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Literature Review Coursework 1 B00191906 , B00187790 , B00186941


For Prof. Thomas Connolly & Dr. Thomas Hainey

1. Abstract Serious games use the technologies of gaming to create fun, motivating games that invokes learning. In order to create an effective serious game, the content and assessment integration both have to be effectively understood in order to implement educational content and learning outcomes to learners. Serious games could be advantageous to sex education in the classroom. The content and assessment integrated within the games must be entirely relevant to the audience and teaching environment. Our paper discusses the impact of such a serious game within sex education and how effective it may be to impart sexual health knowledge to a young audience in schools.

2. Introduction Sex education in schools has been described as lacking by learners because of the quality of lessons students receive. Research which we have discovered found that 26% of pupils in secondary school do not receive sex education and the information that they do get can be unreliable. Sexual education should be positive and respectful, which should empower young adults to live healthy lives after their time at school. Our research regarding serious games found that assessment is a vital part of evaluating the success of learning. There are many factors which influence the success or appropriateness of the form of assessment in serious games. Game based learning (GBL) in sex education is venerated by researchers as a positive method of communicating sexual health. Conception is often taught at schools that have sex education and by using as serious game we believe that it will give learners a fun and motivating alternative to traditional pedagogical methods. Serious games offer the learner encouragement and motivation for the subject they are attempting to learn: particularly sexual education games. We decided that in order to solve the problem of poorly implemented sexual awareness in schools, we have designed a serious sex game that prompts the learners to guide a sperm through stages of impregnation, through the vagina to reach the ovum in order to develop an embryo leading to the foetal stage. The game will engage players with a variety of gameplay styles, while still conveying learning content. Problems which our game aims to address are the need for sex educational content for those which are not taught in schools and to provide positive awareness of sexual health to young adults who may have the wrong interpretation of their sexual health. This game could offer those who are not formally taught a quick and fun alternative. Regardless of the knowledge being taught in schools, pupils still find themselves misunderstanding facts. As the subject has no formal tests which would determine if students retain knowledge, this game will not only teach pupils; it will assess their performance and give the appropriate feedback to reinforce the educational content. Moreover, challenges we are expecting in development is how we could relate the gameplay with the stages of conception. Sex education is still a sensitive subject, we are challenged to present the game in an appropriate style to not offend. This paper intends to highlight the usefulness and appropriateness of GBL in sex education.

B00191906 1. How have other researchers addressed the overall problem area? Game based learning in a subject as sensitive as Sexual Education is both rare to find and very often done poorly. It is an area that has barely been tackled, yet could provide an extremely engaging way to teach young people about the processes of conception, sexual health and more.

One previous example of a game made for such a topic can be found on Channel 4’s website. In March 2009, Channel 4 produced a documentary detailing the epic journey sperm cells take on their mission to fertilize an egg, called “The Great Sperm Race”. Alongside this critically acclaimed documentary, Channel 4 also commissions a Flash game for visitors to play on their website. The game is prefaced by a warning that it may not be suitable for children younger than thirteen. Using bright bold colors, a relaxing soundtrack and short, effective stages, the game challenged players to take control of a sperm cell in a frantic race to fertilize an egg. Between stages, the game would present the player with facts about the different stages and challenges the player would come up against. It is an effective tool for teaching small facts to a younger audience, and was generally well received amongst those that played it. A small minority however found the game immature and offensive, believing that it was unsuitable for a younger audience. Unfortunately, besides some user comments on the site for apparent teachers who used the game in their classes, no information can be found regarding the effectiveness this game had as a learning tool.

Channel 4 had a second attempt at commissioning a sexual education game with “Privates”, released in 2010. A much more traditional video game, it features a squad of small animated characters tasked with invading peoples private parts and cleansing them of STDs and other conditions. With a much more modern style of gameplay, “Privates” was aimed at teenagers of all ages who regularly play more standard video games. Throughout the levels, a narrator will provide facts about the area of the body you are currently playing in, the conditions you are fighting against and ultimately aims to provide useful knowledge in a method teenagers are already familiar with. The game garnered a lot of controversy however from various different groups, including feminist organizations, who argued that the game depicted woman as nothing more than disembodied genitals made for conquering. The developers of the game, Zombie Cow, have openly admitted that they were aiming for the teenage male demographic with their game, however never intended to promote misogynistic ideas. The game was also blocked from being released on Microsofts Xbox Live Marketplace, due to the subject nature and depictions of genitalia. Despite the controversy, “Privates” was awarded with a BAFTA in 2011, and is still one of the most original takes on the sexual education subject so far. Another site, called KidzWorld, produced a short interactive trivia game called Quiz! Sexual Education 101. As the name implies, it aims to teach teenage children the dangers of sexual transmitted disease, conception and sexual health. Consisting of

ten multiple choice questions, the user receives immediate feedback after each answer, including whether they were right or wrong and a short paragraph or two about the questions subject. At the end of all ten questions, the game ranks you with a bronze, silver or gold medal, and either berates or congratulates you based on your score. The game uses kid friendly slang and phrases to try and connect with it’s audience, which unfortunately limits it’s demographic somewhat as time goes on. It also seems to push a complete abstinence agenda on the user.

The Middlesex-London Health Unit has produced two games aimed at teaching teenagers the dangers of sexual transmitted deceases. “Adventures in Sex City” and “Adventures in Sex City 2: Alcohol and Substance Abuse” are both very tongue in cheek, comedic takes on the problem. Tailored towards a more immature target audience (but no less important), the games feature a parody superhero squad named “The Sex Squad”, featuring members with names like “Captain Condom” and “Wonder Vag”. After a lengthy intro in which an evil villain named “The Sperminator” is shown terrorizing a city, the user takes control of their character of choice as they answer a series of trivia questions. Again, the user is presented with immediate feedback on their decisions with short paragraphs of information relevant to the questions.

