Using games to aid learning is a growing field. The software is often used for business modelling but not always. Blitz Games Studios is developing software to help medical staff who have to deal with trauma scenarios. Henry Tucker scrubs up to investigate.

Back in 2005 to 2006 Blitz Games was looking at the opportunities for diversifying into the field of serious games using its underlying technology and the skills of its staff to create engaging entertainment games.

Mary Matthews, Strategy and Business Development Director at Blitz Games Studios, explained where the idea came from.

'The catalyst for the software is twofold. One was the work being done in the United States, particularly with America's army, which started off as a sort of recruiting tool, and became a training tool as well. Secondly it followed on from conversations we had with Professor Bob Stone at the University of Birmingham, who is probably one of the world's foremost experts in this and in the human computer interface.

'The University of Birmingham also had connections with the Royal Centre for Defence Medicine, which is also based at the University. They were looking at what was going on in America, so, as a result, the Royal Centre for Defence Medicine wanted to test the potential for game-based learning in a medical scenario.'

When Blitz started looking further into the idea, the question came up: 'What kind of subject matter experts and what kind of expertise would you have to buy in, to take us as an entertainment games developer into this new field?' Mary said that Blitz was determined to create a game that was not only engaging and entertaining, but would 'make a difference and deliver validated learning'.

Trauma Trainer

The result was the first prototype of Interactive Trauma Trainer. The idea was to look at whether it was possible to create a game that would support medical staff who might be posted to a battle zone, perhaps unexpectedly or after a period of time. In this situation they would have to do a different kind of medical practice, and would therefore need to refresh their skills in trauma medicine to prepare them for the problems they might face in such conditions.

With the Royal Centre for Defence Medicine the staff at Blitz visited some front line medical operating situations to get an idea of what they are like. They took reference photographs and looked at how everything was laid out, how people moved around and what kind of equipment they used. The Blitz team then recreated it all with one particular scenario, which was somebody bleeding from a wound in the neck.

In this initial version there were three roles you could play: a nurse, a doctor and an anaesthetist and you could swap between those roles according to the skills that would be needed at any one time as the scenario played through.

The first thing that you had to do was discover the cause of the bleeding and then try to stem it. If the player took the wrong route and the bleeding wasn't stemmed, this could lead to further complications; the airway might become blocked and then they would have to do an emergency intubation to help the casualty breathe.

Track progress

Once the player has completed the task, it's possible to check the progress of each decision they made. This way the trainers can set particular goals. They could say that the players should do X within a certain time frame and then Y. The player's performance could then be measured against those time frames. The trainers could check the performance afterwards to see if the players had intervened correctly at the right time.

'The Royal Centre for Defence Medicine were thrilled with the results and found it extremely helpful, but it remained as a prototype. They didn't take it any further at the time and I don't know whether it ever will, to be honest. It was a useful experiment,' Mary said.

This was followed up in October 2005 when the DTI, as it was known then, offered an open competition for funding, grants for research and development in areas that were going to be important for the future of UK Plc, and for the first time this included simulation and modelling.

Expert consortium

Blitz applied, and built a consortium with the University of Birmingham, University of Sheffield, Birkbeck College London and a company called Select Systems International, as they brought expertise in learning systems management and training needs analysis.

There was also a consortium of smaller specialist partners one of whom was Advance Life Support Group, which is a medical education charity that advises NATO on triage, Coventry Centre for disaster management and also a firm of London architects called GMJ that has a virtual model of London, which is extremely accurate.

The idea behind working with the Royal Centre for Defence Medicine was for Blitz staff to meet senior MoD medical staff and also to attend a triage exercise. When they did this they were amazed to see that during the exercise staff just put tags on people and laid them down on the ground. All that was written on the tags were vital signs and they thought there had to be a better way of doing this.

Having realised this, the Blitz team asked themselves some more questions. Is it as engaging and as realistic as it could be? How much does it cost to get these casualties to come in and lie down, and get the trainees to the centre to walk round and read the tags? If the software could be realistic and cost less to run, only then would it be viable.

Triage Trainer

Triage Trainer is what came out of these findings and at first glance it looks a lot like your standard entertainment computer game. The setting is just after a bomb blast and there are a number of casualties that need to be assessed and treated.

The game demands that you check certain things in the right order and then the player decides what they think is wrong with the patient and what treatment they require. During this time the patient's heart rate and or blood pressure can change, which could signify other complications.

In the current version of Triage Trainer each player has up to 10 casualties to deal with. Their trainer can set how many they need to deal with depending on how they want to test them.

These can have a combination of 30 different injury types, which are based on the real injuries that the Manchester Royal Infirmary had to deal with after the IRA bombing in Manchester in 1996. In the current build, all the patients look the same but the plan is to make them as varied as possible.

No guessing

Not only does the game show the trainers how the person has done in terms of whether they got the diagnoses right but it can also show if they got things right by guessing. This is because a lot of emphasis is placed on doing things in the right order so that things aren't missed.

Just as with entertainment games, making the setting look as realistic as possible is very important. Blitz has lots of experience of doing this, so as well as the people crying out in pain there are sirens going off and other noises.

Although Blitz has considered haptic devices, such as controllers that vibrate, and other sensory additions to make the experience even more lifelike it doesn't currently use them. The reason for this is that the game is browser based so that it can be run almost anywhere without needing specific equipment.

'It's a point and click interface, so that anyone who can navigate a webpage can do this, because some initial research about the profile of the kind of users indicated that they were slightly older, with quite a high proportion of female workers, who did not feel comfortable with the idea of games and games consoles, but who were perfectly comfortable with PCs and web navigation,' Mary explained.

Understandably this sort of learning isn't suitable for everyone but in control trials, compared with traditional written assessment, the game playing group were more accurate in prioritising casualties and treatment and in following the correct steps.

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