After a long day at a global health meeting, senior level nurses and midwives huddled over a game board, intensely concentrated. Scrabble addicts? Settlers of Catan competitors? Parcheesi enthusiasts? If you guessed any of the above, you were wrong. The health professionals were playing Maternity Clinic, a serious board game developed by Jhpiego, an international non-profit and affiliate of the Johns Hopkins University that has been a leader in global education since its founding 42 years ago. The Global Learning Office, which supports efforts to build the capacity of health care workers in the countries where Jhpiego works, has begun exploring the use of serious games to promote learning.
From 2012-2014, Jhpiego contracted Smart Game Systems (formerly Smart Green Institute) to develop a serious board game, with input from Jhpiego staff who are experts in the field of maternal/newborn health. The game is played collaboratively in a simulated game environment where perinatal patients enter the clinic (game board) with a variety of care needs. Each player is a designated character, either a nurse, midwife or physician who is allotted a certain number of resources in order to provide care.
The purpose of the game is to promote teamwork and efficient and effective use of a set of resources that reflect what is available to clinicians in reality: human capital (family members of patients), medicines, transport, and inherent character strengths such as empathy, creativity and intelligence. The team of players combine their resources to collectively care for the patients in the clinic beds. The goal of the game is to successfully treat, discharge or refer a sufficient number of patients. If too many patients die or are discharged untreated, then the players collectively lose. The game was successfully field tested in Botswana, as well as at several global meetings.
Playing the game can be frustrating. “Event cards” create barriers that interrupt care, such as “the electricity went out” to “medication stock out” to “ambulance broke down.” At times, the death of patients in the game results from the accumulation of a series of event cards, along with less than ideal use of resources or lack of teamwork. Still, it has been striking how highly rated the game is. This is due to what Smart Game Systems Jonathan Estes calls “hard fun,” which motivates game players and enhances the reward of successfully “beating the game,” or, in this case, avoiding the death of a patient.
Currently, the game is undergoing final changes to character and player card images, before it is ready for widespread dissemination. Based on recommendations from the evaluation study done in Botswana, the recommendation is to use the game in pre-service education, with students of nursing, midwifery and medicine, ideally with representatives from all those groups playing together. Games similar to Maternity Clinic but focused on malaria and HIV/AIDS care will be under development in the coming months.
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