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Guidelines for designing effective games as clinical interventions: Mechanics, dynamics, aesthetics, and outcomes (MDAO) framework

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Abstract

Games are a successful pedagogical tool to change attitudes and behaviors. This chapter will examine how games facilitate change, discuss common pitfalls, and outline best practices for making serious games for clinical practice. Sustained engagement and motivation are key to lasting clinical interventions. When developing a game for clinical practice, the designer should avoid "punishing by rewards" (Kohn, 1993), damaging motivation towards the desired goal. Understanding game design principles is crucial to creating intrinsically engaging experiences that lead to lasting motivation. The Mechanics, Dynamics, and Aesthetics (MDA) framework is widely accepted by game designers as a framework to make compelling games. Using MDA as a base for understanding how to create engaging experiences, this chapter proposes a new framework for serious games called Mechanics, Dynamics, Aesthetics, and Outcomes. MDAO describes how to design a game that is intrinsically motivating and effective by focusing on the interplay between outcomes and other vectors of design.

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... Several studies have analyzed the various elements of game mechanics. For example, Hunicke et al. (2004) indicated that game mechanics usually include achievements, collections, badges etc. Browning (2015) suggested that mechanics are the controls, tools, obstacles, and rules that limit the ways in which users play. Hamzah et al. (2015) proposed that features such as points, levels, leader-boards, virtual goods, badges, gifts, and charity can be considered to be game mechanics. ...
... Aesthetics represent the emotional responses of players to game dynamics. While dynamics help players to achieve the desired outcomes, aesthetics determine the players' engagement with the game (Browning, 2015). Aesthetics are the results of the players' interactions with the game system. ...
... Playfulness illustrates an individual's intrinsic feelings when they are actively engaged in an exercise (Huang and Hsu, 2014). Playfulness is related to the concept of aesthetics that describes players' emotional responses (Browning, 2015). Second, playfulness motivates game system utilization (Chung and Tan, 2004). ...
By adapting Brunswik's lens model and the mechanics, dynamics, and aesthetics (MDA) framework, this study empirically investigated how perceptions of the game features (mechanics), influence game-challenge reactions (dynamics) and playfulness (aesthetics); these influences affected service experience evaluation. The findings revealed that locatability, navigability, and controllability exert positive effects on game-challenge reactions, whereas navigability and nostalgia had positive effects on feelings of playfulness. Furthermore, the relationship between game-challenge reactions and playfulness was determined to be nonrecursive, and both of these factors positively influenced service experience evaluation.
... It is therefore important, as Bohyun (2015) and Robson et al (Robson et al, 2016) put it, that, the perspectives of both the designer and the player be taken into consideration as one develops a game for learning purposes. Browning (2016) takes this argument further by stating that, in designing games for learning purposes, one should consider both the intrinsic motivation and effective engagement of the player or student, by focusing on the interplay between the outcomes and other vectors of the design. ...
... Aesthetical appearance of any activity is likely to spark more interest in engaging with the content. To ensure that students have fun whilst learning, it is imperative the game has elements of excitement, wonder and engagement (Hunicke, et al., 2004;Bohyun, 2015;and Browning, 2016). In this pilot study the game board made use of different coloured spinal vertebrae as blocks with scattered radiographic images throughout the board, see figure 1. ...
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Gamification is used encourage the learner to participate in a competitive activity, to encourage engagement and desire to learn. In the Radiographic Practice module, students learn three core radiography performance standards; professionalism, technique and clinical performance. To address these standards, a pilot radiography board game was developed to determine its effectiveness at improving engagement and interest with learning material and its use as a teaching and learning tool. A qualitative, explorative descriptive research design was used, involving focus group interviews with the radiography students. The students recommended some changes and adjustments on the game design and dynamics. They further described the board game as a fun activity and demonstrated that it was possible to learn whilst engaging with the subject material and group discussions. The board game enabled the students to apply critical thinking skills and be introduced the concept of professionalism in the clinical setting.
... Nevertheless, there have been many critics for the absence of other game dimensions, like narratives. These criticisms lead to several improvement proposals to update the MDA framework, keeping its systemic approach to game design [11]- [13]. The MDA simplicity makes it very useful for game design and game analysis. ...
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