved, resource constraints, and their practical significance (Deshpande & Huang, 2011).

Computer support and simulation

It must provide simulation, as it is a simulation-based serious game. This may include (1) facilities for realistic visualization of operations systems and their dynamics, and (2) means for developing player/operator interfaces (Van der Zee & Slomp, 2009), (3) a calculation tool (spread sheet, calculator etc.), or (4) databases (Greenblat, 1988).

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3.2.2 Characterize Adaptive Simulation-Based Serious Games – Proposed Format

This section translates the checklist of characteristics of adaptive simulation-base serious games into a proposed format. This format originates from the practical experience of Smit (2013) as is described in her wXp study. In addition, a brainstorm interview with experts on simulation-based serious gaming (Appendix V), led to the following proposed format for adaptive simulation-based serious games:

Mini-games for learning style #1 Mini-games for learning style #2 Mini-games for learning style #3 Level 1: facts, terms Mini-game 1 Mini-game 4 Mini-game 7 Level 2: processes Mini-game 2 Mini-game 5 Mini-game 8 Level 3: process optimization Mini-game 3 Mini-game 6 Mini-game 9

Same learning objective Figure 3.1 Proposed format for adaptive simulation-based serious games This proposed format can be explained as follows:

Table 3.5 Legend for proposed format for adaptive simulation-based serious games (part 1 of 2)

Legend Meaning

Learning objective The underlying learning objective that teaches the players to optimize their own processes in the context of lean.

Mini-games

Level 1: facts, terms

The players learn the general facts and terms related to the learning objective. Level 2:

processes

The players learn how these facts and terms are translated into the processes that are common in their organization. It should be tested with the organization whether these processes are indeed common.

Level 3: process optimization

The players learn to independently optimize their own processes. Using simulation, different scenarios can be created for players to respond to. Learning styles Each learning style leads to the same learning objective. Shifts between

learning styles ensure that different types of learners are accommodated to achieve the learning objective associated with a specific level.

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Table 3.6 Legend for proposed format for adaptive simulation-based serious games (part 2 of 2)

Legend Meaning Trigger

The horizontal arrows indicate a shift between learning styles.

By the player: A shift between learning styles can be triggered by the players’ preference. Thus the player can choose a preferred learning style at any time in the game.

The vertical arrows indicate a shift between levels of difficulty. Note, this can go upward or downward, depending on the player’s performance. With each advancement of the level of difficulty, the player comes closer to the learning objective.

By winning or losing: A shift to a higher level of difficulty is triggered when the player wins the level. A shift to a lower level of difficulty is triggered when the player performs poorly at the current level, i.e. the player loses 3 consecutive times. By the game operator: In addition the game operator can intervene, i.e. enable a player, who cannot beat the current level, to still play a higher level.

By the player: Lastly, a player can always choose to play a lower level, to refresh that knowledge.

This proposed format also links to the checklist of adaptive simulation-based serious games: Table 3.7 Checklist of Characteristics of Adaptive Simulation-Based Serious Games

Characteristics of adaptive simulation-based serious games

Link to the checklist

Roadmap The learner’s progress is indicated by the advancement through the levels. Goal orientation The levels are designed to develop capabilities to achieve the learning objective. Scenario sequencing Inside the levels the game operator will be able to parameterize and sequence

targeted mini-games.

Experimentation Inside the levels the player will be able to experiment.

Guidance Inside the levels, guidance can be provided in the form of instruction, demonstrations, hints, lecturing, question and answer sessions, books, or videos.

Feedback Inside the levels, feedback can be provided about what was right or wrong, and what to do instead.

Double-loop feedback The different learning styles provide the ability to change the way of learning, and therefore achieve the same learning objective with an alternative learning style.

Multi-lingual The game can be written in different languages; allowing the player to indicate its preference.

Object oriented principles of reuse and inheritance

The game can use objected oriented principles of reuse and inheritance. Holistic understanding The levels should build upon each other to create a holistic understanding of

the underlying learning objective. Computer support and

simulation

The game is computer supported, and the levels can use simulation for (1) a realistic visualization of operations systems and their dynamics, and (2) means for developing player/operator interfaces (Van der Zee & Slomp, 2009), (3) a calculation tool (spread sheet, calculator etc.), or (4) databases (Greenblat, 1988).

In addition, the adaptive levels link to lean notions, such as 5S (explained in chapter 4), in which the S’s build upon each other. Moreover, it helps to gradually grow the learners’ skills in process optimization with each advancement in levels; from facts and terms (level1) to the ability to independently optimize their own processes (level 3).

