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Design and Empirical Validation of Effectiveness of an Online Story-based Gamification Platform for Sex Education

Ng, Joshua University of California, Irvine ngyf@uci.edu

Rescue Mission: Gamification of Sex Education for Hong Kong Students

Joshua Ng, Xuanxi Xu, Sam Chu, and Wendy Wu

University of Hong Kong

East China Normal University

University of California, Irvine

Abstract

With both liberal social values emerging into a society that still upholds traditional Chinese values, sex education (SE) is being increasingly difficult to be discussed in Hong Kong (HK). Since minimal resources has been provided for instructors to educate their students on SE, alternative methods of educating SE has to be derived urgently before sexually related health risks such as sexually transmitted infections and unplanned pregnancies continue to grow. One of these alternative methods is through the process of gamification (Kapp, 2012), which had been yielding more positive results than traditional classroom settings (Arnab et. al., 2013; Bull et. al., 2012: Frost et. al., 2012). “Rescue Mission” (RM) is gamified platform catered towards HK secondary school students to foster their learning experience of SE. While rescuing a virtual dying patient, players of RM would also learn and engage in the discussion of SE supported with gamified elements. After playing with RM, users are expected to be informed about and be more aware of the attitudes towards SE. A prototype of RM was launched in 2017 and 100 HK secondary school students had tested its effects. Although only a pilot study, all participants had a mean score of 85.98 (SD = 4.12) from the readings they had read, suggesting its effectiveness to HK secondary school students.

Rescue Mission: Gamification of Sex Education for Hong Kong Students

Hong Kong (HK) societic values has been increasingly liberal; those values are not limited to sex and relationships. One of the effect of this phenomenon is the increasing numbers of underage sexual intercourse among HK adolescents (Family Planning Association of Hong Kong, 2012). Unfortunately the increase of underage sex has also increased the numbers of several health issues especially amongst HK adolescents. Two of these health issues are the spread of sexually transmitted infections (STI) and unplanned pregnancy (Tsang, 2014). To prevent the health risks of unsafe sexual activities, adolescents should be properly informed about sex education (SE).

Regrettably current SE atmosphere in HK is far from adequate. According to Red Ribbon Centre (2014), HK secondary school instructors only spend on average three hours per academic year teaching topics related to SE and had received minimal training and resources to educate students on SE. But to complicate this issue, traditional Chinese values further obstruct topics related to SE being discussed in and outside of classrooms (Chang, 1991, Okasaki, 2002). With the above factors affecting the overall SE atmosphere, HK adolescents had minimal, if any, exposure to the wholistic discussion of SE. This phenomenon also arguably restricted awareness of safe sex among HK adolescents which could further intensify the already increasing numbers of STI and unplanned pregnancies (FPAHK, 2012; Tsang, 2014). With the current SE atmosphere in HK, an effective method to educate HK students in SE and to have them engage in a healthy discussion is imminent and urgent.

Gamification: An alternative method

Current literature suggests alternative methods to foster SE and discussion within and outside of classrooms; one of which is through gamification (Kapp, 2012). Some scholars had defined game as “systematic” abstracts which allows its participant(s) to engage in a fictional “conflict” (Salen & Zimmerman, 2004). Gamification is to use elements of games to foster “learning and engagement” of a certain subject or idea (Kapp, 2012). Even though there were no standardized measures, Kapp (2012) suggested twelve elements present in games. The elements are (1) “Abstractions of concepts and reality”; (2) “Goals”; (3) “Rules” (Keller, 1987), (4) “Conflict, competition, or cooperation” (Malone & Lepper, 1988); (5) “Time”; (6) “Reward structures”; (7) “Feedback” (Hunicke, 2009); (8) “Levels”; (9) “Storytelling”; (10) “Curve of interest”; (11) “Aesthetics”; (12) “Replay or do over”. Several theories from previous literature supports gamification in education. One of which is motivation theory, especially in the taxonomy of intrinsic motivation (Lepper, 1988; Malone, 1988). Other theories are self-determination theory (Ryan and Deci, 2000), social learning theory (Bandura & Walters, 1971), and flow theory (Csikszentmihalyi, 1975). Previous research had demonstrated the efficiency of using games in education compared to dictated classroom approaches (Arnab et. al., 2013). One of the conclusions was gamification creates effective interventions which stimulated peer involvement within the discussed topic. The interactive process of gamification is not only engaging but also pedagogically sound, which are vital to effective learning (Arnab et. al. 2013). Other prior researches had applied gamification in sex education in their respective cultural contexts and achieved positive results (Bull, Levine, Black, Schmiege, & Santelli, 2012; Frost, Lindberg, & Finer, 2012). Therefore gamification could be an effective alternative to the current model of HK secondary schools to foster a more engaging discussion of SE.

Rescue Mission and its game elements

The e-learning platform “Rescue Mission” (RM) was developed with funding from the Hong Kong Jockey Club Charities Trust to educate HK secondary school students on the proper information and information and attitudes of SE by gamifying the learning process. RM only has one goal to its players: To rescue a dying patient. But to rescue the patient the player has to correctly answer multiple-choice questions from different modules about SE. These questions were derived from readings from institutions that had been contributing to developing SE, such as FPAHK. Answering the questions correctly would improve the patient’s health, even becoming a superhuman. Failing to answer the questions correctly would deteriorate the patient’s health, even to his death. Fortunately, the patient could be resurrected by correctly answering more questions. The player would receive a second chance if they answer a question incorrectly at first, but they would only receive 80% of the score as a slight penalty for a correct second try. There is also an online leaderboard for the player to input an alias to compare their scores to other players.

