Högskolan i Skövde

The burden of cardiovascular diseases (CVDs) and the risk factors in adolescents are rising in Nepal, a low-income setting. Therefore, focusing on health education related to diet and physical activity for adolescents in their formative years is urgent. A digital medium may be an efficient way to reach this technologically oriented group. We developed a digital educational game through a collaboration between researchers in health and informatics from Nepal and Sweden and piloted the game as part of the ‘Heart-Related Intervention with Digitalization Among Young Adolescents (HRIDAYA)’ study.

We found that 99% of adolescents had access to smartphones and 92% had access to the internet. The digital game was developed for android devices due to their predominance in Nepal. First, a survey was conducted among 649 adolescents to identify their digital prerequisites as well as their gaps in CVD-related knowledge, attitude, and practice. Second, the identified gaps defined the learning goals of the game, forming the foundation for an initial draft of the game concept. Third, we created a game paper prototype and tested it among 10 adolescents to explore their visual recognition and preferences. Based on the findings, we chose two levels of fidelity and tested them with 44 adolescents. We found that a higher-fidelity abstract style resulted in more positive feelings. This style was subsequently used for the final game. Fourth, the game was developed through an iterative process, which included both culturalization efforts and ensuring educational viability. Finally, the completed digital educational game ‘Happy Heart’ was played by 176 adolescents. It consisted of seven mini-games related to sugar, salt, and fat in different food items, physical activities, balanced diet, and nutrition groups. Immediate audio and video feedback kept the players motivated. Written texts in the game journal addressed knowledge gaps that could not be converted to game mechanics.

In conclusion, a digital education like Happy Heart may be helpful in increasing knowledge, attitude and practice regarding CVDs among Nepalese adolescents. The development process indicated that the digital game has the potential to reach many adolescents and that they were receptive to the game. As the game is a low-cost educational effort that can easily be scaled up, it provides a promising avenue for cardiovascular health promotion in similar low-income settings.

Understanding players’ diverse visual recognition and visual preferences, especially in cross-cultural contexts, is critical for the creation of effective serious games. This study aimed to examine how varying levels of fidelity affect players' visual recognition, visual preference, and overall experience in serious gaming, using a mixed-method case study in the Bhaktapur district, Kathmandu, Nepal. Forty-four participants, aged 13 to 16 years, were enrolled in an A/B gameplay test. Fourteen students participated in in-depth interviews, thirty-six completed a questionnaire, and twenty-two provided valid telemetry data. We found that higher fidelity led to more positive affect, better recognition, stronger preference, higher familiarity, and positive emotional response from players. However, challenges were encountered regarding the identification of local food items. This highlights the key role of visual literacy, as adolescents are more influenced by familiar media than by real-life experiences in terms of visual recognition and preference. Effective visual communication in serious games should consider individual differences and the playing environment. This study contributes to serious game research by providing insights into an underrepresented demographic and demonstrating the importance of cultural context in visual communication. Findings offer practical guidance for game developers to design more inclusive and effective serious games.

För att möta utmaningarna med att examinera stora studentgrupper inom högre utbildning krävs genomtänkta överväganden kring val av examinationsformer. Studiens syfte är att undersöka hur lärare vid vårt lärosäte hanterar examination av stora studentgrupper, med intentionen att synliggöra examinationsmetoder som är rättssäkra, effektiva och skalbara samtidigt som de främjar lärandet. Tre metoder för att examinera stora studentgrupper har identifierats: Digitaliserad examination med automatisk rättning; muntlig examination med uppföljande frågor och slutligen; individuella praktiska prov. Studien bygger på sex semistrukturerade intervjuer och diskuterar möjligheter med dessa examinationsformer och hur de kan kopplas samman med olika kunskapsnivåer i Blooms reviderade taxonomi. Samtidigt pekar den på de viktiga utmaningar som finns, såsom rättssäkerhet, tidskrävande förberedelsearbete och återkoppling på examination till studenterna. Det är också tydligt att studentgruppens storlek i vissa fall starkt påverkar vilka examinationsformer som används trots att respondenterna upplever att det kan finnas andra examinationsformer som skulle vara bättre ur ett pedagogiskt perspektiv. Studien är genomförd som ett projekt inom ramen för Arena för högskolepedagogisk utveckling vid Högskolan i Skövde under 2023.