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3.3 Review an Existing Modeling Framework

This section assesses to what extend the proposed format, as clarified in section 3.2.2, is addressed by an existing conceptual modeling framework in lean manufacturing education, in order to uncover its main shortcomings. This existing aggregated framework consists of an integration of 3 aggregation levels and 4 key decisions (Van der Zee & Sloot, 2014). The aggregation levels provide an overview on the connection between the teaching method, serious game, and simulation.

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The focus adaptive simulation-based serious games is mainly positioned in the area of the simulation model (level 3). Therefore, this level is the main area of focus, and is explained most elaborately below.

3.3.1 Level 1: Teaching Method Design

The teaching method design process, as characterized by Laurillard (2002; 2013), consists of five stages: (1) analyze the student’s learning needs, (2) define learning objectives, (3) design specific learning activities, (4) test with pairs of students, and (5) design media prototypes. After these stages, the designer can implement the teaching method using training-on-the-job or using serious games.

3.3.2 Key Decision 1: Serious game?

The designer can implement the teaching method using a serious game, or using an alternative, such as training-on-the-job. The advantages of serious games are for reasons of visibility, reproducibility, safety, economy, and system availability (Raser, 1969). It can focus in-depth on a limited set of issues, for a larger number of students, within a limited period of time (Van der Zee & Sloot, 2014).

3.3.3 Level 2: Serious Game Design

The serious game design process, as characterized by Greenblat (1988), consists of five stages: (1) setting of game objectives and parameters, (2) model development, (3) representational style and form for model elements, (4) game construction, and (5) game preparation. This process serves as a reference model for simulation and gaming.

3.3.4 Key Decision 2: Computer Support?

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3.3.5 Level 3: Simulation-Based Serious Games Design

The simulation-based serious game design process, as characterized by Van Der Zee et al. (2012), consists of five activities, described in the table below:

Table 3.8 Conceptual Modeling Framework for Simulation-Based Serious Games

Activity Details (with examples of the Refaja Hospital ED department)

1. Understanding

the learning

environment

 Understand the subject matter, context of use, and likely players/operators, preferably by

interviewing clients and subject matter experts.

• Identify:

 Clients, i.e. emergency departments of hospitals.

 Subject matter, i.e. the lean methodology of 5S.

 Subject matter experts, i.e. hospital management, lean experts.

 Players, i.e. the staff of the hospital.

 Operators, i.e. emergency departments of hospitals.

 Context of use, i.e. during workshops.

 Explore learning needs given the environment, i.e. training in process improvement in a lean

context.

 Decide on the appropriateness of a computer-based game format.

2.a. Determine the

modeling objectives

o Identify the game’s pedagogic purpose, i.e. teach staff lean principles to enhance their skills

in improving their own processes. These processes can include current processes, that they are currently performing, and future processes, that management predicts to emerge in the nearby future.

o Express modeling objectives in terms of players’ achievements in mastering their decision

making skills, i.e. enhance players’ skills in improving their own processes using the 5S methodology, resulting in their processes meeting the hospital’s standards, as set by management, under time pressure.

2.b. Determine the

general project objectives

o Establish and assess project requirements on resource use, i.e. to cut expenses and to meet

the project time line, the model detail will be limited to the context of 5S processes, and less to the context of medical processes.

o Clarify the model nature and its use with respect to:

o Visualization: displaying model entities and their detail (2D, 3D, schematic, iconic, etc.),

i.e. when 5S processes are not well executed it results in items piling up.

o Player interaction: how to facilitate players’ interaction with the model, i.e. dragging the

items that have piled up, in order to perform the 5S processes.

o Responsiveness: what delays (execution times) are acceptable for model’s responses to

players’ decisions (i.e. the model responses should be in seconds to guarantee timely completion of the game)?

o Model/component re-use: how easily can the model accommodate alternative

groups of players, with possible different background, i.e. through mini-games that accommodate different learning styles and levels of difficulty.

3. Identify the

model outputs

 Check the modeling objectives for relevant performance measures indicating player

achievements, i.e. meeting process standards under time pressure.

 Establish model outputs (explanatory measures) helping to identify potential bottlenecks in

system operations and plain player achievements, i.e. countdown of time, items piling up if 5S processes are not well applied.

 Determine format for representing responses, i.e. numerical data of the times it took to

perform their processes (such as high scores of the fastest times).

