Let’s take a closer look at medical gamification and how tools from the gaming industry can be used for gaming that is designed for our wellbeing and health.

“In medicine in general, I have not seen a lot of cases where gains have been fully integrated,” explains Maria Hwang. “It is more gamification, meaning there are game aspects that are added to whatever system they have, whether that’s an application or that’s a whole infrastructure and people go through certain steps to accomplish their goals.”

Maria goes on to explain, “It is a little bit unfortunate coming from a game designer perspective to see that it’s just using one element of games that are sometimes we like to say it’s tricking the patients.”

So you provide incentives. For example, for type 2 diabetics, we want them to log their meals. So every time you log something, you get a point for something. Every time you take a picture of your meal, you get a point. Every time you log your glucose measures, you get a badge.

Then you share that with your other friends, then you get a social media badge or not. Those are the superficial gamification aspects that we’re putting into these apps or infrastructures, says Maria. That will incentivize the patients to do something that they don’t want to do.

“From what I can tell, that’s the extent of how games are being used in medicine. We can go a little bit further and take advantage of all the affordances of games and make it more beautiful.”

Some efforts have been made in terms of mental health. There’s a lot of games that address mental health. It’s a full-blown game where people play it in and, some communities talk about the characters, the issues, the conflicts they resolved inside the game, and really from that, they’re healing and doing therapy. The goal is to keep relaxed. This is the neurofeedback headset that it comes with.

There’s one sensor right here at the front that is reading your brainwaves. The more relaxed you are, the bigger your midnight grows in the game. We have been trying to teach kids if you change the way they think, then the world out there looks different. It’s an incredibly powerful metaphor, says Maria. So, there are efforts in that area.

Maria explains that from a game designer perspective, the majority seen is only using superficial incentivized aspects of games, at least in medicine.

But it’s changing.

Twitch Plays Pokémon (TPP) was an exciting era in gaming, especially for game designers who were curious about how such a project could work. For those who are unfamiliar, Twitch Pays Pokémon is a social-experiment-slash-game played live on Twitch, where actions and decisions are crowdsourced via the chat function.
Dan Shefelman lived through that moment and remembers all the fascinating ways the game evolved around its clear obstacles.
“I thought we’d seen it all. We’ve seen multiplayer games, we did platform games, we had FPS, we’ve just seen every genre possible. And then, Twitch Plays Pokémon comes around.”
The most glaring obstacle was how thousands of commands given by the chat could be distilled into one cohesive decision so the game could progress.
“[I asked if] it needs to take one input and the character moves. And they said no, all these people are putting in that input and they’re – somehow – getting averaged. Well, you know, at one point, then a voting system came out.”
The technology also had to answer the question of lag. If a user gave an input from South Korea, and another user gave an input from Brazil, which would arrive first? Would the first one count before the second? These questions were slowly rising, and communities developed out of the solutions people found. Eventually, they developed a voting system, until another problem arose.
“The voting system went away and it was just this incredible phenomenon of how we deal with, basically, overpopulation . . . Maybe it’s almost like a democracy deciding on a policy. And they did.”
This happened outside of the game, and players returned ready to navigate it as a team, like a crowd-sourced game.
“We as a team, a world team, we can beat that by coming together as communities to plan and strategize, to play one game,” says Shefelman. “Like a million people played one game together with one character. And that was basically a new genre.”

From advances in virtual reality (VR) technology to more basic play, gaming is increasingly used to help people heal and manage illnesses and disorders of all kinds.

For example, VR is a great space for healthcare providers looking to utilize games for good to treat patients. Those suffering from body dysmorphic disorder can use VR to make them feel more comfortable in their own bodies; additionally, soldiers suffering from PTSD have been found to benefit from VR treatment as well. One study followed soldiers who, after incorporating VR, saw a tremendous decrease in PTSD-related symptoms.

Voice technology like Amazon’s Alexa devices have also proved helpful in dealing with health issues. For example, communicating with individuals who are type 2 diabetic, who have a certain lifestyle, and family members who are not. Voice communication technology can help avoid conflicts not just by start dialogues, but also by tracking what food is available in the fridge and proposing recipes that can accommodate type 2 diabetic family members as well as a those who are unafflicted.

Now, imagine if this voice communication system adds game elements to the process to create a more fun, engaging experience. Here’s a scenario: there’s a certain amount of ingredients left in your fridge, and Alexa provides potential recipes you could make. By adding gaming elements, perhaps family members can participate in a cooking competition together, with points awarded for including more protein as opposed to carbs.

This is just one example for how to make treating a medical issue, especially chronic diseases like type 2 diabetes, a less exhausting, more engaging experience. Instead of individuals feeling like they must apologize for perceived inconveniences caused by their illness, they can make it something fun and invite others to participate in their lifestyle. If gaming can be a vehicle for achieving that, it could be a huge win for not just the medical community, but the gaming community as well.

