CVM @ Innovate: Clinical Cases as Text-Based Games

Earlier this year, Jay Hsiao, Instructional Designer from the Office of Teaching and Learning, participated in the 5-week eXperience Play (XP) Cohort and learned about developing text-based games that provide students opportunities to learn through game play. A similar concept is gamification, in which gaming elements are used in non-game contexts, such as experience points, badges, and leaderboards.

At the 2017 Innovate Conference on May 16, Jay was invited to showcase his work with the cohort during the Steal My Idea session.

In text-based games:

  • Instructors must empathize and think about how non-experts approach a particular subject.
  • Instructors can create simulations that carry students step-wise through complex subjects.
  • Instructors get to have fun and be creative in the process!
  • Students can exercise control over their own learning, think critically and make their own decisions.
  • Students can practice and learn from experience, in an environment where they can fail safely.
  • Students have an opportunity to exercise empathy and consider how others, including experts, may approach a particular subject.

Jay’s project is based on an ophthalmology case developed by Dr. Eric Miller of Veterinary Clinical Sciences, which is currently used in an DVM ophthalmology elective course.

This proof of concept was developed with the free open-source Twine software, which not only provides a very easy way to create text-based choose-your-own-adventure games, but also powerful scripting capabilities for advanced progress tracking, complex logic, and so on. In the Twine-based case, users would first review information relevant to the case, then be presented with a list of diagnostic tests that they can choose to run in an effort to narrow down the diagnosis. Users are given a set amount of budget, and the cost of each test they run would be taken out of the budget.

The case is currently implemented and delivered through OneNote Online, which provides a binder-like interface not unlike a medical file, and allows students to take notes in their assigned section of worksheets.

A similar case simulation tool that is currently being used at the CVM is Dr. Julie Byron’s Case Manager, which is an “on-line teaching system to allow veterinary students to review complicated cases, by applying their knowledge to real world cases and receiving immediate feedback.” The development of the tool has been documented in the journal article entitled Development and Pilot of Case Manager: A Virtual-Patient Experience for Veterinary Students.


Have a cool idea? Feel free to consult with the Office of Teaching and Learning!

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