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Games People Play
December 07, 2009
By Matt Bolch
The person who first said, "Practice makes perfect," certainly knew what he was talking about.
Whether executing a defensive driving maneuver, performing emergency surgery, finding waste and inefficiency in a manufacturing process, or calming an irate customer, many key skills can only be acquired through trial and error. OK, maybe the skills can be learned on the job or through extensive apprenticeships (physicians "practice" medicine, don't they?), but at what cost?
Simulations increasingly have become more sophisticated, tackling more complex scenarios and throwing trainees more curves for a higher level of hands-on learning in a safe environment. But higher sophistication doesn't necessarily translate into a better learning experience. As companies of all sizes have discovered over the last decade, simply throwing technology at training doesn't improve the outcome. A well-developed game or simulation, delivered in a fashion that fits the learning style and culture of an organization, will win out over whiz-bang every time.
Certain industries remain on the cutting edge of simulation technology, including the aviation industry, the military, and health care, but flight simulators and computerized patients don't come cheap.
Health Sims
That hasn't stopped Banner Health from building the nation's largest medical simulation education training center, which recently opened in the medical ward of a former system hospital in Mesa, AZ. At 55,000 square feet, Banner Simulation Medical Center is larger by a factor of two than the next largest such facility in the country and dwarfs the Phoenix-based nonprofit's former 6,000-square-foot testing center, says Dr. Mark Smith, system director of simulation and innovation. The center features 55 hospital beds and rooms, two operating rooms, ICU facilities, and much more.
Smith, an OB/GYN, has been teaching during all of his medical career, including laparoscopic surgery in the late 1980s. Several years ago, he noticed a convergence of several events that signaled an increased reliance on simulated training and convinced Banner executives to build the system's first simulation training center. The success of the first program led to the larger facility, which teaches much more than the nuts and bolts of patient care.
"Without a question, this is better than the apprentice method, where skills are practiced on the patient," Smith says. "Continual learning leads to continual improvement. Today's patients are more acute, sicker, and we have more therapies at our disposal, which means more chances for errors."
In fact, a recent investigation by the Hearst Newspapers indicates that 200,000 people in the U.S. die each year from preventable medical mistakes and infections, more than double the number the Institute of Medicine reported a decade earlier.
High-tech mannequins are the basis of the Banner training regime, providing near-real health experiences (heart attacks, births, IV training, etc.), so health professionals can learn before working on real people. These mannequins talk, bleed, breathe, sweat, and replicate a host of medical problems and challenges for training purposes. The use of mannequins can objectively measure a practitioner's level of competence while honing skills in a risk-free environment. In another instance, cyber gloves worn by a surgeon can measure movements precisely, while providing tips for improvement.
Plans call for the annual training of nearly 2,000 nurses, nurse practitioners, physicians, residents, and emergency health-care providers, who will learn various health procedures in simulated environments. The medical center also will focus on building team dynamics. In one example, respiratory therapists might be paired with ambulance drivers, paramedics, and first responders to teach communication skills, teamwork, and proper procedures for handing off patients from an ambulance to the emergency room. "There is a perception in health care that you can do [a procedure] once and be good at it, and that's just not true," Smith says.
Cost of Entry
Nevertheless, high-level simulations remain out of reach for all but the most well-heeled, maintains Michael Zyda, director of the USC GamePipe Laboratory. Zyda chaired a committee on modeling and simulation a decade ago for the defense industry, which continues to be a leading user of the technology.
"The price of developing technology is what's holding many companies back," says Zyda, noting the U.S. Army recently paid $17 million to license a game engine and then looked to the Czech Republic to hire developers.
What's happening in the development arena can be compared to the early days of the Internet, as complex hypertext markup language (HTML) coding gave way to the point-and-click functionality of software such as Dreamweaver, so Websites could be built faster and with less effort and expertise.
Zyda believes cost-effective tools that will bring customized training simulations within the reach of more companies are around the corner. He also believes in the power of smartphones such as the iPhone as training vehicles, and he has formed a startup company to explore smartphone game development for corporate training use.
But tools already exist to help training officials create effective simulations quickly and easily. Jacklyn Williford, training manager at San Diego-based ImageWare Systems Inc., purchased a desktop development suite from OutStart in 2007 and now spends hours on sales presentations that formerly took days using HTML and Flash.
Williford, the only employee in her department, needed a simple solution that didn't require advanced programming knowledge to master. During a one-week trial, she created both a demonstration and a simulation with only one call to OutStart for assistance.
Besides sales presentations, Williford creates simulations that emulate the company's identification, biometric, and digital imaging offerings, so training can take place at a client site without someone having to lug and calibrate the company's sophisticated equipment. A similar simulation is useful at trade shows, allowing attendees to explore the product offerings and jump to the product that most intrigues them. "The simulation has the same functions, the same feel as our equipment without actually having the equipment on site," Williford says. "Internally, we can use the same simulation to train our sales staff."
Because the company deals with the federal government and military, any system had to be SCORM (Sharable Content Object Reference Model) compliant and work with other learning management systems.
Building Blocks of Learning
Dayton Superior, a manufacturer of products for the construction industry, has found great success not with sophisticated computer simulations but with a game featuring piles of LEGO building blocks and a desire to build relationships among workers and tear down barriers to communication, notes Mike Smith, group manufacturing manager for the company based in Dayton, OH.
The company licensed the game from Definity Partners, keeping the core Lean improvement concepts derived from building LEGO Jeeps as efficiently as possible while infusing the game with Dayton Superior's culture and visioning messages. The result has been nearly $2.5 million in sustainable labor savings in the last three years amid a $10 to $12 million reduction in overall labor costs. The company also has reduced its inventory greatly, although Smith says hard dollar savings are difficult to quantify.
The game is used as an ice-breaker, as teams of employees from vice presidents to janitorial staff members at a plant or distribution center work together to build as many Jeeps as possible during a prescribed time period. During evaluation sessions between builds, Lean concepts are introduced and reinforced during the three to four months Smith's team is at a location.
"To make improvement sustainable, you need that amount of time to change behavior and make it stick," Smith says. "The game does a great job teaching the Lean concepts it's designed to teach. I haven't had a group that wasn't excited to go through it."
And who can't have fun playing with building blocks?
Quick Tips
Considering training simulations? Here is some advice from Paul R. Damiano, president of Good Works Consulting, a Greensboro, NC-based management consulting company specializing in leadership and team development:
• Don't play "games": Never call your simulation a "game." Participants don't like playing "games," and clients certainly do not want to pay for them. Always refer to it as a simulation, experiential activity, or interactive learning exercise.
• Break the rules: You should know how to run the same simulation multiple ways depending on group dynamics. Don't be afraid to add new wrinkles and nuances to better meet your learning objectives.
• Stay out of the way: Many simulations fail because they are over-facilitated. You do not need to jump in to "rescue" the group. Group failure often provides the best forum for true learning.
• Debrief from the inside out: Start your debrief with individual reflection, then have participants share their insights with a partner or within a sub-group. Only then can you move to group-level processing and discussion.
• What to always ask: You should always ask questions that force trainees to apply insights and make connections back to their work environment. This is the true litmus test of an effective simulation.
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