Gaming is becoming an increasingly sensory experience. Pong, as a 2D game, was satisfying. Now gamers are expecting to play tennis in a VR on Mars.
Another big part of the future is going to be Augmented Reality and Mixed Reality. You’ll be playing a game in an actual space with minuscule glasses and not a giant Oculus while interacting with other people and holograms. There will be multiplayer games fighting a hologram in the middle of Times Square. That technology is already available, but games are now going to use it on a large scale. Games will come out of virtual reality and the console, into public spaces.
Sluice, a web-based multiplayer game made by The Molecule, a company in New York City, is a harbinger of the future.
Web-based gaming is going to be huge. People walk by a giant screen with their iPad or phone. There’s rain coming down, and there are little paddles and buckets. Anyone can log in and control a paddle. There could be over 100 people walking by and playing this game, the point being to fill up your bucket.
That a game could be an open platform in an open space, where people come with their phones, connect to the game, and play simultaneously, is fascinating. In Pokemon Go, people were connecting and playing the game in a real space.
If there’s a real dinosaur coming down Broadway, and everyone is shooting it from different places with their iPhones, that would be cool. I would play that game.

Community is a big component to the gaming industry. According to Maria Hwang, community is essential and one of the most beautiful aspects of games, especially in the modern day.
In these communities people learn how to strategize, how to talk to each other, what not to say, what to say, what was courteous, what was not courteous, and what was the decorum. In a lot of MMORPGs (Massively Multiplayer Online Role-Playing Games) you form groups and teams inside the game and then you do missions together.
Anything you can think of that’s in a game has a community that it’s involved in, where you interact with people around the world at any time of the day. This is a strong aspect of the whole gaming community.
League of Legends is a great example. There’s a new fancy skin with Louis Vuitton that just came out, and now people discuss what kind of skins they should choose and how much to invest on that. That is a community and you’re meeting new people through that.
The Twitch Plays Pokémon is another wonderful example of how communities were generated because of that specific gaming genre. Players realized they needed to talk to each other if they wanted to beat this game. From there they created groups where they could get together and strategize. This brought communities together and it generated all these beautiful online discussions.
It is just an incredible positive affordance that games have because people inherently and intrinsically love to play games. They want to win, and only through shared knowledge via a community can you achieve that. There are outlier games where you can win all by yourself. But it only gets stronger when you talk to each other, plan together, collaborate, and get some tips.

Games do very well when it comes to the notion of affinity space, according to educational scholar James Paul Gee. If you like a game like World of Warcraft and you have a strong interest in it, you can visit a site on the internet dedicated to the game. Many such sites exist. And in many cases, the websites link to each other. On these sites, you can join a group of people who share your interests or passion. There are all sorts of activities you can partake in, explains Gee. You can review, strategize, theory craft, and mod. You can even set up gameplay. You can redesign, make apps – there is a wealth of possibilities!

And soon, this affinity space will be recognised as a physical space. If you’re at a conference or playing in a land party, you may be in a physical space, but you could also be in a virtual one. As Gee explains, an affinity space comprises of a group of people joined together by interest and passion, because you can take that interest as far as you want. It’s a place where everybody can teach and learn. You teach what you know well while also learning from others at every level of expertise.

Through affinity spaces, games are not only offering a portal into a world where you can show off your problem solving and use the tools listed above, but they’re also giving you a common identity. Not an identity as an American, or White, or Black, but as a World of Warcraft player – a new type of identity in the world.

There are now affinity spaces for everything you can imagine. And they are not only a very powerful way of organizing learning, but also organizing membership, belonging, and identity. As we’re learning today, human beings only feel safe to others, and happy with themselves if they feel they belong, matter, and can participate. Unfortunately, lots of people in America don’t believe that what they do really matters anymore, or that they really are participating in their society. This mentality can make people physically ill.

In extreme cases, it can also become dangerous, warns Gee. Sadly, human beings will take participation and meaning wherever they can find it. So if they can’t find it in a good cause, they’ll find it in a bad one. White supremacist groups are affinity spaces. So was ISIS. So are all of the tremendous networks of physical and virtual spaces through which rich people hide their money offshore. They’re well organized and the people involved learn a lot from each other. They’re very powerful and they give a strong sense of belonging. But they can be dangerous to us. So, Gee recommends that anyone designing affinity spaces for good intentions such as video games should learn how they worked in-game, because the game designers understand their game’s community and intentions.

If you’re trying to get into esports and competitive gaming, you want to make sure you have the right equipment. This ensures you can perform the best when the time comes for you to compete.
A lot of folks grow up with this idea that playing video games on their television is the best experience or the most optimal. But according to Malik Forté, a 14-year veteran in the gaming industry, the input rate on most televisions isn’t as good as when you’re playing on a monitor, even if you’re playing on a console.
Malik insists that if you switch over from a tv to a monitor you’ll notice that the latency from the time you press a button on your controller to the time you see it play out on the screen is going to be a lot shorter. You will gain a lot more comfort as a player knowing that as you press buttons on your controller the resulting actions are happening with minimum latency.
Outside of the monitor, the most important thing is to make sure the game settings are comfortable for you. The biggest misconception in competitive gaming is that you must follow the top pros’ settings. None of that is true. You need to do what’s best for you and your gameplay style.
Everybody has something different that works for them. Malik Forté plays shooters without vibration because if he is pressing a button and the controller shakes, it hurts his accuracy. Some people need that vibration as a cue for when things are happening to them within the game world. Preferred settings are really case by case. You need to find what is best for you before you decide when it comes to those small mechanical decisions.