4. Identify the

model inputs

o Select qualitative and quantitative data that can be changed in order to represent alternative

system configurations appealing to (alternative) groups of players, i.e. walking time to specific items.

o Determine range over which model inputs may be varied, i.e. it takes between 30-60 seconds

to prepare the items for the intravenous therapy system.

5. Determine the

model content: scope and level of detail

o Determine model scope:

o Identify the system boundary

o Identify all components in the real system that lie within the model boundary

(include player roles).

o Assess whether to include components.

o Determine model detail (attributes) for all components included.

o Identify assumptions and simplifications concerning model scope and detail and assess their

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3.3.6 Key Decision 3: Choice of Simulation Tool?

Game use stresses some specific demands on tool features, such as (1) facilities for realistic visualization of operations systems and their dynamics, and (2) means for developing player/operator interfaces (Van der Zee & Slomp, 2009).

3.3.7 Key Decision 4: Choice of scenario?

The choice of game scenarios can help the game operator adjust parameter setting for model inputs and/or model initialization to match students’ learning needs to model settings.

3.3.8 Assessment of the existing conceptual modeling framework

This section assesses to what extend these characteristics are addressed by an existing conceptual modeling framework, in order to uncover its main shortcomings. The focus adaptive simulation-based serious games is mainly positioned in the area of the simulation model (level 3). Therefore, this level is the main area of focus of this assessment.

The table below consists of four columns. The first and second columns lists the characteristics of adaptive simulation-based serious games, and the needed design activity. The third and fourth column links this design activity to the existing conceptual modeling framework, and assesses whether the design activity already exists or whether an extension is needed.

Table 3.9 Assessment of existing conceptual modeling framework for Simulation-Based Serious Games Characteristics of

adaptive simulation-based serious games

Design activity Link to existing

framework’s activities (cf. Van Der Zee et al., 2012)

Extension needed?

Learning objective The learning objective is identical to the pedagogical purpose of the existing framework.

Activity 2a: Determine the modeling objectives. No Mini-games Level 1: facts, terms

Each level of difficulty should have its own sub-learning objective. Yes Level 2: processes Level 3: process optimization Shift between levels of difficulty

Shifts between levels of difficulty are triggered by the players’ performance: a higher level of difficulty is triggered when the player wins the level. A shift to a lower level of difficulty is triggered when the player performs poorly at the current level. Since this shift between levels of difficulty determines the game content, this design activity is related to the model inputs. Activity 4: Identify the model inputs. Yes Shift between learning styles

Shifts between learning styles are triggered by the players’ preference: the player can choose a preferred learning style at any time in the game. Since this shift between learning styles determines the game content, this design activity is related to the model inputs.

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This high level assessment, on the level of activities, indicates that the existing conceptual modeling framework already addresses the learning objective. However, it falls short on addressing the sub-learning objective of each mini-game, as well as the shifts between levels of difficulty and learning styles. This gap is bridged by extending this framework. These extensions are inspired by existing work on the design process of adaptive simulation-base serious games.

3.3.9 Existing Work on the Design Process of Adaptive Simulation-Based Serious Games

Existing work on the design process of adaptive simulation-base serious games has been done by Smit (2013). Her study uses a matching matrix, which is a stepwise approach to designing adaptive games. It includes five steps: (1) information analysis, which determines the organization’s objectives, the change objectives, and describes the management strategy, (2) the objectives of concrete learning route, which describes the desired business process, determines root causes of the problem, determines the design of processes and information management, (3) determine the objectives of the game, which analyzes teaching procedures, determines how the organization achieve their goals and determines how workers in general achieve their goals, (4) determine assessment framework, which determines operational goals, objectives with regard to ambition coach, and the framework of the teaching strategies, and (5) the editorial interpretation of game environment.

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4 AN ADAPTIVE SIMULATION-BASED SERIOUS GAME – ED PROCESS

IMPROVEMENT

This chapter illustrates the extended conceptual modeling framework by use of a case study concerning a serious game that is setup according to the mini-game concept on the lean design of an emergency department. A prototype was designed for Refaja Hospital, using Microsoft PowerPoint, in order to test whether it meets individual learning needs. The resulting single-player adaptive simulation-based serious game prototype can then be further developed into a real game.

The setup of this chapter will follow the activities of the existing conceptual modeling framework of simulation-based serious games: understand the learning environment (section 4.1), determine the modeling objectives (section 4.2), determine the general project objectives (section 4.3), identify the model outputs (section 4.4), identify the model inputs (section 4.5), and determine the model content (section 4.6).

