Culture of participation (CoP) shows its utility in the video games creation field in term of both, efficiency of production, and acceptance and retention of gamers. The authors consider the particular case of video game for health. This field involves the inclusion of various roles such as patients, game designers and health professionals to create a complex product which takes into account not only the health aspects but also video games playful mechanisms. For this reason the authors suggest that researches should be done to create a holistic participatory design approach and promote a culture of participation for games for health.
Undertaking meaningful and sustainable participation in organizations requires
accepting the loss of the distinction between producers and consumers. While in domains like
urban design or politics “normal” citizens' participation is well accepted, and while
maker spaces bring into everyday life the hacker culture, for the healthcare domain we
are fare from this point of acceptance. The term participation in the health domain can
have several significations and revert different aspects of the field practice. However,
as [
of roles these people can have will vary depending on the patient's health and on the aid the hospital or the care center is able to assure. 2
When we talk about culture of participation (CoP) in the healthcare domain, we first think about humanitarian assistance, particularly during crisis. Actually, during a period of humanitarian crisis, hundreds or thousands of people around the world organize themselves to provide logistical, food or medical support for local people in need. Many organizations like the Red Cross or Médecins Sans Frontières are able to quickly provide emergency medical assistance across the world. Furthermore, humanitarian aid is increasingly structured and professionalized, and the only good will is not enough: humanitarian organizations are now looking for professionals and specialists from diverse professions. Thereby, participation in this context is an “experts' concern”: professionals participate together to provide assistance to population who is just recipient. To moderate this latter statement, we still have the massive financial participation of laypeople across the world to support these humanitarian organizations.
More in general, medical institutions and services – or other health personnel – are
complex systems. They include highly specialized knowledge and skills aimed to treat
the higher number of people possible. They form what can be called an expert group,
using their special skills on a second group, the laypeople (patients and relative), which
is inherently in a subordinate position: this second group is requesting care and is
usually devoid of health competencies. As this expert/non expert relationship is the essence
of care it is essential to facilitate and improve the communication between these two
groups. Muller [
Doctors, specialists and different kind of therapists, partners and family, will interact with the patient and can influence more or less directly his health. This influence could happen through diagnosis, prescriptions, manipulation, psychological or emotional support, advice or assistance to the sick person. This rich ecosystem is rarely enacted in the form of a joint action, as the “myth of the expert” is well alive. Proc. of Second International Workshop on Cultures of Participation in the Digital Age - CoPDA 2014 Como (Italy), May 27th, 2014 (published at http://ceur-ws.org).
Copyright © 2014 for the individual papers by the papers' authors. Copying permitted for private and academic purposes. This volume is published and copyrighted by its editors.
The video game one is a young booming industry. Initially seen as a niche business, video games were able to open to the entire population, regularly innovating and reducing border between players and game creators.
At first, video games creation was reserved to few programming geniuses and specialized studios delivering their products in a physical format. In this scenario players had a simple “reactive” role. However, in the last ten years we are seeing a real upheaval with many initiatives promoting broad participation and reconciliation between game designers and players. As first example we can cite the abundant number of video game creation tutorials found on the web or in magazines, targeting all competencies levels and players' profiles. To this first example we can add the increasing number of middlewares offered to the public to create in an efficient and intuitive way video games, introduction that explains in part the upsurge of independent game developers works.
In the same way, game jams (i.e., gathering of game developers for the purpose of planning, designing, and creating one or more games within a short span of time) take now place on a planetary scale and help further democratize video games creation.
Finally, crowd-funding has been a key driver for video game creation. Many projects are only possible thanks to this participatory funding system. In this way consumactors (a term defining users that are consumers and actors at the same time) define the major trends to be followed by the industry.
Moreover, CoP in video game is not just about creating a whole video game. Sometimes developers allow and supply with tools the creation and the sharing of players' 'mods' – an alteration of content from a video game: they can be entirely new games in themselves or simply add new features, rules or items. Gamers' content creation is probably the most visible usage of CoP in VG. Some well-known examples of this trend are Little Big Planet1 or Spore2. This games give players a content creation tool that enables levels, creatures and vehicles design, as well as the possibility to share them online and get feedbacks. An other famous participatory video game is Minecraft3, in which players are free to collaborate, share or stole resources, build unique huge constructions or destroy others' creations in a massive virtual cubic world. The Internet is full of original and successful collaborative creations and participatory cities built in this game.
Hence, the video game industry has taken advantage of its culture of participation to bring closer game creators and players, increasing its own potential and diffusion.
While there is a theoretical discussion around participation in the health domain, for what concerns the relationship participation/health/computer science, a number of user4 Proc. of Second International Workshop on Cultures of Participation in the Digital Age - CoPDA 2014 Como (Italy), May 27th, 2014 (published at http://ceur-ws.org).
Copyright © 2014 for the individual papers by the papers' authors. Copying permitted for private and academic purposes. This volume is published and copyrighted by its editors.
centered approaches have been introduced for the development of health information
systems. We can cite in particular Participatory Design (PD), usability engineering [
Out of the health field, different design tools and methods for conceiving serious
games have been proposed, such as the usage of technical tools [
Games for health are still recent and, as seen before, very few methods or tools exist in order to improve communication and collaboration between all the different concerned actors. We believe, however, that games for health have a real interest and an increased culture of participation in this area would strengthen their creation, use and potential.
As seen, the video game area has various culture of participation forms, trying to involve players so that they became not only consumers but also actors. On the contrary, the medical world requires increasingly sophisticated and specific skills naturally taking away patients from all active roles. Yet patients are increasingly concerned about their health and the related decisions, they are more aware and connected, and challenge health professionals' position of “holder of the truth”. As a result there is an increasing loss of confidence towards them. This attitude is coupled with the patient's will to get involved in his own healing and rehabilitation, if only given the opportunity and means.
As it is possible to create and share games in the public domain it seems quite profitable to do the same in the serious game for health one for example for rehabilitation exercises. Thus, a health care provider could, for example, re-use a playful exercise created by a doctor or a physiotherapist colleague. This would save time, easily vary the exercises and allow to discover new possibilities explored by the community and not only by a single therapist. Proc. of Second International Workshop on Cultures of Participation in the Digital Age - CoPDA 2014 Como (Italy), May 27th, 2014 (published at http://ceur-ws.org).
Copyright © 2014 for the individual papers by the papers' authors. Copying permitted for private and academic purposes. This volume is published and copyrighted by its editors.
Even if from our discussion, it seems difficult to reconcile the video games and the
healthcare worlds, there is a notable example proving that it is not only possible but
also profitable to make the video games and the medicine worlds to cooperate through
technology. Foldit4 is a puzzle video game invented to imagine protein folding
possibilities in order to improve the knowledge about proteins and their modeling. Thanks
to this experience that brought together more than 200 000 non expert users [
Expand and promote the culture of participation in video games for health seems thus to be a way to capitalize on the great potential of video games in order to develop rehabilitation methods or health treatments. 7 http://fold.it/portal/
21 Proc. of Second International Workshop on Cultures of Participation in the Digital Age - CoPDA 2014 Como (Italy), May 27th, 2014 (published at http://ceur-ws.org).
Copyright © 2014 for the individual papers by the papers' authors. Copying permitted for private and academic purposes. This volume is published and copyrighted by its editors.