Face-the-Case
Achieving health literacy through
game play
Overview
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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
Game World
Skill shops (3)
 Collaboration Café
 Case room
 Bling boutique
 High score board
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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)
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Skills
Information
Communication
Cultural Competency
Summarizes main concept
Convey instructions
Recognizes own belief system
Applies criteria to variety of information
sources
Body language
Self identifies ethnic group
Eye contact
Expresses biases
Touch
Seeks other's beliefs
Posture
Identifies most major languages in service
area
Synthesizes information to create new
concept
Compares new knowledge with prior
knowledge
Validates understanding of information
through discourse
Find information
Comforting
Communicate with angry person
Identifies most major languages in service
area
Communicate with confused person
Communicate with anxious person
Chooses appropriate methods of
information retrieval
Language barrier
Effectively searches for information
Hearing impairment
Retrieves information online
Intubated person
Retrieves information in person
Aphasic
Refines search strategy
Language specific fluency
Manages information
Create patient instructions
Compose letters, memos and notes
Knows of community support services
Ability to assess client's health literacy
Case Studies in Health & Human
Services
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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
Companion Collaborators
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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
PDA
Holds inventory and status information
 Inventory consists of skill objects
 Status includes
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Case history (solved and unsolved)
 Skill dollar count
 Bling buck count
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Game Activities & Events
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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
Mini-Games
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In addition to buying skills, players will be able to play minigames 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
Narrative Structure
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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)
Game Play Sequence
Info
Emporium
Culture
Bazaar
Login
Review
Case Study
Communications
Market
Face the
Case
Collaboration
Cafe
Buy Bling
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
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Sample Game Play – Step 3
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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.
Sample Game Play – Step 4
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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
Sample Game Play – Step 5
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Step 5: Player enters the Culture Bazaar
and buys two skills
Knows of community support
services
Create patient instructions
Sample Game Play – Step 6
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Step 6: Player enters the Communications
Market and buys one skill
Able to compose letters, memos
and notes
Sample Game Play – Step 7
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Step 7: Player enters the Collaboration
Café and chooses a companion
Lawyer
Sample Game Play – Steps 8 & 9
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Select a cluster of skills from inventory and
apply to active case
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 10 & 11
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Player receives feedback
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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
Audience
1,200 undergraduate allied health students
(e.g. future nurses and social workers)
 Game is aimed at a population of preprofessionals 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
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The Production Team
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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
Technologies
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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.)
Expected Outcome
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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
Is it Fun?
1 Tooth extraction
3 Faculty
meeting
5 Day at the water park
2 Airport security
4 Potluck lunch