Play Your Protocol: Structuring the Development of Clinical-Protocol-Based Serious Games
Resumo
Serious medical games must translate safety-critical domain knowledge into requirements, art assets, interaction mechanics, and executable software, yet their development often relies on repeated negotiation among physicians, game designers, artists, and developers. This paper presents Play Your Protocol (PYPr), a digital game design method for serious visual-novel games based on clinical protocols. The Action Design Research (ADR) methodology proposed by Sein et al. (2011) was adopted as the main research strategy, given its support for continuous intervention and evaluation of the artifact throughout its construction. Across an exploratory cycle and three refinement cycles, the process evolved from a direct transfer of a BPMN-oriented game design method to a workflow centered on domain-native artifacts, storyboards, an Art Guideline, and staged expert validation. The final method was evaluated with nine participants, and open responses were analyzed using content analysis, producing 72 recording units and 82 coded occurrences. Clinical cases emerged as the most frequently used bridge between medical knowledge and development decisions, while intermediate validation improved alignment but remained vulnerable to delayed expert feedback. The contribution is process knowledge for game software engineering: domain-native boundary artifacts, explicit visual-fidelity requirements, and intermediate validation loops can structure interdisciplinary development, while expertresponse time must itself be treated as a process dependency.
Palavras-chave:
Game Development Process, Serious Games, Software Engineering, Clinical Protocols, Medicine Games
Referências
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Tadeu Moreira de Classe, Renata Mendes de Araujo, Geraldo Bonorino Xexéo, and Sean W. M. Siqueira. 2019. The Play Your Process Method for Business Process-Based Digital Game Design. International Journal of Serious Games 6, 1 (2019), 27–48.
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Janne M. Koivisto, Elina Haavisto, Hanna Niemi, Pekka Haho, Susanna Nylund, and Jari Multisilta. 2018. Design Principles for Simulation Games for Learning Clinical Reasoning: A Design-Based Research Approach. Nurse Education Today 60 (2018), 114–120. DOI: 10.1016/j.nedt.2017.10.002
Gesa Krause-Jüttler, Jan Weitz, and Ulrich Bork. 2022. Interdisciplinary Collaborations in Digital Health Research: Mixed Methods Case Study. JMIR Human Factors 9, 2 (2022), e36579. DOI: 10.2196/36579
Jadete Barbosa Lampert, Nilce Maria da Silva Campos Costa, Gianna Lepre Perim, Ively Guimarães Abdalla, Rinaldo Henrique Aguilar-da Silva, and Regina Celes de Rosa Stella. 2009. Tendências de mudanças em um grupo de escolas médicas brasileiras. Revista Brasileira de Educação Médica 33, 1 Supl. 1 (2009), 19–34.
Caroline Lima, Geraldo Xexéo, and Tadeu Classe. 2025. Beyond Play Your Process - Game Design and Business Process Model: A Rapid Review. In Anais do XXIV Simpósio Brasileiro de Jogos e Entretenimento Digital (Salvador/BA). SBC, Porto Alegre, RS, Brasil, 35–47. DOI: 10.5753/sbgames.2025.9632
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Aisling M. O’Carroll, Erin P. Westby, John Dooley, and Kevin E. Gordon. 2015. Information-Seeking Behaviors of Medical Students: A Cross-Sectional Web-Based Survey. JMIR Medical Education 1, 1 (2015), e4. DOI: 10.2196/mededu.4267, Published online: 29 Jun 2015.
Mor Peleg. 2008. Computer-Interpretable Clinical Guidelines: A Methodological Review. Journal of Biomedical Informatics 41, 4 (2008), 744–763.
Maung K. Sein, Ola Henfridsson, Sandeep Purao, Matti Rossi, and Rikard Lindgren. 2011. Action Design Research. MIS Quarterly 35, 1 (2011), 37–56.
Sissel Steihaug, Anne K. Johannessen, Marian Ådnanes, Børge Paulsen, and Russell Mannion. 2016. Challenges in Achieving Collaboration in Clinical Practice: The Case of Norwegian Health Care. International Journal of Integrated Care 16, 3 (2016), 3. DOI: 10.5334/ijic.2217
Alberto Cabas Vidani and Luca Chittaro. 2009. Using a Task Modeling Formalism in the Design of Serious Games for Emergency Medical Procedures. In 2009 Conference in Games and Virtual Worlds for Serious Applications. IEEE, 95–102. DOI: 10.1109/VS-GAMES.2009.24
James Q. Young, Jeroen J. G. Van Merrienboer, Steven Durning, and Olle Ten Cate. 2014. Cognitive Load Theory: Implications for Medical Education: AMEE Guide No. 86. Medical Teacher 36, 5 (2014), 371–384. DOI: 10.3109/0142159X.2014.889290
Laurence Bardin. 2011. Análise de Conteúdo. Almedina Brasil, São Paulo.
T. M Classe, R. M. Araujo, and G. B. Xexéo. 2018. Process model game design: Uma ferramenta para apoio a sistematização de design de jogos digitais baseados em processos de negócio. SBGAMES (2018).
T. M Classe, S. W. M. Siqueira, R. M. Araujo, and G. B. Xexéo. 2020. Play your process-um método de design de jogos digitais baseados em modelos de processos de negócio. Anais Estendidos do XVI Simpósio Brasileiro de Sistemas de Informação (Anais Estendidos do SBSI 2020) (2020), 142–157. DOI: 10.5753/sbsi.2020.13136
Tadeu Moreira de Classe, Renata Mendes de Araujo, Geraldo Bonorino Xexéo, and Sean W. M. Siqueira. 2019. The Play Your Process Method for Business Process-Based Digital Game Design. International Journal of Serious Games 6, 1 (2019), 27–48.
