The Disease Game is a computer simulation designed to aid students in practicing test selection, disease diagnosis and disease management skills. Features of the simulation include a game format, digitized images and videos, and the ability to add additional patients

Reichman, William C

Takamori, Kim E

Thompson, Diana K

English

CommonKnowledge

Pacific University 
CommonKnowledge 
College of Optometry Theses, Dissertations and Capstone Projects 
5-1998 
The disease game: An interactive simulation program designed to 
teach ocular disease management skills 
William C. Reichman 
Pacific University 
Kim E. Takamori 
Pacific University 
Diana K. Thompson 
Pacific University 
Recommended Citation 
Reichman, William C.; Takamori, Kim E.; and Thompson, Diana K., "The disease game: An interactive 
simulation program designed to teach ocular disease management skills" (1998). College of Optometry. 
1259. 
https://commons.pacificu.edu/opt/1259 
This Thesis is brought to you for free and open access by the Theses, Dissertations and Capstone Projects at 
CommonKnowledge. It has been accepted for inclusion in College of Optometry by an authorized administrator of 
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The disease game: An interactive simulation program designed to teach ocular 
disease management skills 
Abstract 
The Disease Game is a computer simulation designed to aid students in practicing test selection, disease 
diagnosis and disease management skills. Features of the simulation include a game format, digitized 
images and videos, and the ability to add additional patients. 
Degree Type 
Thesis 
Degree Name 
Master of Science in Vision Science 
Committee Chair 
Diane P. Yolton 
Subject Categories 
Optometry 
This thesis is available at CommonKnowledge: https://commons.pacificu.edu/opt/1259 
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THE DISEASE GAME: 
AN INTERACTIVE SIMULATION PROGRAM 
DESIGNED TO TEACH OCULAR DISEASE MANAGEMENT SKILLS 
By 
William C. Reichman, BS 
Kim E. Takamori, BS 
Diana K. Thompson, BS 
A thesis 
submitted to the faculty of the 
College Of Optometry 
Pacific University 
Forest Grove, Oregon 
for the degree 
Doctor of Optometry 
May, 1998 
Advisors: 
Diane P. Yolton, PhD, OD 
Robert L. Yolton, PhD, OD 
THE DISEASE GAME: 
AN INTERACTIVE SIMULATION PROGRAM 
DESIGNED TO TEACH OCULAR DISEASE MANAGEMENT SKILLS 
SIGNATURE PAGE 
William C. Reichman, BS 
Kim E. Takamori, BS 
Diana K. Thompson, BS 
Diane P Yolton, PhD, OD 
Robert L Yolton, PhD, OD 
BIOGRAPHY 
William Reichman was born in Lawton Oklahoma and graduated from Pacific 
University in 1996 with a Bachelor of Science Degree in Visual Science. He 
will graduate from Pacific University College of Optometry in May, 1998. 
Kim Takamori was born in Hawaii and graduated from Pacific University in 1996 
with a Bachelor of Science Degree in Visual Science. She will graduate from 
Pacific University College of Optometry in May, 1998. 
Diana Thompson was born in Washington state and graduated from University 
of Washington in 1994 with a Bachelor of Science in Biology. She will graduate 
from Pacific University College of Optometry in May 1998. 
ACKNOWLEDGMENTS 
We would like to thank our advisors, Dr. Diane Yolton and Dr. Robert 
Yolton: Dr. Diane Yolton for her vision to create an interactive learning aid for 
the optometric student and Dr. Robert Yolton for his help in creating and 
"debugging" the Game into a playable as well as educational format. We also 
would like to thank Dr. Alan LeRoy for taking the input from Drs. Yolton and us 
and programming it into the "Disease Game." 
ABSTRACT 
The Disease Game is a computer simulation designed to aid students in 
practicing test selection, disease diagnosis and disease management skills. 
Features of the simulation include a game format, digitized images and videos, 
and the ability to add additional patients. 
INTRODUCTION 
Computer simulations are becoming increasingly popular as an effective 
method for educating students. Simulations allow students to function without 
anxiety and expense of actual patient encounters. They also allow students to 
learn at their own pace and to make errors without significant consequences. 
Recently there has been considerable interest in developing ocular 
disease management skills with Optometry. To help optometry students learn 
these skills, a computer simulation called The Disease Game was created. The 
Disease Game is designed to enhance their ability to select the most 
appropriate tests for a patient with an ocular disease and to use the test results 
to determine a correct diagnosis and management strategy. The Game does 
this by using an interactive format in which the player first selects a patient 
