Healthy Competition: Multiplayer Digital Games in Health Education

The focus of this dissertation is on the role of multiplayer digital games in adult education, with a particular emphasis on health education. Although interest in the use of digital games for serious applications has been increasing since the early 2000s, there is a significant gap in understanding on the use of multiplayer digital games in adult education. In the context of health education, there has been a large amount of research conducted in to the use of repurposed commercial games for predicting performance of trainees and health students on surgical simulators. However, beyond this niche research into game based learning is notably less cohesive. There has been some research into the use of digital games in areas such as for delivering insulin management training, but understanding of the processes for widespread application of games based learning in the health sector is limited. Additionally, almost no research has been undertaken into the use of multiplayer digital games in health education, whether it be for tertiary or adult learners. In this dissertation two digital games were developed, implemented and evaluated to explore the value of multiplayer games for supporting cooperation and collaboration in health education. The first game, They Know: Anatomy, was a real time team based strategy game designed to support anatomy revision by second year medical students. The second game, the Qstream: Cancer Cup Challenge, was a team based asynchronous online program designed to reinforce understanding of how to identify and manage adverse events by oncology registrars. A design research framework informed the methodology used in this dissertation. This framework emphasises the need to use multiple iteration cycles to develop a comprehensive understanding of player experiences with the digital games they encountered. Data on participant experiences with the digital games was collected using qualitative methods, including post-game surveys and semi-structured interviews. Between iterative cycles data on participant experiences with the digital games were analysed so that future implementations of the game could be modified to maximise cooperation and collaboration between players. At the conclusion of the study period data collected across all implementations of the digital games were analysed to increase understanding of how multiplayer digital games supported cooperation and collaboration between learners. Findings from this dissertation demonstrate that multiplayer digital games can be used to engage medical students in anatomy revision and medical oncologists in adverse events retraining. This is the first study to look at the use of digital games for either of these demographics. Additionally, this dissertation identified four ways through which multiplayer digital games foster collaboration between players: through the development of a team strategy to win the game, by facilitating !iii shared decision making, by working towards a shared goal, and by creating a sense of investment in a team. Finally, findings from this dissertation contribute to the literature on the implementation of game based learning in adult education. This is an under researched area, but one that warrants further focus in future if game based learning is going to be successfully incorporated into curricula and training activities for adult learners. This dissertation adds to the literature by presenting new knowledge on how and why multiplayer games support collaboration between learners. Additionally, it appears that multiplayer digital games offer diverse, flexible and immersive experiences to adult learners in a way that single player digital games may not. Finally, multiplayer digital games provide new avenues for support self-directed learning by encouraging cooperation between large groups of students in a manner that is not normally achieved in online learning environment

Crafting content: the discovery of Minecraft's invisible digital economy

This thesis presents an ethnographic study that aims at explicating the work of creating content in Minecraft. The existing literature paves the way in understanding Minecraft’s community by providing fragments of what players do. However, the game is studied mainly from a ludic perspective or is treated as a resource to explore distinct research agendas, instead of a field of study in itself. As such, particular phenomena that are situated inside Minecraft’s community are lost. The conducted fieldwork discovered the invisible digital economy that is part of this community. More specifically, the chapters to follow elaborate on the actors involved in this economy, covering their roles, responsibilities and goals. Furthermore, the lived work of content production is unpacked by presenting the various work practices members attend to in commissioning, creating, and delivering Minecraft content. It also becomes evident that there is a complex division of labour at play, which is based on a fragmented infrastructure as Minecraft itself does not support the wide range of activities that are necessary for carrying out the work. Essentially, actors bootstrap the market’s infrastructure by appropriating or even creating bespoke systems for conducting the various work practices that are entailed in this business. On top of that, these systems are utilised for articulation work, which is necessary for tracking progress between the geographically dispersed actors, accounting for conducted work and addressing contingent scenarios. The main contribution of this PhD project is the discovery of this digital economy, which evidently plays a significant role in Minecraft’s current form and development. Additionally, prevailing understandings of Minecraft’s ecosystem are re-visited, re-examined, and re-specified, based on the empirical evidence presented in this thesis. Finally, a number of design implications are raised with regard to addressing the game’s lack of CSCW support

Crafting content: the discovery of Minecraft's invisible digital economy

This thesis presents an ethnographic study that aims at explicating the work of creating content in Minecraft. The existing literature paves the way in understanding Minecraft’s community by providing fragments of what players do. However, the game is studied mainly from a ludic perspective or is treated as a resource to explore distinct research agendas, instead of a field of study in itself. As such, particular phenomena that are situated inside Minecraft’s community are lost. The conducted fieldwork discovered the invisible digital economy that is part of this community. More specifically, the chapters to follow elaborate on the actors involved in this economy, covering their roles, responsibilities and goals. Furthermore, the lived work of content production is unpacked by presenting the various work practices members attend to in commissioning, creating, and delivering Minecraft content. It also becomes evident that there is a complex division of labour at play, which is based on a fragmented infrastructure as Minecraft itself does not support the wide range of activities that are necessary for carrying out the work. Essentially, actors bootstrap the market’s infrastructure by appropriating or even creating bespoke systems for conducting the various work practices that are entailed in this business. On top of that, these systems are utilised for articulation work, which is necessary for tracking progress between the geographically dispersed actors, accounting for conducted work and addressing contingent scenarios. The main contribution of this PhD project is the discovery of this digital economy, which evidently plays a significant role in Minecraft’s current form and development. Additionally, prevailing understandings of Minecraft’s ecosystem are re-visited, re-examined, and re-specified, based on the empirical evidence presented in this thesis. Finally, a number of design implications are raised with regard to addressing the game’s lack of CSCW support