Ultimately, and despite Channel 4‘s best efforts, most of the sexual education games available for play online consist of nothing more than question and answer titles. These types of games have many drawbacks. For one, they assume the user has prior experience in the subject matter, rather than trying to teach the user new information using unique techniques that become available with games based learning. By simply asking the user multiple choice questions, the user is not learning through engagement, but failure. Only when the user has either answered (or guessed) the question right or wrong do they gain any new information about the subject matter. The user will progress through the game whether they answer all questions right or wrong. This is where games such as “The Great Sperm Race” and “Privates” really gain an advantage over the competition. By providing the user critical information before and during gameplay, and then testing the users memory of it by challenging them in game, the user has to learn in order to progress. Combining relevant factual information with gaming concepts gives users who are accustomed to video games a memory hook that is harder to forget than simple questions and answers. In engaging with a users already established method of learning, these types of games can be very effective in teaching new information to persons who would normally rather forget it.

REFERENCES Channel 4, The Great Sperm Race Game [Online] Last Accessed 11/01/2012

Channel 4, Privates [Online] Last Accessed 11/01/2012 KidzWorld, Free Sexual Education Quiz [Online] Last Accessed 11/01/2012 Middlesex-London Health Unit, Adventures in Sex City [Online] Last Accessed 11/01/2012

B00187790 How have other researchers addressed the problem of integrating content into a serious game?

2 Content Videogame content has two forms: multimedia and gameplay. Multimedia content includes music and sound effects, 3D and 2D models, animations images. Gameplay is seen as what players can do inside the game. Content in videogames can be further divided into two groups: assets and behaviours (Gomez-Martin, GomezMartin and Gonzalez Calero, 2012). Assets are the elements that go into the game that can be seen (textures, 3D models) or heard by the player (sound effects, music). Behaviours are the interactions that can be done by the player with game objects and the reaction depending on the players own actions. Games based learning will use these forms of content to introduce educational content.


Content in Commercial Games.

Generally content in video games would include physics; for player and object movements, collision between objects. AI; scripting pathways for characters, planning. Graphics; environments for players to play in, characters, objects in game. Sound content could include music, sound effects for different interactions and voice over. Story is often found in games and use of cut-scenes would advance plots further. Downloadable content is not often used to supply players with extra content. For a fee, players can buy extra features such as new levels for the single player campaign and map packs for multiplayer gaming. Equipment and clothing is often sold as DLC to alter the looks and aesthetics of playable characters in game. As different games will vary in gameplay; strategy, platformers, action, etc. content would vary from each game to provide different forms of entertainment (Routledge, 2009).

2.2 Content in Serious Games Content required in serious games differs from traditional video games. In serious games content for learning has precedence. Before learning content can be integrated into a serious game we must understand what content is. Aldrich (2004, 2005) details a variety of content types: linear, cyclical, system and open-ended. Linear content, movies or a book are examples of content that moves the user along a set path to the end with no deviation. Linear content is regularly used for education and training: books, lectures. Cyclical content is performing an activity repeatedly, in time the actions and approach will improve. Aldrich defines cyclical content as ‘DNA of video-games’ (Aldrich, cited by Seeney, Routledge, 2009). System content puts the user in an environment with realistic conditions and external factors. Open ended content presents content with no set experience. There is variety as the game should rarely repeat twice and no right or wrong path.

2.3 Intrinsic and Extrinsic Content Engaging students with intrinsic content is known to stimulate learning. Students who are motivated intrinsically will enthusiastically pursue a task as they find the educational content interesting and will study to benefit themselves in order improve their knowledge (Hainey, 2011). Two other content categories are intrinsic and extrinsic content. Intrinsic games has learning content integrated into the framework of the game. This type of content allows users to play the game and learn from it. Extrinsic games do not have the learning outcomes as integrated with the gameplay. These games have the learning and gaming separated, an example would be answering a test after completing the game. Training and e-learning tends to use linear and extrinsic content. Games can use a combination of the content categories, despite games allowing a variety of content types, the difficulty is combining the different content types so they seamlessly blend together with the learning content to effectively convey the learning outcome. “The balance of content with affective components within serious games is a delicate one and in order for the application to be effective, the right balance must be achieved.� (Seeney and Routledge, 2009) Malone and Lepper (1987) identifies four different factors for intrinsic motivational learning that could be applied to design intrinsic content; challenge, curiosity, control and fantasy. Having the users challenged is often used to reinforce theories for intrinsic motivation. Making a challenge too difficult or simple will not promote much intrinsic learning. To stimulate intrinsic motivation, the learning content should be at a moderate level of difficulty. Literature reviewed by Tang, Hanneghan and Rhalibi (2009) found learners who are required to use problem solving were engaged with challenging learning contents. In games, goals are seen as an important appeal for the players. To continue intrinsic learning, tasks are set for the players. Short term and long term goals can effectively be set throughout the course of a game for a motivational experience. A degree of randomness should be present to vary the level of challenge as player’s progress. Players curiosity can be stimulated with contents often found in games, such as; graphics, light, sound and manipulating the level environment. This is known as sensory curiosity and is used to engage a player. Choice is a high intrinsic factor for example giving the players the ability to decide how they will approach tasks, the decision to choose what content they want to learn first so they can learn at their own rate, difficulty of game.

2.4 Endogenous and Exogenous Content Appelman & Goldsworthy (1999) identifies in order to create an effective learning environment would require the designer to balance the density of the content with the players ability to understand the content presented to them as they progress through the game. Most serious games are classed as endogenous games but it is

common to have exogenous elements. Research has shown players retain most knowledge when a game with intrinsic learning content is effectively coupled with fantasy content (Robert F. Kenny, Glenda A. Gunter, 2007). Games tend to have elements of fantasy to draw in the players, Charsky (2010) explains fantasy elements give players exciting gameplay and motivation to continue playing. Fantasy can be put in two categories: exogenous or endogenous. Exogenous fantasy is where learning content is used as a reward, an example the plot advancing. These incentives are given to the player for successfully completing a level or correctly approaching a task. These games are often referred to as drill and practice. Endogenous educational games have the gaming and learning content presented together at the same time. The games fantasy content goes towards the player’s knowledge.