identified only by number from a list of available cases. A digitally recorded 
voice announces that the "doctor's next patient has arrived" and a picture of the 
patient is displayed on the screen. The player then selects various tests from 
pull-down menus. The menus include subjective, vision, anterior segment, 
posterior segment, imaging, lab, and neurologic. As each test is selected, the 
results of the test is shown to the player. If a picture or movie icon is shown 
beside the test name, the player goes to the menu entitles picts or movie and 
selects the picture or movie associated with the test. The picture or movie will 
always be available to view throughout the game after being selected. 
Each test has a cost listed next to it on the pull down menus. When a test 
is selected, its cost is deducted from the patient's fee which is set at $100 at the 
beginning of the visit. The object of the Game is to select only the tests that 
indicated on the basis of the patient's history and the results of previous tests. 
When the player has selected all of the tests he or she feels is necessary to 
make a diagnosis, the diagnosis and treatment option is selected. The player is 
informed that she/he can earn $50 if the diagnosis is correct on the first attempt. 
If the diagnosis is not correct, the Game gives the player a second chance and 
$25 is earned if the second diagnosis is correct. To select the diagnosis, a list 
of the possible diagnoses are given grouped as to anatomical location. The list 
is scrolled and the player selects the diagnosis from the list. The player is then 
told whether the diagnosis is correct. If the first and second attempts at making 
the diagnosis are incorrect the Game gives the correct diagnosis. 
Once the correct diagnosis is achieved, a management strategy needs to 
be selected. The three management strategies that are presented are (1) 
manage by sending the patient away/referral to specialist, (2) managing by 
monitoring and supportive therapy only and (3) manage by using topical TPAs. 
With each of the three categories, a correct option selection earns the player a 
$50 bonus while and incorrect selection earns the player a $50 penalty and 
play of the patient is discontinued. 
If the first option, mange by referral is selected, the player then has a 
choice of professionals to choose from such as cardiologist, corneal 
ophthalmologist, and glaucoma ophthalmologist. 
If the second option, managing by monitoring and supportive therapy 
only, is selected, the player then selects up to three options from a list such as 
warm compresses, lid scrubs, lubricants. 
If the third option, manage by using topical TPAs, is selected. a list of 
drugs is presented and the player can choose up to 3 options. If the drug or 
drugs is correct, then the player needs to choose either supportive therapy 
and/or a return to clinic time. 
A major advantage of the Game is that it can provide an interesting and 
challenging practice experience at a time and place convenient to the player 
and without the need for examination equipment, live patients, office staff, etc. A 
second advantage of working with the Game is that errors are not as costly as 
they would be if they were made with actual patients. A third advantage is to 
allow the player to gain experience with patients not commonly seen during 
their clinic time. 
The Disease Game uses actual patient photos, videos and chart 
information. Adobe Photoshop, Adobe Premiere, Video Fusion, Sparkle and 
Movie Player were used in producing the digital pictures and videos for the 
game. Apple Simple Sound was use to produce the audio portion of the Game. 
HOW TO "PLAY" THE DISEASE GAME 
1. Turn on computer, inset CD. 
2. Double click on CD. 
3. Double click on the Disease Game mw icon. 
4. A screen then appears and scrolls instructions. 
5. Click on the screen to proceed. 
6. Now you enter the name of the doctor and press return. 
7. To open a patient, go to the file menu and scroll down to open patient. 
8. List of patients are presented in the control box and click on the patient 
that you would like to play. It should then become highlighted. 
9. Click on open. 
10. It will then show the patient you have selected. 
11. Click on open. (Note: to open the patient faster, you can double click on 
its name.) 
12. A picture of the patient is displayed. To proceed, click on the close box in 
the upper left corner. 
13. Now the game begins. 
14. Select from the menu display a test you would like to purchase (ie. 
subj, vision, ant, post), scroll down to a specific test in the category and 
release the mouse. The test results will appear. 
15. Continue selecting specific tests that you think will help you in the 