4.1 Activity 1: Understand the learning environment

4.1.1 Identifying subject matter experts: lean, health care operations, and simulation-based serious game design

In order to design an adaptive simulation-based serious game for this client and these players, meetings were set up with experts on lean, health care operations, and simulation-based serious game design. These ‘wXp meetings’ were used to brainstorm, and provide feedback and courses of action, on the design of the adaptive simulation-based serious game (Appendix V).

4.1.2 Identifying a subject matter: 5S

5S is a workplace organization method for efficiency and effectiveness by following the 5 phases:

Table 4.1 Description the lean methodology of 5S and its 5 phases (Stephenson, 2015) Phase Description (Stephenson, 2015)

1. Sort To sort through everything in each work area. Keep only what is necessary. Materials, tools, equipment and supplies that are not frequently used should be moved to a separate, common storage area. Items that are not used should be discarded or recycled.

2. Set in order

To organize, arrange, and identify everything in a work area, as well as throughout the facility, so that items can be efficiently and effectively retrieved and returned to their proper storage location. This step could also simply be called "put away." Put things away in a logical storage location that makes commonly used tools and materials convenient and easy to access. The most commonly used tools should be readily available. Those items that are not frequently used should be kept out of the way by storing them in a more remote location.

3. Shine Cleaning up the clutter and sorting out what was needed from those tools, materials, and supplies that are not frequently needed.

4.

Standardize

Simplifying and standardizing the 5S practices to make them more effective and efficient. Old habits are changed and new work practices established. The new practices are documented in written standards which ensure that 5S goals are achieved in an effective and efficient manner.

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1. It matches with the notion of learning levels, since the S’s of 5S build upon each other. 2. It matches with the redesign of Refaja Hospital according to 5S principles.

3. It matches with the lean notion of process optimization.

Along with this lean methodology a learning objective was defined in the following section.

4.1.3 Identifying the client: the Emergency Department of Refaja Hospital

The Refaja Hospital is part of the Treant Zorggroep; an organization that provides care to 300,000 residents of the region Hoogeveen-Emmen-Stadskanaal. Treant Zorggroep joins forces with twenty care centers for the elderly (in Region Emmen and Hoogeveen), and three hospital locations (location Schepers, Bethesda, Refaja) (Treant, 2015).

Figure 4.1Organizational chart of Treant Zorggroep

In this organizational chart, the care centers fall under the heading of CARE, and the hospital locations under the heading CURE. The hospital Refaja therefore falls under one of the CURE RVEs. Each RVE have a business manager and a medical manager. As head of the ED, the contact person Jenny Northman reports to the operations manager RVE IC / ER / surgery. This in turn reports to the Board of Directors, which reports to the Supervisory Board. The mission of Refaja Hospital is:

"Medical and nursing care, provide diagnosis and treatment that the patient (directly) needs 24/7 and when necessary, forward the diagnosis and / or treatment to a specialized hospital so that unnecessary suffering, delay in the healing process, prolonging hospital stay or even death is prevented" (Pinkster, 2014).

The objective of Refaja Hospital is:

"To provide emergency care to all patients presented by both GPs, specialists, ambulance, or by the referrer itself. The department provides the care that is high quality, secure and trusted 24/7” (Pinkster, 2014).

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The ED’s interest in lean principles, along with their need to train their staff to improve their own processes, made them a viable client for the adaptive simulation-based serious game.

4.1.4 Identifying the players: the staff of the Emergency Department of Refaja Hospital

The players of this game contain all staff of Refaja; both management and non-management. This ensures that all staff trained to improve their own processes, in a lean context. This matches with the lean notion that employees are able to substitute for each other. However, the model content will be primarily focused on the process setup of medical operations. As a result, the primary target group can be seen as the non-management staff (ED doctors and nurses), while the secondary target group can be seen as the management staff.

4.1.5 The appropriateness of a computer-based game format: confirmed

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4.2 Activity 2a: Determine the modeling objectives 4.2.1 Defining a learning objective

The game’s learning objective was defined as follows:

To teach ED staff the 5S methodology to enhance their skills in improving their own processes. These processes originate from existing case studies from the lectures of the ED, which include various patient scenarios, i.e. a patient with a low blood pressure who needs intravenous therapy.

This learning objective has the following elements: Table 4.2 The elements of the learning objective

Element Reason

5S This matches with the lean methodology of 5S. Teach staff to

enhance their skills in improving their own processes.