2.5 Procedural Content In game content that is created during the runtime of a game, for example; sound effects, graphics, NPC’s. (Nitsche, 2006). Procedural content was used in early games since it was the only way to fit vast amounts of data into the limited data storages. Nowadays developers tend to use prefabricated elements.

3. How to Integrate Content into Serious Games The purpose of serious games is to successfully integrate learning objectives with elements found in traditional video games such as playability and entertainment. Before the serious game is developed, content must be decided first. Developers must integrate content that is relevant to the learning outcome and ensure the content is effectively communicated to the user. In order to effectively motivate the player and maintain their interest; game time and learning time must be balanced (Sauvé & Samson, 2004). It is common then for educational game designers to follow certain steps to segment content in a serious game. The first step would be to decide the subject to be taught and the target audience. Determine the major content segments from the learning objects and the target audience. Describe the content elements and relate them to the specific tasks and the larger segments and finally come up with questions or items for every content element. Guidelines for effective serious games have been extensively researched. Research carried out by Whitton (2009 citied by Karshenas & Haber, 2012) determined six key criteria’s for effective learning. Content should stimulate active learning and drive the player to test different routes or ideas and provide the necessary feedback for them to reflect upon. Engaging the player is important for a serious game, by allowing interactive content and control in the learning environment it will engage the player to delve into the game further. The game must suitable for the choice of subject. Goals must be parallel to the learning outcomes. During the game, support should be given to the player throughout to prevent them being stuck at one point. Since different players will have different prior knowledge of the game type, the game should facilitate those with or without experience.

Another guideline for integrating content, specifically pedagogical content, seamlessly into game play by Tang and Hanneghan (2010) states goals in the game must be clear. As the user progresses through the game, the game should become more challenging while still plausible to complete. Content should stimulate the user’s abilities and is in detail. By playing the game and completing the objectives, the knowledge gained from the learning outcomes should be transferable to the real world. The completion of the challenges should be down to the players own abilities by understanding the learning content. Players should be given feedback on their performance to aid them and when mistakes are made the appropriate feedback should be given so they can recognise their mistakes and learn from it. A separate guideline was formed for implanting pedagogical content. Teaching content can be integrated into elements often found in games such as storytelling.

4. How Content is integrated into our game. Sex education in schools to this day is still a sensitive subject and debated whether it should still be taught in primary or secondary education. It is important to have content suitable for the target audience and presented tastefully without being too explicit. For our game we intend to teach human conception; by guiding the player through each stage of the process. To effectively sustain the attention of the player we can apply the design model proposed by Gagnes(1977) the Nine events of instruction to our serious game. Like many video games we intend to draw in the player’s attention through appealing art, animations, sound and gameplay. Variety is important to maintain interest. As the players progresses through each level, gameplay will change to present new challenges. Educational content and learning outcomes will be presented before each level begins. Instructions will be presented on screen and will tell the player the interactions that can be made and the objective of the level that will relate to a stage during conception. This game will contain both endogenous and exogenous content. Before and during the game the player will be given information on conception. It is important to integrate the educational content with gameplay, we will do this by having the player control a sperm making through the female reproductive system. Gameplay will revolve around what the sperm would have to deal with through each stage of the reproductive process. For example avoiding white blood cells which would kill sperm. To ensure the player knows how they are doing during the game, there will be graphics to show the players health bar and progress in the game. Feedback will be given to the player during the game if they are failing to progress or continually fail the objectives. Should the player game over they will be told why they failed and be given an explanation relating to the actual process of human reproduction. By following Keller's(1987) there will be multiple levels, each level will play differently from the last to give a variety of game play styles to the player.

REFERENCES Marco A. Gómez-Martín, Pedro P. Gómez-Martín, Pedro A. González-Calero. (2009). Games- Based Learning Advancements for Multi-Sensory Human Computer Interfaces:

Techniques and Effective Practices. Chapter 7: Content Integration in Games-Based Learning Systems Aldrich, C. (2004). Simulations and the Future of Learning: An Innovative (and Perhaps Revolutionary) Approach to e-Learning. San Francisco: Pfeiffer Aldrich, C. (2005). Learning by Doing: A Comprehensive Guide to Simulations Computer Games, and Pedagogy in e-Learning and Other Educational Experiences. M. Seeney and H. Routledge (2009). Games-Based Learning Advancements for MultiSensory Human Computer Interfaces: Techniques and Effective Practices, Chapter 6. Dennis Charsky (2010). From Edutainment to Serious Games: A Change in the Use of Game Characteristics. Games and Culture 5(2) 177-198 Sauvé, L., & Samson, D. (2004). Evaluation report on the Mother Goose generic game shell for the project Generic games: Multipliers of Canadian multimedia educational content on the Internet. Québec, QC, Canada: SAVIE and Fonds Inukshuk inc. Robert F. Kenny, Glenda A. Gunter (2007) Endogenous Fantasy – Based Serious Games: Intrinsic Motivation and Learning. International Journal of Human and Social Sciences 2:1 2007 Saeed Karshenas, and David Haber (2012) Developing a Serious Game for construction planning and scheduling education: Construction Research Congress 2012 © ASCE 2012 Tang, S., Hanneghan, M., & El-Rhalibi, A. (2009). Games- Based Learning Advancements for Multi-Sensory Human Computer Interfaces: Techniques and Effective Practices. Chapter 1: Introduction to Games-Based Learning. Liverpool John Moores University, UK Tang, S. and Hanneghan, M. (2010), "Designing Educational Games: A Pedagogical Approach," in Design and Implementation of Educational Games: Theoretical and Practical Perspectives, P. Zemliansky and D. Wilcox, Eds., Hershey, PA: IGI Global, ISBN13: 9781615207824, pp. 108-125. Gagne, R. (1977). The Conditions of Learning. New York: Holt, Rinehart and Winston Appelman, R. (2007). Serious Game Design: Balancing Cognitive and Affective Engagement. Digital Voodoo Review. Retrieved 28th April2008. URL: < Itemid=9> Keller, J. M. (1987). Development and use of the ARCS model of motivational design. Journal of Instructional Development, 10(3), 2- 10. Malone, T.W., Lepper, M.R(1987) Making Learning Fun: A Taxonomy of Intrinsic Motivations for Learning: Aptitude, Learning and Instruction. Volume 3: Conative and Affective Process Analyses Connolly, T.M., Boyle, E.A., Stansfield, M., Hainey, T.(2011) The differences in motivations of online game players and offline game players: A combined analysis of three studies at higher education level(2011) Computers & Education 57 (2011) 2197 - 2211.

