Video game design and physical therapy.

The Smithsonian Institution recently conducted a symposium on electronic and non-electronic game design. The three speakers developed such games as Donkey Kong, Magic: The Gathering, and Ultima Underworld. I took my son, an avid video game player. However, I was surprised by how much of what the speakers said related to physical therapy. As this issue of the Buyer's Guide was being prepared, I was reminded of those similarities.

Parallels between video game design and physical therapy? There are more than might first seem apparent.

Some players of video games focus on the technology. Which is better--PlayStation 2, Xbox, or GameCube? But the speakers who had developed electronic games--Shigeru Miyamoto, senior managing director, Entertainment Analysis and Development Division, Nintendo Co; and Doug Church, chief technology director, Eidos North America--barely mentioned the merits of the different hardware. Implicit in their discussion was that a competent designer could construct an enjoyable game for any of the platforms. In fact, Miyamoto said that some technology-specifically, today's hand-held controllers--has become too complicated. He's advocating a return to simpler controllers, so that those devices don't become a barrier between the player and the game.

Working on this issue of the Buyer's Guide, we considered some cover designs that focused largely on technology and equipment. After review, though, we felt that an emphasis on the "human element" better represented the mission of the magazine. APTA's Vision Statement 2020 similarly suggests that technology should not come between a patient and a physical therapist (PT). It says, in part, "While fully availing themselves of new technologies, as well as basic and clinical research, physical therapists will continue to provide direct care." (1) As with electronic games, technology in physical therapy should assist PTs in their mission, rather than become its focus.

Some game design development practices also may be applicable to physical therapy. Church said that he creates each game while imagining three distinctly different players. The first player focuses on understanding the rules and the strengths and weakness of the characters, and then very deliberately chooses the combination of strategies and actions that best will ensure victory. The second player prefers to be tricky or clever. And the third likes bold, dramatic moves. A successful game must appeal to each type of player, and each player must have a chance to win using his or her preferred strategy.

The game developers are doing nothing more than applying personality types to game playing, just as the profiled PTs do in "Understanding PT, PTA, and Patient Personality Types." (2) That article examined a system that defined four personality types: Artisans, Guardians, Idealists, and Rationals.

A game player who understands the rules and deliberately selects the strategies to best ensure victory? The Guardian personality assumes there is a "right" way to do things, is rules oriented, uses a detailed and thorough approach, and expects people to "play" their roles.

A player who prefers to win using cleverness? Rationals are pragmatic; their specialty is strategy. Give them the latitude to figure out how to accomplish their tasks.

A gamer who likes bold, dramatic moves? An Artisan expects quick action, works in the here and now, and is validated by visible results.

Interestingly, Church didn't mention the traits of an Idealist. Perhaps Idealists are not avid players of video games. They prefer harmony and dislike conflict, clock-watching, and being compared to others.

The point is that game design and physical therapy both are benefiting from an understanding of personalities and temperaments.

In addition to satisfying varying personalities, the Smithsonian session's speakers said, popular games allow players freedom of choice. Players become dissatisfied if the system limits their options. That observation might as easily be applied to direct access and the consumer's right to choose.

Another discussion topic explored whether game design is a science or an art. The panelists finally agreed that it really involves both. And that echoed APTA's slogan "The Science of Healing. The Art of Caring."

The parallels between game design and physical therapy aren't perfect, of course. Further, the similarities--the recognition of personality traits, the desire of players or patients for freedom of choice, and the concern that technology may be building rather than removing barriers, for instance--can be found throughout society. And that's the point: there are certain nearly universal traits and patterns. Nevertheless, physical therapists and garners often describe these elements in surprisingly similar language.

Don Topper is Editor. He con be reached at [e-mail].

References

(1) APTA's Vision Statement for Physical Therapy 2020. Available at www.apta.org/About/aptamissiongoals/ visionstatement. Accessed June 16, 2004.

(2) Coyne C. PT, PTA & patient personality types. PT--Magazine of Physical Therapy. 2004:12(4): 46-53.