diagnosis and treatment of the disease. 
16. Occasionally an icon will be displayed beside the test name, one for 
movies or pictures. To view these, go to the menu entitled picts or movie, 
scroll down and select the movie or picture you just purchased. These 
picture and movies will always be available to view throughout the game 
after being purchased. 
17. To view the picture, after the mouse is released on the picture you have 
selected, the picture will show up. To continue playing the game, click on 
the close box in the upper left corner of the picture. 
18. To view a movie, after the mouse is released on the movie you have 
selected, the movie will show up. In order to play the movie, click the 
play button that is located in the lower left hand corner of the control box. 
Some movies have a scroll bar at the bottom of the control box that 
allows you to select individual frames of movie. 
19. When you feel confident that you have enough information to diagnose 
and treat, go up to the file menu , click the mouse and scroll down to 
diagnosis and treatment; then release the mouse. 
20. A screen appears advising you that you can earn $50 if you correctly 
diagnose it the first time, otherwise you have a second chance. Click 
continue in the control box. 
21. A list of various ocular structures where the disease is located and a 
scrolling list of possible diagnoses along with ICD-9 codes appears. 
Select the ocular location first. This moves the diagnoses and ICD-9 
code scroll list to that area of anatomy. 
22. Click on the diagnosis you think is correct and then click on enter. 
23. If your diagnosis is correct, control box for management strategies 
appears. Now select one of the three managements by clicking with the 
mouse. 
24. If refer the patient has been selected, next select an appropriate referral 
source and you will be given credit for the patient. If you select the wrong 
referral source, you will be shown a correct choice in addition to your 
choice. This will end your encounter with this patient and now you can 
choose another patient to play. 
25. If manage with supportive therapy only is selected, select the proper 
therapy (up to three can be selected). 
26. If manage with supportive therapy only was selected, and a correct 
therapy was then selected, the player will be given credit for the patient. 
If the player selected a wrong supportive therapy, a correct one will be 
shown in addition to your choice. This will end this patient and now 
another patient can be played. 
27. If manage with drugs is selected, select the proper drug or drugs from the 
alphabetical list (up to three can be selected). The player is now 
prompted to select a supportive therapy (if appropriate) by clicking on the 
ones chosen (up to three can be selected). 
28. If manage with drugs and supportive therapy was selected and if your 
choice is correct, you will be given credit for the patient. If your choice is 
wrong, a correct drug(s) and supportive therapy will be shown in addition 
to your choice. This will end this patient and now another patient can be 
played. 
29. If either manage with supportive therapy only or manage with TPAs was 
selected, you then need to selected an appropriate return to clinic time. If 
correct, you get credit. If not, you are penalized. Either way, the patient 
encounter is complete and you can choose another patient. 
CONCLUSIONS 
The goal of this project was to create an interactive software program 
simulation to aid in teaching disease management skills. The program has 
been completed along with 17 simulated patients. The students who have 
played the game have found it to provide an interesting and challenging 
educational experience. As more simulated patients are created, the value of 
the Disease Game will increase. But even in its current form it demonstrates the 
value of computer simulation in education. 
The next step for the "Disease Game" will be developing more patients 
for the students to play. In addition , The Game may be used on the Internet by 
presenting unusual patients on Pacific's Web Page or as part of a continuing 
educational program. 
COMPUTER REQUIREMENTS 
The Game will run on a Macintosh computer with (1) a CD player, (2) 
system 7.5 or newer operating system, (3) a 68040 or better processor, (4) a 
minimum RAM of 4Mb, and (5) Quick Time 2.5 or better. 


The disease game: An interactive simulation program designed to teach ocular disease management skills

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The disease game: An interactive simulation program designed to teach ocular disease management skills

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