Nitsche, Michael/ Ashmore, Calvin/ Hankinson, Will/ Fitzpatrick, Rob/ Kelly, John and Margenau, Kurt, 'Designing Procedural Game Spaces: A Case Study' in: Proceedings of FuturePlay 2006 (London, Ontario October 10-12, 2006) (digital proceedings) Routledge, Helen (2009) Games- Based Learning Advancements for Multi-Sensory Human Computer Interfaces: Techniques and Effective Practices. Chapter 16: Games-Based Learning in the Classroom and How it can Work


5. How assessment is integrated into serious games – Sex Education 5.1

What is assessment to humans

To ascertain an accurate representation of how to integrate assessment into a sex education video game in schools, we must first understand what it means to assess. Assessment involves a process of evaluating information. This process involves determining what a valuation of success equates to for the assessment to contain any benefit to the learner. We assess to measure if someone has learned from their experience and if the method of teaching has been of any benefit to the learner. According to Mislevy et al., (2003) assessment is a: “machine for reasoning about what students know, can do, or have accomplished, based on a handful of things they say, do, or make in a particular setting.” The final product of the learning should not simply be a consideration in assessment, but also the people desiring to be taught. Evaluating people's method of learning is important - particularly in a school classroom environment where there are many young people requiring to learn. An individual’s learning style could be viewed in such a way using Blooms Taxonomy of learning. As Mary(2005) professes, “Bloom's Taxonomy is a multi-tiered model of classifying thinking according to six cognitive levels of complexity.” He defines three domains of learning which are categorised into a cognitive scale: from the top of the series, working downwards is: "evaluation, synthesis, analysis, application, comprehension and finally knowledge." From Benjamin Bloom's calculations, learning cannot be achieved on the higher level on the scale before a lower segment of his taxonomy has been emblematised within the learner. Figure 1 shows Bloom’s taxonomy.

Fig 1: Blooms Taxonomy of learning

People learn using different procedures to enable them to conceive a particular aspect of the learning material. Blooms Taxonomy deduces that people will not be able to expand on knowledge without first evaluating, by themselves, what the

content is attempting to permeate and influence them to recognise why the information is correct. Blooms metacognitive theory provides an understanding of aptitude and provides a substructure of evaluating how a person may learn. Yet, it is not always a precise logical process to consider Blooms theory of how people learn. It is substantial to determine whether learning is an internal process or a series of external inputs and outputs. The human brain itself has not been understood by neuroscientists and they themselves have not given a complete answer. According to Sporns et al (1994) “A long-standing controversy in neuroscience has set localisationist views of brain function against holist views.“ These contestable views points conceptualise that there are many ways to interpret the internal processes of the brains of vertebrates. The complex nature of the brain makes it challenging to distinguish how someone has learned content without extensive research of the parts of their brain which control their actions. Evidential outputs of what the brain has processed (for instance, results of a written test) would therefore be an easier method of understanding whereby someone has learned: and an arguably more accurate method compared to the yet to be completely understood psychology of the brain. Assessment may therefore be examined under the following principals of learning:   

Cognitive: mental skills (Knowledge) - What the learner is capable of learning and what the learner already knows about the subject. Affective: growth in feelings or emotional areas (Attitude) - How the learner reacts to certain areas of the learning process. Psychomotor: manual or physical skills (Skills) - What physical abilities has the learner got to enable them to learn new information. Chen and Michael (2005)

Mitgutsch (2008) supports that assessing learning has more concern presently with how humans understand the content which is being provided to them which support the theory of the afore mentioned principals of learning: “Digital Game-Based Learning in the twenty-first century (cf. Prensky 2002) postulates a specific perspective on the process of human learning. While traditional theories of learning concentrate on the content of learning, and fathom learning under the condition of teaching (which goes back as far as Plato’s Menon, cf. Mitgutsch & Sattler 2008), today’s typical theories focus on cognitive processes and try to locate acts of learning in the human brain.” To extract these qualities of peoples learning ability, assessment must be considered in regard to what is being addressed through the content and the learners themselves. In relation to game based learning (GBL) fortunately, serious games can build on both the long history of traditional assessment methods and the interactive nature of video games to provide testing and proof of learning. Chen and Michael (2005). The principals can therefore be analysed using traditional pedagogical methods of teaching. They assess learning of individuals progress. For instance teaching methods such like; quizzes, examinations, verbal tests, presentations, written assessments or aural examinations. The methods can provide the teacher with an overview of the skills that have been learned and what subject

areas a certain student is in need of development in. Hollis et al (2006) found within their research that students, who became active during their learning, retained the content better than those who did not.