There are several design details that RM take advantage of the game elements suggested by Kapp (2012). With “Abstractions of concepts and reality”, the patient can be resurrected and to have super powers, which are both fantastical elements but they motivate the player to learn more about. The player also fulfills the goals of rescuing the patients and potentially to compete with other players, while indirectly fulfilling the goal of the designer - to learn about SE. The rules of the game is clearly defined; wrong answers would have negative reinforcements while right answers would have positive reinforcements. There are less conflicts and cooperation being exhibited as RM is a single-player game, but competition is clearly demonstrated with the leaderboard system. Time is not a resource in-game, but is one within competition between players as most players are trying to get the highest scores in the least amount of time. RM also exhibits reward structures as the in-game reward is the patient’s health while social reward in the leaderboard. Feedbacks are also available in-game as there would be sub-texts informing the player in both failed and successful attempts; moreover, both the sub-texts would guide the player to think in a certain direction if they have failed their attempts as scaffolding support. RM also has multiple modules and topics of SE to learn from. The last question of each module is a “Challenge Question” and would reward the player with bonus points if they correctly answered the “Challenge Question”. RM does not have a deep narrative, but there is a sense of narrative in rescuing the dying patient. Although aesthetics is a subjective concept, the illustrations on RM were all original. RM also has freedom to fail but different levels of consequence.

RM does demonstrate most, if not all, of the elements being proposed by Kapp (2012). But RM have also added two additional elements which further foster the SE learning experience in the context for HK students. The first is anonymity on the leaderboard. The player may enter their alias instead of their actual names which may reduce the social stigma from peers for either scoring too high or low. The accessibility of RM is also critical as a design element; making RM a public online domain may let HK students to learn about SE and compete with others as long as they have a device that connects to the internet and a registered account.

A prototype of RM was launched in 2017 to test its effects. The population were one hundred (100) HK local secondary school students. All the participants had an assigned alias and password to login, but may write their own alias on the leaderboard for anonymity. The participants may login and use RM whenever they wish. The mean score was 85.98 out of 100 (SD = 4.12) on the questions as of 16th October 2018. Although this is only a pilot study, the result is certainly welcoming to the use of gamification of SE in HK secondary school students. Further studies will be done to examine the effectiveness of RM in a not too distant future.

References

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Li, Xuanxi East China Normal University lixx@dedu.ecnu.edu.cn

Wu,Wendy The University of Hong Kong wendywu@hku.hk

Chu, S. K.W. The University of Hong Kong samchu@hku.hk

Abstract

This study aims to design and develop a game-based learning environment to help students learn Sex Education (SE) knowledge. A game-based platform named "Rescue Mission" (https://smartchoicesv2.proj.hkedcity.net/rm/)has been developed based on social learning theory, self-determination theory, flow theory, and motivation theory. This study described the design of this platform. This study may shed light on how information technology used to foster sexuality education (SE) among secondary school students.

Introduction

Didactic approaches to Sex Education (SE) have been shown to yield limited outcomes when compared to approaches that stimulate peer discussion and debate. Creating effective interventions, which stimulate peer involvement, remains a demanding task and finding a solution that is not only engaging but also pedagogically sound is vital. A case thus exists for exploring how game technology might facilitate more feasible solutions (Arnab et al., 2013).

With the context of formal classroom based secondary education in mind, Arnab et al. (2013)’s study discusses the development approach of a digital game PR:EPARe (Positive Relationships: Eliminating Coercion and Pressure in Adolescent Relationships) aiming to assist the delivery of Relationship and Sex Education (RSE). Although most schools in the UK do include RSE in their curriculum delivery, the nature and content of what is taught can vary widely and is often dependent on the skills and dedication of PSHE leads and their colleagues. Using digital resources presents an opportunity for supporting a certain level of consistency of delivery, under the proviso that its design ensures students and teachers find it engaging and rewarding to use and the solution is pedagogically sound. In this case, a game-based learning approach was explored capitalizing on its engaging nature with early research indicating efficacy for learning.

When delivering lessons on topics such as personal relationships and sexual health, this benefit of assistance from a relevant professional can be substantial and the benefits of encouraging discussion amongst peers have been demonstrated (Mellanby, Phelps, Crichton, & Tripp, 1995).

Reference:

Arnab, S., Brown, K., Clarke, S., Dunwell, I., Lim, T., Suttie, N., . . . Freitas, S. d. (2013). The development approach of a pedagogically-driven serious game to support Relationship and Sex Education (RSE) within a classroom setting. Computers & Education(69), 15-30.
Mellanby, A. R., Phelps, F. A., Crichton, N. J., & Tripp, J. H. (1995). School sex education: an experimental programme with educational and medical benefit. [Research Support, Non-U.S. Gov’t]. British Medical Journal, 311(7002), 414–417.