This matches with the general lean principles. It enable staff to foster understanding of the bigger picture, increase idea generation, enhance their employability, and reduce boredom and fatigue (Hopp & Spearman, 2011), and improve their companies’ responsiveness to increasingly changing customer demands(Bell et al., 2008; Bellitto & Day, 2009).

Own processes Processes that Refaja staff currently performs. These processes are obtained from the case study scenarios of their lectures.

An element that this learning objective does not include are scenarios for patterns in patient streams that may emerge in the immediate future. The ED’s management states that their current medical patient analysis processes, such as the ABC methodology (appendix V; interview II), already allow for the large variety of patients for today and for the future. Therefore, the game’s learning objectives is particularly focused on the case study scenarios of their current processes.

4.2.2 Extension 1: Determine the sub-learning objectives

For each level of difficulty there needs to be a sub-learning objective which related to game’s learning objective.

Table 4.3 Sub-learning objective of each level of difficulty Mini-games for learning style #1 Mini-games for learning style #2 Mini-games for learning style #3

Level 1: facts, terms To teach the facts and terms of 5S, in a way that the ED’s staff can relate it to their current processes.

Level 2: processes To teach ED staff to apply the 5S, in the way that the ED’s standards dictate. Level 3: process

optimization

To teach ED staff to independently optimize their current processes, by designing rooms using to the 5S principles and experiencing the result.

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4.3 Activity 2b: Determine the general project objectives 4.3.1 Project requirements

The requirements of this project was to illustrate the ‘adaptive’ concept of simulation-based serious games, during the time frame of the thesis project (10 weeks) while keeping costs near zero. In order to meet these targets, this project only required a prototype of the adaptive simulation-based serious game, which was created in Microsoft PowerPoint. The resulting single-player adaptive simulation-based serious game prototype can then be further developed into a real game.

4.3.2 Model Nature

The model nature will be as follows:

Table 4.4 Visualization of the adaptive simulation-based serious game Visualization Details

Language Dutch and English. Since the players (staff of Refaja Hospital) are native Dutch speakers, the game’s standard language is Dutch. Additionally, non-Dutch staff have the option to switch the language preference to English.

Model interaction

Model interaction is added to the game: Player interaction

Level 1 Buttons. To entering the correct multiple choice answer.

Level 2 Dragging. Dragging the items that have piled up, in order to perform the 5S processes.

Level 3 Controlling. Controlling the nurse/doctor to pick the correct items in a simulated 3D environment.

Visualization Visualization is added to the game: Dimensions Visual elements Level

1

2D  Pictures of Refaja Hospital, so that player can link 5S practices to their own processes.

Level 2

2D  Items piling up into chaos, so that players have to perform 5S practices to create a clutter-free workplace.

Level 3

3D  A 3D environment of the ED of Refaja Hospital, so that players can improve their own processes in a recognizable workplace.

Additionally, all levels share the following visual elements:

 A countdown of time, that beats like a heart.

 When there is only 1-minute remaining, the screen starts to vibrate, sirens start to sound, and blood stains may appear on the screen.

 The logo of Refaja Hospital.

 A wiki page where players can read the theory of 5S, so that they can make better decisions during the game.

 Ambulances, doctors, items, and rooms of Refaja Hospital.

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4.4 Activity 3: Identify the model outputs 4.4.1 Determine performance measures

The learning objective, as defined in activity 1, is to teach ED staff the 5S methodology to enhance their skills in improving their own processes. The performance of this learning objective is measured by the players’ ability to meet the process standards under time pressure (i.e. a clock that counts down). This time pressure links to the urgent day-to-day processes of ED staff, in which timely responses can literally save lives.

4.4.2 Explanatory measures

The explanatory measures of performance are as follows: Table 4.5 Explanatory measures of performance

Explanatory measures

Reason Tolerance levels

Countdown of time

To provide the sense of time pressure at each mini-game. This time pressure links to the urgent day-to-day processes of ED staff, in which timely responses can literally save lives.

All mini-games are under 5 minutes, which keeps the mini-game short, and allows for a quick assessment of the player’s knowledge. Since players move up in levels by winning, the short time span of the mini-game allows the player to quickly play at a challenging level, which will ensure a more entertaining and educative game.

Precise times depend on the mini-game (game content; table 4.9).

Items piling up into chaos.

To provide the sense of chaos, which results from insufficiently applying 5S practices, which can lead to an ineffective and inefficient workplace.

Every 15 seconds a new item is added to the chaos. Therefore, the player will need to perform 5S practices at a speed of 15 seconds per item, in order to decrease the chaos.