However, these methods have weaknesses as they may seem insipid forms of assessment and may demotivate learners to learn. To evaluate the students’ further, assessment of each method could be considered in the following categories which are available to the teacher to implement. While formative and summative assessment aim to increase the learners knowledge of a subject, teachers must acknowledge what their students are interpreting throughout the assigned learning time period. The three types of assessment used in serious games according to Klaus-Dieter Thoben (2007) provided by Chen and Michael's views are: "Completion Assessment - Did the player complete the lesson or pass the test?. In-Process Assessment - How did the player choose his or her actions? Did he or she change their mind? If so, at what point? And so on. Teacher Evaluation - Based on observations of the student, does the teacher think the student now knows/understands the material?” Completion assessment is replicative of traditional assessments. It offers a linear view of the student’s progress which may help the student learn but there is no evidence that the student has retained all the knowledge taught. In-process assessment could offer the student and the teacher the best possible method of evaluating the success of the learning experience: "For example, students are required to write out each step of the process they followed. Erasures are often disallowed in incorrect steps and conclusions so that errors in the process can be more easily seen by the teachers. This is because the errors and corrections can be valuable indicators, sometimes more so than just giving the correct answer." Chen and Michael (2005) This form of assessment allows the teacher to track the student’s progress and underpin the reasoning for what the student thought about a certain subject. Assessment is successful when the teacher can evaluate the results and make changes to correct any faults in the students learning. Furthermore, in order to extract these details psychometrics could be used to highlight these qualities in GBL. “Psychometrics is the field of study concerned with measuring mental capabilities.” Chen and Michael (2005) aptitude testing is a common form of assessment integration which is widely used in GBL to assess mental capabilities. They may take the style of multiple choice questions (MCQs) or oral examinations and are particularity useful in identifying areas which a person is capable or needs to develop skills in. The results can be analysed and a general vindication of a person’s capabilities can be confirmed. Although, it is not always the best option of formative assessment Since the results may not be definitive of a person’s comprehension of a subject, it is imperative that there should be a wider focus of how a person has learned the content presented to them. Assessment within a classroom should be about the teacher tracking the student’s progress says Black and William, (1998) "Teachers need to know about their pupils' progress and difficulties with learning so that they can adapt their own work to meet pupils' needs -- needs that are often unpredictable and that vary from one pupil to another."

The teacher and the students must have clear communication within the learning process - particularly because of the young audience who's attitudes towards their learning may require motivation or guidance/help in areas. Stapleton (2004) suggests that the teacher should have a part in the students learning but should not impede upon the learner-centred approach to learning which games embody. This suggestion is developed from Albert Einstein’s comments in Prensky (2001), which Stapleton describes as “the role of the teacher is to create an environment that promotes learning through interaction. “

This relationship between the teacher and the subject matter should mean that the students get the best possible help with their learning experience –regardless of the learning approach, the teacher must create the environment and provide feedback. Furthermore, formative and summative assessments in the traditional implication; require a level of input between the student and the teacher: not just when measuring GBL. It is difficult to predict how well a serious game would calculate assessment. Shute et al., (2009) formulates, through the aid of Cannon-Bowers and Kulik (2006), that serious games for learning are not fully understood in the context within schools and that there should be more research on the effectiveness of GBL assessment in schools: “For instance, Cannon-Bowers (2006) recently challenged the efficacy of game-based learning, 'We are charging head-long into game-based learning without knowing if it works or not. We need studies.' Furthermore, of the evaluation studies that have been conducted, the results of games and simulations effects on learning are mixed. For example, Kulik (2002) reports that a meta-analysis of six studies of classroom use of simulations found only modest learning effects, and two of the six studies could not find any increase in learning at all.” Traditional forms of learning are similar to the results of Cannon-Bowers (2006) which is a problem when assessing students work. In order to evaluate the learning process within serious games or using traditional teaching methods, assessment should contain a variety of the elements discussed to securely relate to the students and the teachers attitudes towards the learning process. This means that all areas of teacher/student ability and motivation for their learning have been analysed. The assessment should be objective rather than subjective to form the most appropriate method of evaluating the learning process. Connolly et al (2012) documents the many forms of assessment integration in serious games according to various academics: Quest types are another form of assessment in GBL. McAlpine, et al., (2010) says ”Quest type games can be used in formative and/or summative assessment.” Their analysis of a quest game discovered that assessment was “primarily integrated using selection (selecting the correct answer), matching (matching the correct answer to a description) and locating (locating particular items or NPCs in the game). The game produced a report which then was passed to a human marker to verify the game and provide summative assessment.” This type of game utilises a mixture of techniques to make the learner in control of their own learning. The fact that they can be used for formative or summative assessment is positive that the outcomes can be evaluated to retrieve a better reading of the learning approach than that of other methods.

Another example of assessment in serious games is monitoring of states via completion assessment, processes assessment and teacher evaluation. Torrente et al (2008) investigated a “visual editor for <e-Adventure> giving the instructor the ability to enter three kinds of assessment: a) associating a final grade to end states (completion assessment) b) association of partial increments when states are reached (process assessment); c) the association of time counters between states, which could be potentially used for teacher evaluation. Default <e-Adventure> outputs include: whether the game has been completed or not, a numerical assessment of the student’s performance, the time from the beginning to the end of the game and real-playtime excluding times when the player is not interacting with the game.“ This form involves what Chen and Michael term as the three types of assessment. It considers the audience and provides feedback, engages the player with a fun challenge, allows the teacher to create the correct type of assessment environment and gives the learner multiple methods of learning the content and learning from mistakes they have made. Moreover, the use of an assessment model or profile could be integrated into GBL to assess performance. Zielke et al., (2009) provides his experience of an assessment profile; “Summative assessment utilising a 3D Asymmetric Domain Analysis and Training (ADAT) model for analysis of cultural behaviour such as: positive and negative actions.” The outputs in the training provide reasoning for the players actions which could prove vital in teaching a certain aspect of the training. Feedback is therefore an important aspect of learning.

Augustin et al., (2008) reviewed Micro-adaptive no-invasive assessment of competencies of which “Proposes micro-adaptive non-invasive assessment of competentices and knowledge based on a player’s solution to a particular overall problem taking into account the players interactions with objects in the learning situation without compromising the game.” This is similar to the assessment profile but with more focus on the feedback the player receives as they play the game. It encourages the learner to realise what they have done in relation to the learning process. Kinshuk el al., (2010) reviewed a game which “Provides formative and summative feedback using a game to teach Java programming skills utilising the five following different quest types: greeting, delivery, multiple-choice/true or false, fill in the blank and coding.” This variety of quest types are engaging and allow the learner to experience learning through a process and feedback which is useful indeed.

