The Journal of Continuing Education in Nursing

NOTES ON CONTINUING EDUCATION

Jeffrey K Zurlinden, RN, MS

Abstract

I DON'T MAKE THE RULES, I PLAY THE GAME

Games are useful instructional tools. Regardless of the game's objectives, the activity directly involves the learner with the subject matter, increases communication between learners, provides a change of pace, and may be a source of humor or an emotional outlet. The National Medical Audiovisual Center (NMAC) offers this definition: "A game involves students in activities, usually competitive, in which there are rules for play and criteria for winning. It does not necessarily reflect reality."1 The game's author defines reality for the duration of the game, and the author provides the learner with a unique series of experiences. Time can be stopped so that each element of a situation may be examined, or long spans of time can be compressed to show possible future consequences of present actions. The sequence of experiences in the game can also be altered from the expected natural course of events. Any element in the game can be exaggerated to illustrate a point. Reality can be changed in any way to achieve the authors purpose for the game. Signe Cooper states that games "... can be used for teaching factual information, changing attitudes, exercising skill, or assessing performance."2 This article describes a board game which presents factual information as part of the initial orientation of registered nurses.

The game, entitled "i don't make the rules, I Play The Game," was written to address an unavoidable learning need of newly hired RNs. Incoming RNs are unfamiliar with a wide variety of nursing department policies and customs which are arbitrary and sometimes unwritten. The policies and customs are not related to the professional practice of nursing and are impossible to know except through experience with the specific orienting institution. Experienced nurses may have to unlearn the policies and customs used by their previous employer before new policies can be assimilated. After participating. in this instructional event the learner will

1 . become familiar with nursing policies and customs concerning dress code, vacation, scheduling, leaves of absence, sick time, holidays, and paychecks,

2. state where policies and customs are available for review, and

3. become acquainted with other orientees.

The last objective uses the activity surreptitiously to enable orientées to build a support group among themselves and help ease their transition to a new workplace.

A game was chosen as. the instructional event rather than a lecture, independent reading, or an audio-visual presentation. Lecture was tried and discounted as tedious and boring. Independent reading was deemed unsuitable because some of the material is unwritten, some is subject to interpretation, and most is tedious to read. An audio-visual presentation would have been more time consuming to produce and more difficult to edit when changes in policy and customs occurred. The game, however, is less boring, more easily edited, and very inexpensive to produce. It presents the information in the same random and fragmented pattern in which it seemingly occurs during employment, and it allows the learner to question and seek clarification at any point without interrupting a lecture or audio-visual presentation.

In brief, the play of the game progresses as each player individually and sequentially moves around the board the number of spaces indicated by the roll of a die (Figure 1). When players land on a sick time, leave of absence (LOA), holiday, policy manual, chance, tradition, vacation, or community chest space they read aloud the top card of that category found on the "administration" board (Figure 2) and follow the instructions of reward or penalty. The cards are arranged in random order within each category. The game continues until…

I DON'T MAKE THE RULES, I PLAY THE GAME

Games are useful instructional tools. Regardless of the game's objectives, the activity directly involves the learner with the subject matter, increases communication between learners, provides a change of pace, and may be a source of humor or an emotional outlet. The National Medical Audiovisual Center (NMAC) offers this definition: "A game involves students in activities, usually competitive, in which there are rules for play and criteria for winning. It does not necessarily reflect reality."1 The game's author defines reality for the duration of the game, and the author provides the learner with a unique series of experiences. Time can be stopped so that each element of a situation may be examined, or long spans of time can be compressed to show possible future consequences of present actions. The sequence of experiences in the game can also be altered from the expected natural course of events. Any element in the game can be exaggerated to illustrate a point. Reality can be changed in any way to achieve the authors purpose for the game. Signe Cooper states that games "... can be used for teaching factual information, changing attitudes, exercising skill, or assessing performance."2 This article describes a board game which presents factual information as part of the initial orientation of registered nurses.

The game, entitled "i don't make the rules, I Play The Game," was written to address an unavoidable learning need of newly hired RNs. Incoming RNs are unfamiliar with a wide variety of nursing department policies and customs which are arbitrary and sometimes unwritten. The policies and customs are not related to the professional practice of nursing and are impossible to know except through experience with the specific orienting institution. Experienced nurses may have to unlearn the policies and customs used by their previous employer before new policies can be assimilated. After participating. in this instructional event the learner will

1 . become familiar with nursing policies and customs concerning dress code, vacation, scheduling, leaves of absence, sick time, holidays, and paychecks,

2. state where policies and customs are available for review, and

3. become acquainted with other orientees.