In order to meet the challenges of examining large student groups in higher education, well-thought-out considerations regarding the choice of examination forms are required. The purpose of the study is to investigate how teachers at our university handle the examination of large student groups, with the intention of making visible examination methods that are legally secure, efficient and scalable while promoting learning. Three different methods for examining large student groups have been identified: Digitized examination with automatic correction; oral examination with follow-up questions and finally; individual practical tests. The study is based on six semi-structured interviews and discusses possibilities with these forms of examination and how they can be connected with different levels of knowledge in Bloom's revised taxonomy. At the same time, it points to the important challenges that arise, such as legal certainty, time-consuming preparation work and feedback on examinations to the students. It is also clear that the size of the student group in some cases strongly influences which forms of examination are used, even though the respondents feel that there may be other forms of examination that would be better from a pedagogical perspective. The study has been conducted as a project within Arena för högskolepedagogisk utveckling at the University of Skövde during 2023.

Rapporten bygger på tre delstudier med olika datainsamlingstekniker:

• En bibliometristudie av svensk spelforskning baserad på data från Scopus respektive SwePub.
• En enkätstudie över svenska spelforskningsmiljöer.
• En intervjustudie om svenska spelforskarmiljöer.

Bibliometristudiens ansats har varit bred. Materialet inkluderar därmed även poster som endast har en perifer koppling till spel, men returnerar i fallet SwePub färre än 3000 poster. Spelforskning bedrivs på många lärosäten i Sverige och publiceras inom många ämnesområden. Totalt 95 forskare har en publicering som omfattar 10 eller fler spelpublikationer1. Det finns starka lokala kluster av forskare som sampublicerar men sampubliceringen mellan svenska och nordiska lärosäten är inte så omfattande. Jämfört med Finland har Sverige färre publikationer med ett tydligt fokus på spelforskning.

Enkätstudien visar att spelforskarmiljöerna oftast består av ett antal forskare med olika ämnesmässig bakgrund där de själva definierar sig som spelforskare snarare än att organisationen som sådan gör det. Miljöerna har sammantaget och högt räknat runt 30 aktiva doktorander men siffran är osäker. 94% av respondenterna anger att deras forskning ligger inom ”spel för andra områden än underhållning” och endast 6% anger ”spelteknikfokus”. 44% anger ”spelbranschen”. Det är tydligt att spel för just underhållning inte ligger fokus för svensk spelforskning. Detta är remarkabelt då den svenska datorspelsindustrin är en multimiljardindustri fokuserad på just spel som underhållning. Det finns alltså en mycket stor diskrepans mellan industri och svensk spelforskning.

Intervjustudien ger en bild av att spelforskningen bedrivs inom splittrade miljöer, av forskare med olika ämnesmässig bakgrund. Det finns en tydlig upplevd brist på forskningsfinansiering inom adekvata områden och det finns brister i de finansieringsinstrument som finns idag. Detta påverkar såväl vilken typ av forskning som kan bedrivas inom spel och rekryteringen av forskarstuderande. Respondenterna är överlag mycket positivt inställda till idén om en nationell forskarskola. Flera ser också Svenska Spelforskarrådet som en viktig aktör för att stärka svensk spelforskning både nationellt och internationellt.

Rekommendationer:

• Det bör finnas en tydligare egen hemvist för forskning och utbildning inom spel för att tydliggöra kärnan i området.
• Fokus för forskningen behöver förändras så att spel för underhållning kommer mer i fokus.
• Finansieringsinstrumenten för spelforskning behöver förändras för att möjliggöra en sådan förändring.
• En nationell forskarskola inom spel bör inrättas.
• Det finns anledning att lära av framgångsrika miljöer i Finland och Danmark.