A robust assessment should consider the audience it is attempting to teach and how well the audience will perceive the content - how mature the audience. It should provide the learner with feedback and encourage them to learn more; creating an intrinsic motivation for the learner to concentrate on the content. This is particularly important when teaching about sexual education to a young audience. Abikwi (2012) identifies through Bowley and Walther, that attention deficit disorder may cause disruption to the learning process:

“According to Bowley and Walther (1992), when pupils with Attention Deficit are left unidentified by educators, the cumulative effects of low self-esteem, chronic school failure and inadequate social skills may lead to adolescent antisocial behaviour, which include alcoholism, drug abuse, dropouts, and even suicide.” Therefore the teacher must ensure that the pupils are happy and motivated. Analysing both the teacher and the students input to their learning is pivotal when measuring assessment: whether it be a serious game for learning or a traditional form of integrating assessment into the learning environment. A form of feedback is therefore important to help the students distinguish between what they have learned and what is correct.

In our group’s serious game for sex education we utilised completion assessment, which takes place as a formative and summative experience. The game is called “Seed”. The game assesses the player’s ability to learn about how sperm fertilises the ovum through completion assessment which occurs as a formative and summative learning experience. The player challenges themselves at the mini games which are stages of the fertalisation process. After each stage, they are quizzed about what they have learned. Each step has a differently styled mini game challenging them to get to the end of the section after a brief description of what is really occurring sexually. At the end of the game, even if they got questions incorrect, they get a second change at the entire quiz and the correct answer is then displayed. The game makes the player aware of what the fun is aiming to address in a mature and positive manner by not putting too much pressure on getting the correct answers, while encouraging players to become involved in the game play.

Fig 3. “Seed” screen capture of the quiz element of the game


Sex Education Assessment

Secondly it is important to understand how sex education should be taught in order to understand how assessment is properly integrated into GBL. Sex education In Scotland has an elaborate listing of principals and aims in order to protect and nurture the young people’s development in their life: “Sex education could be defined as a lifelong process whereby children and young people acquire knowledge, understanding and skills, and develop beliefs, attitudes and values about their sexuality and relationships within a moral and ethical framework” The overall objective of sex education aims to raise awareness of sexual behaviours in young people such as unplanned pregnancies or sexually transmitted infections. Moreover, the experiences of such an important topic of life should instil young people with a positive outlook of their sexuality and relationships. Sex education is effective when it is respectful of everyone involved in the process and when it makes young people think about the subject seriously which allows them to be safe and enjoy their sexuality. The second principal states that sex education in Scotland "should contribute to the physical, emotional, moral and spiritual development of all young people within the context of today's society” Sex education should be a positive experience and encourages young people’s development. Sexual education GBL in Scottish schools is progressing due to the awareness of appropriate content and the benefits that it offers: "Since 2006 Education Scotland's game-based learning initiative, The Consolarium, has been working with teachers across Scotland to explore and share just how the appropriate use of computer games can have a positive impact on teaching and learning. More recently, it has been encouraging pupils to become creators - not just consumers - of games with a game design initiative." Scottish education is now embracing GBL. In relation to sex education Simon Egenfeldt- Nielsen's investigation into games used in education provides evidence from an expert in the field of educational study that games can improve learning in sex education: Bensen et al. (1999) ”Video games are motivating and can improve knowledge related to sexual education.“ Similarly Nielsen provides the opinion from “Thomas et al. ‘Students learn from playing video games both on specific knowledge items and in self-efficacy. Maintaining a consistency of motivation and relevance to subject should incite an overall experience of constructive study with a serious sex game.


Assessment of serious games for sex education

An example of a game which integrates assessment in sex education is the quiz game named sex101. It incorporates the traditional style of assessment within education. It is an in-process assessment game which encourages the user to choose an option; if the answer is wrong they are shown why they are wrong, which is rather positive and constructive towards their learning. It uses a point system which reports how many points the player has scored - a correct answer merits a point while a wrong one offers zero points. When the player selects an answer and

presses continue, the reasoning for their answer is displayed (whether they got it right or incorrect). Graphics are used to enliven the pedagogical theme of assessment, but it does not seem particularly engaging for a serious game despite its usefulness in teaching the content effectively. The game is successful in integrating "challenge, fantasy, curiosity and control." Malone and Lepper (1987) believe that these attributes are influential to a game in which the player is motivated to learn.

The quiz achieves these factors through the informal yet serious aspects of its design/aesthetics. The answers have been designed to allow for imagination yet contain a serious point of summative learning of the overall objective of teaching a young audience about sexual issues. This is particularly good to allow the young audience to find out what they know about the subject. On the contrary, this could be a negative aspect of the MCQ type assessment when considering young people and sexual awareness. Depending on the maturity of it's audience, some may feel ashamed or pressured into picking the correct answer. This is not a positive aspect of sexual education which should feature within a serious game if all students are to be given a fair chance at learning what could be useful life experience.1 Mark Griffiths' (2002) research about an HIV/AIDS program concluded that Game-playing resulted in significant gains in factual information about safe sex practices, and in the participants’ perceptions of their ability to successfully negotiate and implement such practices with a potential partner.

Adolescents had a positive experience using "a time travel adventure game format" and the content described prevention practices using safer sex. It is clear that the evidence provides an argument that game which encourage a story or theme - in which the assessment element is almost invisible - benefit the learners more compared to game such like quiz games. Richard Van Eck (2006) asserts: “Learning is integral to the story of the game world—players are never asked to step out of the game world to do something (although they frequently do so when stuck).” In order to enhance the students learning experience when using GBL for sex education, focus must be put towards the involvement of the content while allowing for interesting engagement but in relation to a coherent theme. Assessment in the classroom dictates this ruling also but is less likely to be as engaging as a video game. Black and Wiliam (1998) support this view: “Pupils who encounter difficulties are led to believe that they lack ability, and this belief leads them to attribute their difficulties to a defect in themselves about which they cannot do a great deal. Thus they avoid investing effort in learning that can lead only to disappointment, and they try to build up their self-esteem in other ways.”