The last objective uses the activity surreptitiously to enable orientées to build a support group among themselves and help ease their transition to a new workplace.

A game was chosen as. the instructional event rather than a lecture, independent reading, or an audio-visual presentation. Lecture was tried and discounted as tedious and boring. Independent reading was deemed unsuitable because some of the material is unwritten, some is subject to interpretation, and most is tedious to read. An audio-visual presentation would have been more time consuming to produce and more difficult to edit when changes in policy and customs occurred. The game, however, is less boring, more easily edited, and very inexpensive to produce. It presents the information in the same random and fragmented pattern in which it seemingly occurs during employment, and it allows the learner to question and seek clarification at any point without interrupting a lecture or audio-visual presentation.

In brief, the play of the game progresses as each player individually and sequentially moves around the board the number of spaces indicated by the roll of a die (Figure 1). When players land on a sick time, leave of absence (LOA), holiday, policy manual, chance, tradition, vacation, or community chest space they read aloud the top card of that category found on the "administration" board (Figure 2) and follow the instructions of reward or penalty. The cards are arranged in random order within each category. The game continues until all of the cards are read. Figure 3 contains one example of each category of administration cards. The game may be used with groups of five to seven players. The instructor must remain available to answer questions and clarify misconceptions. One instructor can accommodate several groups of learners playing the game simultaneously. The instructor may choose to be an additional player with a small group of learners.

FIGURE 1

FIGURE 1

The game is followed by a debriefing period. According to NMAC, debriefing "... ensures that students (1) understand the nature of the reality represented, (2) can generalize the principles and concepts represented to other contexts, and (3) question the validity of the representation."3 This game's debriefing is structured as a group discussion addressing three sets of questions. The first set of questions is "Where would a nurse look for the information presented in the game?" and "When is it appropriate to rely on the policy manual, a coworker, or a supervisor?" Second, "What is the policy for sick time, vacation, and holidays?" This is the appropriate time to introduce forms such as a vacation request. The last set of questions is "How do you feel while playing the game?"and "How would you change the game?" The answers will indicate if the learner has mastered the material and provide feedback for improving the game. When games are designed to change attitudes or increase the awareness of existing problems, the question "How do you feel?" must be addressed first.

FIGURE 2

FIGURE 2

"I don't make the rules, I Play The Game" was changed through the process of peer review and field trials. Other staff development instructors read the written description of the game before it was played by orientées. The instructors gave opinions and suggestions about the appropriateness of the objectives and the choice of information presented in the game. As a result of field trials with three orientation groups containing five to seven players, the game was changed to speed its play. This was accomplished by changing the command "lose one turn" to "move backward three spaces," increasing the proportion of "holiday, vacation, etc." spaces to the total number of spaces, and increasing the number of "roll again" commands.

An instructors manual is necessary to detail the learning objectves, rules of the game, materials needed, and debriefing procedure. The instructors manual should be complete enough to allow a person unfamiliar with the game to administer it and conduct the debriefing. The instructor's manual is not a players' manual. Some games hinge on information which is withheld until certain points in the game. In other games the learning objectives may be reserved until the debriefing period to allow the player to personally identify and validate the objectives through the play of the game. A complete instructors manual for the game is available upon request from the author.

In summary, "i don't make the rules, I Play The Game" is an example of a board game used to present factual information to newly hired RNs unfamiliar with the policies and customs of the hospital. The orientées responded favorably to the activity and proceeded quickly through the debriefing discussion. A game in this format could be used during the orientation of new employees to present the nursing department policies and customs of any agency. This format could be used with any situation which contains many discrete and arbitrary pieces of information, and where the learners success in the real life situation may depend on formal policies and informal customs. Examples are games describing the ordering of supplies, laboratory requisitions, or billing. The use of games is not restricted to orienting employees, but may be used with experienced employees when the way of doing business in an area changes. This game is presented as an example to be modified.

FIGURE 3CATEGORIES OF ADMINISTRATION CARDS

FIGURE 3

CATEGORIES OF ADMINISTRATION CARDS

References

  • 1. National Medical Audiovisual Center, Educational Training and Consultation Branch: Workshop on Designing Simulation Activities in the Health Sciences, #2. Chicago, National Medical Audiovisual Center, 1981.
  • 2. Cooper S: Methods of teaching - Revisited games and simulation. J Cont Educ Nurs 1979; 10(5):47.
  • 3. National Medical Audiovisual Center Educational Training and Consultation Branch: Workshop on Designing Simulation Activities in the Health Sciences, #4.1. Chicago, National Medical Audiovisual Center, 1981.

10.3928/0022-0124-19840901-11

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