Delays in process setup times.

To show the effect that an ineffective and inefficient workplace can have on performance.

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4.5 Activity 4: Identify the model inputs

The player can select the following qualitative and quantitative data that can be changed in order to represent alternative system configurations appealing to (alternative) groups of players:

Table 4.6 Model inputs Model inputs Reason

Scenarios The management of Refaja has suggested multiple medical scenarios, to which the player must respond, such as:

Scenario Link to game

content

A patient was involved in an accident with a car bomb See table 4.9 (level 2)

A patients arrived with low blood pressure, who needs intravenous therapy

See table 4.9 (level 3)

These scenarios are also used in the lectures that the ED management currently provides to their staff (as explained in section 4.1.5).

Process setup times.

The process setup times were suggested by the management of Refaja, so that it reflects the real-life process times. Furthermore, it allows them to experiment to see what happens to performance (setup times) when certain processes are improved (faster). An illustrative example:

Scenario Link to game

content A patient arrived with low blood pressure, who needs intravenous

therapy.

 Prepare intravenous therapy system (1 minute)

 Prepare the intravenous therapy shot (2 minutes)

 Prepare the pressure bag (1 minute)

 Prepare the security monitor (1 minute) This should all be done within 6 minutes.

See table 4.9 (level 3)

Extended process setup times.

As a result of insufficiently applying 5S practices, it can lead to an ineffective and inefficient workplace. This causes processes to extend in duration. The management of Refaja can input the duration of this extension, i.e. 30 seconds per missing item (later elaborated in table 4.9; level 3).

Extension 2:

Levels of

difficulty

The shifts between levels of difficulty are as follows: Shift Trigger

To a higher level of difficulty

By winning: If Refaja’s process standards of 5S (i.e. sorting, setting in order, shining, standardizing, sustaining) are met under time pressure (i.e. a clock that counts down), the player advances to the next level.

By the game operator: In addition, the game operator can intervene, in case a player cannot win the level, to enable the player to still play the higher level.

To a lower level of difficulty

By losing: If Refaja’s process standards of 5S are not met under time pressure for 3 consecutive times, the player is sent to a lower level. In this case the current level is locked, so that the player cannot play it until he wins the previous level again.

By the game operator: In addition, the game operator can intervene, in case the player does not have the required knowledge, to send the player back to the lower level. In this case the current level is locked, so that the player cannot play it until he wins the previous level again.

By the player: Lastly, at any point in time, the player can go back to a lower level to improve the required knowledge. In this case the current level remains unlocked, so that the player can still play it.

These shifts between levels of difficulty ensure that players learn at an individualized learning pace, and also measures a player’s progress to the learning objective.

Extension 3: Learning style

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The table above illustrates extension 2 and 3, concerning the model inputs of different levels of difficulty and the learning style. As model inputs, these extension help determining the game content, which is discussed in the following section.

4.6 Activity 5: Determine the model content 4.6.1 Using the Proposed Format

The model content includes the following 4 mini-games: (1) Jeopardy, (2) Elektro, (3) Search in chaos, and (4) Search in scenarios. This is illustrated below:

Mini-games for learning style #1 Mini-games for learning style #2 Mini-games for learning style #3 Level 1: facts, terms Jeopardy

(section 4.2.3)

Elektro (section 4.2.3) Level 2: processes Search in chaos

(section 4.2.3) Level 3: process optimization Search in scenarios

(section 4.2.3)

Learning objective (section 4.2.2)

Figure 4.2 The 4 mini-games of the adaptive simulation-based serious game prototype

These four mini-games illustrate the horizontal and vertical movements of adaptive simulation-based serious games:

Table 4.7 Legend for proposed format for adaptive simulation-based serious games prototype Legend Meaning

The horizontal arrows, which indicate a shift between learning styles, are illustrated in level 1 for the games Jeopardy and Elektro. The player can choose the game that best suits its learning style.

The vertical arrows, which indicate a shift between levels of difficulty, are illustrated in learning style #1 for the games Jeopardy, Search in chaos, and Search in scenarios. The player can only advance to a higher level if the current level has been won. Contrarily, the player is send down to a lower level if the current level has been lost 3 times in a row.

Level 1: facts, terms

Staff learns how Refaja relates to the facts and terms of 5S. Level 2:

processes

Staff learns to apply the first 3S’s (Sorting, Set in order, and Shine), so you can continuously improve the work place design for standard situations.

Level 3: process optimization

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