Find the game at

A serious sex game which does not focus too much on pedagogical assessment offers an equal opportunity to learn for all the students which does not damage their self-belief in their learning. In addition, the game itself should engage the player to feel challenged, fanciful, curious and in control such as Malone and Lepper (1987) identified motivated learning. A second example of a game which teaches about sex education is size five's BAFTA nominated game "Privates" which is hosted by channel 4s website. The game itself provides a casual environment to learn in yet the explicit nature of the content made the game unacceptable for GBL in schools. Figure 2 depicts the age warning in the game â&#x20AC;&#x153;Privatesâ&#x20AC;?.

Fig 3. Age warning for "Privates" sex education game by size five

Mark Griffiths (2002) concurs with the idea that "...Videogames allow participants to experience novelty, curiosity and challenge." They are innovative mediums with the potential to encourage learning in GBL. However although the learner may experience all these positive facets of video gaming while learning about new concepts; the correct environment should be in place to ensure that the audience can be correctly assessed and evaluated without external factors contributing to a negative view of the learners capabilities: thus in turn the young audience do not learn and appertain a dissimilar view of the sexual topic being addressed. Therefore, assessments in sex education games should be implemented within the appropriate environment. Sara de Freitas (2006) found that games/simulations do not appeal to everyone which may disrupt the learning process and allow students to play a fun game, particularly with a game utilising stealth assessment - the assessment of learning is barely visible to the player: "It has also been noted in studies that some learners do not like using simulations or games, in these instances it may be useful to have additional choices of presentation of learning materials, such as textual, or have other more differentiated activities planned. In addition, the level of gaming ability exhibited by young learners in the classroom, for example, has been found to be varied, competency levels can be very different even within one learner cohort, and this may have an impact upon lesson planning, with opportunities for more learner differentiation (Sandford et al., 2006)."

The game "Privates" failed in this area of assessment. It may have been fun to some; it may have encouraged students to merely play through the game but the central concern of the game is that the content is not entirely suitable for a classroom environment. Controversially, remaining on the issue of stealth games, Shute et al., (2012) suggests that games would not be as immersive without stealth assessment.“ ensure that the assessments are valid, reliable, and also pretty much invisible (to keep engagement intact).” In privates the learner is not bombarded with questions but allowed to explore - in an engaging way - the human body and find out things themselves while allowed to shoot a gun. In order to keep the assessment valid, there would have to be a close relationship with the teacher not least because of the crass nature of the content; but in order to assess what the focus has been for the students.

Moreover, Valerie Shute proposes that "Making use of this stream of evidence to assess students’ knowledge, skills, and understanding (as well as beliefs, feelings, and other learner states and traits) presents problems for traditional measurement models used in assessment”. This demonstrates that stealth games may have assistive potential to aid learning in an appropriate environment despite if the students do not want to play the game itself or not. Teachers would be able to accurately evaluate a students learning progressively - compared to inefficacious non-stealth assessment; "Answering the question correctly is evidence that one may know ascertain fact: one question—one fact." Thus stealth assessment does not entice memorising answers such as MCQ's may indeed persuade adolescents to do.2

Additionally, another game which was deemed unsuitable is the “Adventures in sex city”3 game. It was a promising game in terms of content and purposely built to make a young audience aware of sexual health, but unfortunately the graphics were considered too explicit for a sex education game. It is similar to sex101 with its MCQ based game mechanics but has some rather vulgar imagery which would not be a positive experience for young people learning about sexual health. According to Sue Thomas, a Nurse practitioner in Dalas.; "I would love to be able to show this to kids in schools, but there's no way it's going to make it in the door." This is a dominant issue regarding the serious sex games and it's audience. If the game doesn’t adhere to a positive sexual experience for the learners, the serious game is not respecting the learning process for sex education. In relation to the design of assessment integrated into serious games, a sex education game which follows Gagnes nine events of instruction and is successful in imparting knowledge to the user is channel 4's "The great sperm race" hosted by E4 Figure 3 shows Gagnes 9 events of instruction.


'Privates' won the BAFTA Learning Secondary Award 2011.


Find Adventures in sex city at

Fig 4. Gagne's nine events of instruction

The intent of the game is clear from the beginning as it describes what to do. The game assesses the players ability to follow the instructions which relate to the human fertilisation process. It challenges the player to guide a sperm through the female vagina, cervix and to the uterus and finally to the fallopian tubes to fertilize the egg within set time limits. Each game level introduces what the player is aiming to achieve regarding sexual education. Then when they begin, it is very much a simple mini game which challenges you to win before the clock runs out. It is a successful serious game because it introduces the player to the game and transfixes their attention to the details presented. Next, it creates a precise set of instructions and attempts to stimulate the players thoughts concerning the content and what the games objective is - for instance to avoid the white blood cells (leukocytes) which destroy the players sperm. Feedback of success is instantly given to the player with more instructions and a description of what is happening.

Despite the lack of assessment of their performance, tutors could witness what the students had learned as they work their way through the game. Finally, the last stage in Gagnes nine events of instruction, the game does not enhance retention but provides a detailed and intuitive experience which may possibly encourage replayability which, in turn could improve learning. Zemliansky et al., (2010) advocates that this style of serious game according to Reeves and Okay is what education could benefit from as the game may not provide results for the teacher/tutor to evaluate but it would encourage the students to learn; "Constructivist educators stress that learning is personal, unique, and contextualized for each learner". This reinforces the fact that the teacher must be involved in the process of learning along

with the learners but not necessarily impeding upon the students learning process â&#x20AC;&#x201C; they offer guidance and direction. Furthermore, reflection/feedback must be given if the learners are to recognise a mistake in their learning process.