In serious game development, graphic design needs to be eye-catching, while also depicting subject matter content in a responsible, accurate, and clear way. Previous research has shown that abstract and symbolic game visuals seem to be preferable for learning and providing an engaging experience. Our research focuses on describing the challenges involved in creating effective visual communication through game graphics in cross cultures. In particular, we’re interested in examining if certain styles of visual communication are more or less effective between different cultural demographics. To examine this, we have created a serious game which aims to promote healthy food and nutrition habits to teenagers in both Nepalese and Swedish schools and by doing so also motivate behavioral changes toward healthier eating habits. We are currently conducting studies to see whether preferences and image recognition differ between the two demographical spheres. This paper will only discuss the exploratory study done in Nepal. Ultimately, this paper aims to contribute development guidelines that can aid developers in creating more effective visual communication in their serious games, and we primarily focus on exploring what we call the compromise of ‘clarity’ and ‘appeal’ in the creation of game graphics. We present an initial model for choosing at what level in terms of realism/abstraction and taxonomic hierarchy the graphical components of serious games optimally should be produced in order to solve the dilemma of precise, unmistakable, yet appealing visuals in serious games. It all comes down to two primary decisions: defining the taxonomic hierarchy of the items to depict, and choosing the style in which to depict them. With a better understanding of when different game visuals are more or less appropriate, both in terms of style and in which objects are represented, game developers will be able to balance production costs better while also creating something that strikes the compromise between clarity and appeal.

Background: Digital interventions are promising tools to reach adolescents for cardiovascular health promotion.

Purpose: We assessed adolescents’ knowledge, attitude and practice (KAP) regarding cardiovascular disease (CVD), explored opportunities for a digital intervention, and developed a serious game prototype.

Methods: In total, 649 adolescents grades 8-10 were surveyed in a semi-urban community of Nepal regarding KAP of CVD and digital pre-requisites. Eight focus group discussions (FGDs) separately among boys and girls (n=76) provided deeper understanding of CVD perceptions.

Findings: Median (IQR) percent scores for KAP were 70.6 (10.59), 78.5 (8.46) and 69.5 (11.59), respectively. Good KAP (median percent scores >75%) was found in 27.7%, 69% and 27.8% adolescents, respectively. Knowledge (p<0.001), attitude (p=0.025) and practice (p<0.001) was higher among adolescents in private than government schools. Girls had better attitude than boys (<0.001). Furthermore, 98% adolescents had smartphone access and 91.6% had internet access.

In preliminary FGD analyses adolescents mentioned physical, nutritional, mental, environmental and hereditary causes for CVD. Financial and work-related burdens, plus psychological and family-related issues were perceived to influence CVD severity. Junk food and physical inactivity were health barriers. Adolescents perceived serious games as beneficial and easy to use. Challenging game and attractive visuals were thought to stimulate game use.

Conclusion: With good attitude and excellent digital prerequisites, we conclude that serious games can help fill the existing gaps in knowledge and practice in Nepal. A prototype of “Happy Heart” is being pilot-tested among adolescents as a promising way for digital cardiovascular health promotion.

The visuals of a game is a crucial element when it comes to providing good player experiences. Visuals are also an incredibly complex subject in a game context since different modes of visual representation can be more or less “appropriate” for different settings. For example, while one can look at photo-realism as an impressive feature of a game due to its technical complexity and functionally accurate representation of real-world objects, it might still not be a fitting choice for different audiences, or for different pedagogical strategies. Serious game research seldom focuses on understanding the design of these components or their applicability to different types of learning, and it more often focuses on games’ mechanics and how well they manage to capture subject matter content while still being engaging. The aim of this paper is to explore the gap in visual communication research, describing what studies tend to focus on providing some valuable context. This review was conducted on papers that dealt with visual aspects of serious games. The results show that visual communication is rarely addressed in serious game development research. Future research would benefit from taking visual communication in detail to facilitate the effectiveness of serious games.