In 2014, Ivan Curtiss began his professional esports career when he and his friends started an amateur pro-am league called My Player Basketball Association (MPBA).

Curtiss first met LT Fairly and Lawrence West, also known as ‘BiggWest’ in the 2K community, while playing in various gaming leagues. Through playing together in various leagues, LT had the idea to start his own league. He brought in Curtiss first, then BiggWest came in later down the line. BiggWest marketed the league, assisting LT in anything he knew about day-to-day operations.

Slowly but surely, the league started picking up a lot of traction. Many of the top players, who played the Jordan Rec Center mode at a time when everybody played with their My Players, formed teams to participate in structured and organized leagues.

Later, in 2016, NBA 2K came out with a pro-am mode. This allowed players to come together and form teams in their own arenas and gymnasiums so they could play against other teams like their own. But it wasn’t until a year later that the MPBA was looked at as the premier pro-am league to play in. At that time, they had received a lot of acclaim and success through the league.

In 2017, the NBA 2K League was announced to the 2K community. It was going to be a professional esport league. In the first draft held, over 80% of the drafted players, especially in the first round, participated in the MPBA. And that is where their notoriety began. Curtiss describes it as their wake-up call that this professional esports event was something that they themselves had created. They got to see the success of players who participated in their league develop from amateurs to professionals.

During that season, they were also awarded the opportunity to work with BucksGG, which is the Milwaukee Bucks affiliate team of the NBA 2K league. Curtiss and LT worked as draft analysts. They helped put together their team and roster in the first season. Afterward, LT assisted them in small roles daily, and Curtiss stayed on as a community manager.

“What is a game?” This is the first question Jessica Hammer asks in her game design class.

Pure definitional questions are not actually that interesting for either game research or game design. “The way I try to help my students think about what games are is that there are different lenses or different frames for defining what is or isn’t a game, and you can pick one or a subset of lenses to talk about games with when you are either designing or studying games,” says Hammer.

Typically, Hammer will start by teaching her students about three different frames of how you can look at what a game is. One of these frames is formal. What are some of the characteristics of an artifact that make it a game, whether or not it’s being played, totally in the abstract?

The second is thinking about it aesthetically. Do people feel playful when they’re playing? What is the experience of play? People will play things that are not games, and people will play games in ways that are not playful.

If you think about professional baseball players, are they feeling super playful when they’re playing the seventh game of the World Series? Probably not.

But we still recognize baseball as a game. So these are two different lenses that can get us to different answers about whether something is a game even when we’re looking at the same experience and trying to analyze it.

The third is thinking about what we culturally understand as a game. There are some agreements as a culture about what a game is.

“When I talk about games, I always say, OK, tell me some games you play. People almost never talk about sports because the word ‘game’,“ says Hammer.

If you asked someone “Is sports a game?”, the answer would be “Yes, of course sports are games.”

However, if you asked someone if they played games, they don’t always think of sports or gambling or other kinds of activities that by both formal and aesthetic experiences would certainly fall into the category of games.

Looking at these cultural understandings explicitly is a third way to ask the question of “what is a game” and come up with an answer that is interesting.

As a game designer, someone can’t tell you what the right frame is for your work. But as current-and-future game designers, you are going to have to come up with a frame for your work that you find productive for making incredible experiences for players.

Think about what something being a game means to you, and worry less about some kind of categorical definition that you might spit back on an exam. Because in the real world of games, nobody cares.

There has been a lot of interest coming from schools. The innovative schools in the early days recognized that if they offered esports programs, they’d be wilfully attracting some of the brightest STEM students on the planet.

STEM is a big part of gaming. Engineering is a big part of gaming. And computer science is definitely a big part of gaming. Some of the brightest kids on the planet are coming into STEM programs because of gaming, and the wise schools recognized early on that they could use esports for recruiting.

In that regard, Wim Stocks helps schools that may not have seen that very early tide coming in. They’ve aided them in building their curriculum. They’ve helped schools create the notion of a career by offering a curriculum, training, and learning opportunities for careers in esports and venue design.

Wim Stocks also had a hand in helping a college cultivate local sponsorships to help support the building and funding for an esports program on that particular campus. But they are not just the intercollegiate competitor, enabler, and league. They are also helping schools build far bigger footprints in esports than they might have been able to do independently. So much of esports is focused on competition.

Let’s use an analogy. First, think about the business of traditional sports. Then, think about all the jobs surrounding traditional sports: production, broadcasting, stadium design, agents, analysis, marketing, advertising, and sponsorship. Those same dynamics exist in esports.

One of the schools that Wim Stocks have a close association with has identified that there are 87 different skill sets that they can base their curriculum around to help students who want to be involved in esports build their knowledge, education, and experience. By no means is this a small opportunity. They also work very closely with production companies. There are very specific things to esports that don’t come into play from any other sports or any other experiences. And so that’s a powerful dynamic for esports, the marketing of esports.