Oscar Colteli, Ximo Grandi, Ricardo Tosca, Pedro Latorre, José Salvador Sánchez, Luís Vicente Lizán, Francisco Ros-Bernal, and Conrrado Martínez-Cadenas. 2015. Designing Serious Games for Learning Support in Medicine Studies: A Specific Method to Elicit and Formalize Requirements. In 2014 IEEE Frontiers in Education Conference (FIE) Proceedings. IEEE, 1–4. DOI: 10.1109/FIE.2014.7044156
Aisling Duffy, Neda Boroumandzad, Amanda L. Sherman, Gillian Christie, Imam Riadi, and Sylvain Moreno. 2025. Examining Challenges to Co-Design Digital Health Interventions With End Users: Systematic Review. Journal of Medical Internet Research 27 (2025), e50178. DOI: 10.2196/50178
Marilyn J. Field and Kathleen N. Lohr. 1990. Clinical Practice Guidelines: Directions for a New Program. National Academy Press, Washington, DC.
Alan R. Hevner, Salvatore T. March, Jinsoo Park, and Sudha Ram. 2004. Design Science in Information Systems Research. MIS Quarterly 28, 1 (2004), 75–105. DOI: 10.2307/25148625
David Jaccard, Laurent Suppan, Eric Sanchez, Alexandre Huguenin, and Michael Laurent. 2021. The co.LAB Generic Framework for Collaborative Design of Serious Games: Development Study. JMIR Serious Games 9, 3 (2021), e28674. DOI: 10.2196/28674
Jason Jordan, Jennifer Wagner, David E. Manthey, Markus Wolff, Sally Santen, and Sarah J. Cico. 2019. Optimizing Lectures From a Cognitive Load Perspective. AEM Education and Training 4, 3 (2019), 306–312. DOI: 10.1002/aet2.10389
Janne M. Koivisto, Elina Haavisto, Hanna Niemi, Pekka Haho, Susanna Nylund, and Jari Multisilta. 2018. Design Principles for Simulation Games for Learning Clinical Reasoning: A Design-Based Research Approach. Nurse Education Today 60 (2018), 114–120. DOI: 10.1016/j.nedt.2017.10.002
Gesa Krause-Jüttler, Jan Weitz, and Ulrich Bork. 2022. Interdisciplinary Collaborations in Digital Health Research: Mixed Methods Case Study. JMIR Human Factors 9, 2 (2022), e36579. DOI: 10.2196/36579
Jadete Barbosa Lampert, Nilce Maria da Silva Campos Costa, Gianna Lepre Perim, Ively Guimarães Abdalla, Rinaldo Henrique Aguilar-da Silva, and Regina Celes de Rosa Stella. 2009. Tendências de mudanças em um grupo de escolas médicas brasileiras. Revista Brasileira de Educação Médica 33, 1 Supl. 1 (2009), 19–34.
Caroline Lima, Geraldo Xexéo, and Tadeu Classe. 2025. Beyond Play Your Process - Game Design and Business Process Model: A Rapid Review. In Anais do XXIV Simpósio Brasileiro de Jogos e Entretenimento Digital (Salvador/BA). SBC, Porto Alegre, RS, Brasil, 35–47. DOI: 10.5753/sbgames.2025.9632
Heidi L. Lujan and Stephen E. DiCarlo. 2025. The Paradox of Knowledge: Why Medical Students Know More But Understand Less. Medical Science Educator 35, 3 (2025), 1761–1766. DOI: 10.1007/s40670-025-02379-8
Aisling M. O’Carroll, Erin P. Westby, John Dooley, and Kevin E. Gordon. 2015. Information-Seeking Behaviors of Medical Students: A Cross-Sectional Web-Based Survey. JMIR Medical Education 1, 1 (2015), e4. DOI: 10.2196/mededu.4267, Published online: 29 Jun 2015.
Mor Peleg. 2008. Computer-Interpretable Clinical Guidelines: A Methodological Review. Journal of Biomedical Informatics 41, 4 (2008), 744–763.
Maung K. Sein, Ola Henfridsson, Sandeep Purao, Matti Rossi, and Rikard Lindgren. 2011. Action Design Research. MIS Quarterly 35, 1 (2011), 37–56.
Sissel Steihaug, Anne K. Johannessen, Marian Ådnanes, Børge Paulsen, and Russell Mannion. 2016. Challenges in Achieving Collaboration in Clinical Practice: The Case of Norwegian Health Care. International Journal of Integrated Care 16, 3 (2016), 3. DOI: 10.5334/ijic.2217
Alberto Cabas Vidani and Luca Chittaro. 2009. Using a Task Modeling Formalism in the Design of Serious Games for Emergency Medical Procedures. In 2009 Conference in Games and Virtual Worlds for Serious Applications. IEEE, 95–102. DOI: 10.1109/VS-GAMES.2009.24
James Q. Young, Jeroen J. G. Van Merrienboer, Steven Durning, and Olle Ten Cate. 2014. Cognitive Load Theory: Implications for Medical Education: AMEE Guide No. 86. Medical Teacher 36, 5 (2014), 371–384. DOI: 10.3109/0142159X.2014.889290
Publicado
08/09/2026
Como Citar
LIMA, Caroline da Conceição et al.
Play Your Protocol: Structuring the Development of Clinical-Protocol-Based Serious Games. In: WORKSHOP SOBRE ENGENHARIA DE SOFTWARE PARA DESENVOLVIMENTO DE JOGOS (SE4GAMES), 2. , 2026, São Paulo/SP.
Anais [...].
Porto Alegre: Sociedade Brasileira de Computação,
2026
.
p. 63-70.
DOI: https://doi.org/10.5753/se4games.2026.33067.
