Inside a classroom, opportunities to learn about common viruses arise when illnesses cycle through, like the cold, flu and some conjunctivitis. Those ailments often come and go with students spending a couple of days recovering at home. However, the types of communicable diseases that capture the nation’s attention tend to be more deadly, such as Ebola. While students can learn about how these diseases affect the human body and communities through news, books and movies, another platform has proven itself useful as an educational tool: games. By playing games about how relationships and outcomes are tested by more deadly viruses, players are pushed to work together to ensure survival.
Pandemic is a tabletop game that can be used to teach themes of global interconnectedness. Players must work together to rid the board's cities of infection outbreaks. Either everyone wins together, or all is lost. Players choose role cards, each with specific abilities. For example, “Scientists” can eliminate diseases more quickly than other players and “Dispatchers” can move anyone from city to city, regardless of location on the map. In effect, each player has a “power-up” the other doesn’t. Because there is a player limit of four, it can work best when used in a learning station connected to other content strands. It takes around 30-45 minutes to play.
Games tell stories with player actions (known as “core mechanics”). Matt Leacock, designer of the cooperative board game Pandemic, explained how. “I like to create emergent systems that create story hooks, different beats that you can associate meaning to,” he said. “My games try to get positive and negative beats going, one after another. Something good happens and then something bad happens. While that’s going on--the vacillation of hope and fear--I’m also trying to get that feeling of trying to get the next goal, the next rung has to be just within reach. That challenge has to be just enough to keep you in a state of flow. I think of them [games] as story engines and I try to make them hopeful.” In other words, the life-and-death scenarios in health-themed games keep players engaged in a “state of flow,” the psychological concept of being highly engaged in a task.
There are several games in the Pandemic universe. The dice version, Pandemic: The Cure, sets up in minutes, making it logistically easy to integrate into a class lesson. There is no board; rather, there are six tiles, each representing a major region of the world.
Playing as a pathogen presents a different viewpoint for learning. Plague, Inc. is an app game in which players get to take on that role, playing as bacteria, virus and other contagions. “The world is your Petri dish, and you are in there, tweaking the variables,” said creator, James Vaughan. “It makes people look at the whole issue of infectious disease in a way they wouldn’t ordinarily do.”
Vaughan’s background as an economist has played a role in the game’s ultimate design. Plague, Inc. makes a game out of the world’s interconnected infrastructure systems, similar to other “fishbowl” games, like SimCity. “A lot of economics is about reducing the world down into certain models,” he said. “Then you make assumptions and adjust the models. You see the impact and then try to predict how things might work in the future.”
Upon first playing Plague, Inc., it is tempting to “power-up” the genetic makeup of the pathogen to be as lethal as possible. Doing so, however, can result in failure because if all of the human hosts are killed, the disease dies out. “It brings people to well-known concepts about infectious disease, but in a very different route,” Vaughan said. To succeed, players must take into account global health care systems and interconnected travel networks (airlines, shipping lanes), as well as the economies of developing nations.
Rather than points and badges, player performance is tracked in real-time with graphs and charts. “I wanted to see how the data in the model was changing over time,” Vaughan explained. “The graphs were something helpful when I was initially creating and balancing the model. It turned out that it was also something that players found interesting. The concept of infectious diseases is that of exponential growth. You really have to look at the graph to grasp the consequences of that.” Here, students are presented with an opportunity to work with data in a way that is meaningful and embedded to an experience.
The reward mechanisms and intrinsic engagement that games offer can, theoretically, be used to teach the public about health concerns, such as the benefits of getting vaccinated from communicable diseases (especially amidst the re-emergence of measles in the U.S.). One example is Pox: Save the People, from the Tiltfactor studio at Dartmouth University. It is a cooperative board game (also playable for free on iPad) in which “vaccinated” blue chips must surround “infected” red poker chips. Its core mechanic delivers this message: vaccination circles protect society from cured diseases, like polio, measles and small pox.
Authentic assessments, using open-ended questions and rubrics, can effectively gauge student learning with health-themed games. For example, players of Pox can be asked how—and why—vaccination circles work. Pandemic and Plague, Inc. players can write diary and journal notes during play. What’s more, there are historic parallels to how the small pox affected Native Americans, as well as how the plague traveled along the Silk Road to medieval Europe. Connections can also be made to modern epidemics, too: from Ebola to the measles.
Pandemic has expansion packs with additional role cards and scenarios, including bioterrorist attacks. Because it is a paper-based, students can easily modify (“mod”) their learning by making different versions of roles and situations. For digital learners, Plague, Inc. Evolved (the PC and Mac version) features the Contagious Content Creator, which turns players into designers, affording an opportunity to work within Vaughan’s model. So far, the community has recreated historic plagues, like small pox and Spanish influenza, as well as modeled how infectious ideas—like democracy—spread. In 2014, there was a Christmas-themed epidemic, in which happiness spread worldwide.
REAL WORLD CONNECTIONS
When fears of Ebola in the United States rose in the fall of 2014, so did downloads of Plague, Inc. Vaughan harnessed his player community to raise $76,000. He said, “[People] don’t always realize how a community of gamers can come together as a force for good.” Similarly, in December 2014, “Pandemic Parties” raised money and awareness for Doctors Without Borders, the international organization working to treat Ebola in West African nations. As of February 2015, Pandemic Parties collectively raised over $50,000.
In 2013, the Center for Disease Control (CDC) invited Vaughan to speak about public health issues. (The CDC is headquartered in Atlanta, GA, where play begins on the Pandemic game board.) While there, Vaughan had the opportunity to speak to experts about how to use games to increase public awareness of certain health issues. “Plague Inc. isn’t going to teach someone everything they need to know about infectious diseases,” Vaughan explained. “However, it will get people thinking about disease. That’s something the CDC has tried with the public, like with its Zombie Preparedness Kit. It’s impactful because it turns people on their heads a bit.”