REFERENCES [1] Mislevy, R., Steinberg,L., and Almond, R. (2001). On the Structure of Educational Assessments Journal of education assessment, Vol 1, Issue 1 [2] Forehand, M., (2005). Bloom's Taxonomy From Emerging Perspectives on Learning, Teaching and Technology Journal about Benjamin Blooms learning scale, Vol 1, Issue 1 [3] Tononi, G., Olaf S., and Edelman G., A measure for brain complexity: Relating functional segregation and integration in the nervous system Journal about neurobiology and the complexity of the brain, Vol 91, Issue 11 [4] Chen, S. and Michael, D., Proof of Learning: Assessment in Serious games [Online] Last Accessed: 18/11/2012 [5] Mitgutsch, K., (2008). Digital Play-Based Learning: A philosophical-pedagogical perspective on learning and playing in computer games Journal of learning using digital games, Vol 9, Issue 3 [6] S.T. Paul, J.A. Messina, A.M. Hollis., (2006). A Technology Classroom Review Tool for General Psychology, Journal about how learning is achieved in the classroom, Vol 33, Issue 4 [7] Thoben KD, Baalsrud Hauge J, Smeds R, Riis JO (eds) Multidisciplinary Research on New Methods for Learning and Innovation in Enterprise Networks: Proceedings from the 11th Special Interest Group on Experimental Interactive Learning in Industrial Management, Mai 20-22, BIBA, University of Bremen, Verlagsgruppe Mainz GmbH Aachen: 149-158 [8] Black, P.J and William., D (1998) Inside the Black Box: Raising Standards Through Classroom Assessment Journal of assessment usage in the classroom, Vol. 80, Issue 2, pp. 139-148 [9] Stapleton, A. (2004) Serious Games: Serious Opportunities Paper presented at the Australian Game Developers Conference, Academic Summit, Melbourne [10] Shute, V. J., Ventura, M., Bauer, M. I., & Zapata-Rivera, D. (2009). Melding the power of serious games and embedded assessment to monitor and foster learning: Flow and grow. Journal about embedded assessment, In U. Ritterfeld, M. Cody, & P. Vorderer (Eds.), Serious games: Mechanisms and effects (pp. 295-321). Mahwah, NJ: Routledge, Talyor and Francis. [11] Connolly, T., Hainey, T., Baxter, Gavin J., Boyle, L., Beeby, R., Assessment Integration in games-based learning: A preliminary review of the literature, Journal of how assessment is integrated in game based learning [12] Abikwi M. I., Egbochuku, E. O., Educators of level of qualification: implications in the management of attention deficit hyperactivity disorder among children in Edo State, Nigeria, Journal about attention deficit disorder in primary schools, Vol 1, Issue 3 [13] The Scottish Government: Publication; Protecting Children A shared responsibility [Online] Last Accessed: 18/11/2012

[14] Education Scotland: Game based Learning - The Consolarium [Online] Last Accessed: 18/11/2012 [15] Egenfeldt-Nielsen, S. (2006). Overview of research on the educational use of video games Journal of the use of educational video games, Vol 3, Issue 1 [16] Bensen, C., Stern, J., Skinner, E., Beutner, K., Conant, M., Tyring, S., et al. (1999). An Interactive, Computer-Based Program to Educate Patients About Genital Herpes, Journal about Sexually Transmitted Diseases, Vol 26 Issue 6, pp. 364–368. [17] Malone, T.W. and Lepper, M.R. (1987). Making Learning fun: A Taxonomy of intrinsic motivations for learning. In Aptitude, learning and instruction. Volume 3: Conative and affective process analysis. Lawrence Erlbaum, Hillsdale, N.J, 223-253. [18] Griffiths, M.D. (2002). The educational benefits of videogames. Education and Health. Journal regarding how game based learning can improve education and health, Vol 20, Issue 3 [19] Van Eck, R., (2006) Digital game based learning: it’s not just the natives who are restless…, Journal about game based learning, Vol 41 issue 2 [20] de Freitas, S. (2006). Learning in Immersive Worlds. Joint Information Systems Committee. Journal of immersive worlds in learning , Retrieved August 6, 2008 [21] Online sex education game - "Adventures In Sex City" Not a Hit with Everyone [Online],0,5511089.story Last Accessed: 18/11/2012 Last Accessed: 18/11/2012 [22] Zemliansky, P. and Wilcox, D., (2010). Design and Implementation of Educational Games: Theoretical and Practical Perspectives. Hershey, PA: Information Science Reference; Imprint of: IGI Publishing.

6. Conclusion

To integrate content effectively we will be following proven frameworks to effectively add pedagogical content into gameplay that would motivate learners intrinsically to learn. Ensuring the learning content is correct we researched information regarding conception from biology notes taught in higher education. By having a good understanding of the process ourselves, we then were able to decide how each stage of conception can be made into a game. In order to sustain interest from the learners, game play is varied from each level but can still be easily picked up and played without forcing the player to replay several times to complete a level. As Sex Education is a subject taught to young people, time will be taken to make the content appropriate without having the graphical content explicit. Assessment is the inquest of learning and the overall evaluation of the valuation of successfully conveyed knowledge to the learner. In order to successfully assess if someone has learned we must evaluate the content, the people involved in the learning process and the method of assessment. Many researchers have argued that to expedite the learning process, the sociological implications of these aspects

must be examined together to provide an accurate representation of how people learn. In GBL, assessment is an important and extensive topic which is vital to the progress of the learner, the teacher and the future of GBL. Certain methods offer innovative approaches to learning which encourage motivation for the learner compared to traditional pedagogical methods. On the contrary, this is not always a negative aspect of assessment. Research has found that ensuring that the correct environment, feedback and positive experience is contained within the serious game for sex education, the chances of learning and retaining knowledge is enhanced. Sex education in schools is a problem which could, and is beginning to, emerge due to serious games recognition of their positive influence on young people to motivate them to learn. Assessing the success of GBL with sex education, can only be done with experience. The research suggests that it as long as the games are purposely built for the classroom and age range, there would be no mistakes from a developers perspective. Teachers must remain to do their duty as teacher and provide guidance to their students who participate in GBL with sex education and ensure that externally from the computer screen, they are receiving positive feedback and encouragement about sexual health.

Serious games for sex education  

Academic study of serious games for sex education.

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