MXRKED

 (Thesis Design Document)

Kathleen Rodriguez

EDCT-GE 2095: Research in Educational Communication and Technology

Professor Russell Neuman

Spring 2015

1. Analysis

9. Problem/Need

For decades, many national foundations and public health organizations such as the American Academy of Dermatology (AAD) and the Skin Cancer Foundation have worked hard “to promote anti-skin cancer campaigns, raise awareness about dangers of UVR from both natural and artificial sources, and deliver educational programmes focusing on skin cancer prevention as well as the need to practice sun-safety behaviour (Nahar, 2013).” Despite new and innovative methods to inspire teens and young adults to become more proactive in their everyday skin care routine, from new tv shows (e.g. The big C) to public health campaigns (e.g. Go With Your Own Glow), “skin cancer is (still) the most commonly diagnosed cancer in many Western countries” (Day et al., 2014). According to Day et al. (2014),  “Of all the cancers diagnosed in the United States, Australia and Great Britain, skin cancer is the most common, causing over 16,000 deaths annually in these three countries.”                                                                 Melanoma, the most serious and severe type of skin cancer, remains “the most common form of cancer for young adults 25-29 years old and the second most common form of cancer for young people 15-29 years old” (Bleyer et al., 2006). According to Lange et al. (2007), “ninety percent of pediatric melanoma cases occur in patients aged 10-19.” Melanoma continues to increase “eightfold for women under 40 since 1970” (Fitzsimmons, 2013). Women aged 39 and under are at a higher risk of “developing melanoma than any other cancer except breast cancer” (American Cancer Society, 2015). Melanoma is also known for being “one of only three cancers with an increasing mortality rate for men, along with liver cancer and esophageal cancer” (Ahmedin et al., 2010). Although young males are accountable for 40% of melanoma cases, more than 60% of these cases result in death (Fisher et al., 2013). According to the American Cancer Society (2015), “an estimated 42,670 new cases of invasive melanoma in men and 31,200 in women will be diagnosed in the U.S. in 2015.” In addition, “an estimated 6,640 men and 3,300 women in the US will die from melanoma in 2015” (American Cancer Society, 2015). Even though those diagnosed with melanoma can be treated if detected early, “survivors of melanoma are about nine times as likely as the general population to develop a new melanoma” (Bradford, 2010).

35. Content:

Our skin is “the largest organ of the human body” (Nahar, 2013). It consist of  three main layers: the outermost layer (The Epidermis), the inner layer - (The Dermis) “and the lowermost tissue layer known as tela subcutánea” (or subcutaneous tissue or hypodermis) (Nahar, 2013; Saladin, 2007, p. 135). There are many types of epidermal cells , which include keratinocytes, melanocytes, Merkel cells, and other infiltrating cells (lymphocytes, neutrophils, etc.) (Nahar, 2013). “The three main types of skin cancer are named after the following cells: basal cell carcinoma, squamous cell carcinoma, and melanoma” (Nahar, 2013) . Of these three cancers, melanoma is considered to be the most serious and severe type of skin cancer (Nahar, 2013).

What is Melanoma?

According to the American Skin Association (2012), “Melanoma is a life threatening malignant (cancerous) tumor that originates in cells called melanocytes, which are pigment-producing cells.” Melanocytes are located in the bottom part of the epidermis and they are known for producing melanin, “the pigment responsible for the skin colour” (Nahar, 2013). When our body is exposed to ultraviolet radiation (UVR), whether through artificial tanning beds  or through natural  sunlight, melanocytes start producing more melanin, which leads to the darkening of the skin (Nahar, 2013). Excessive exposure to ultraviolet radiation causes damage to the melanocytes and therefore, increases the risk of having skin cancer (Nahar, 2013).                         Although “the majority of melanomas are black or brown”, some melanomas can also be skin-colored, pink, red, purple, blue or white (American Skin Association, 2012). Melanoma begins on the outermost layer of the skin (The Epidermis) where it is both easily visible and treatable (American Skin Association, 2012). However, if untreated, “it can grow into the skin, reaching the blood vessels and lymphatics”, and can spread to various organs (lungs, liver, etc.) of the body “where it can be fatal” and hard to treat (American Skin Association, 2012).

How is Melanoma diagnosed?

There has been many incidents where people mistaken Melanoma to be a a new, black, abnormal mole. According to the American Skin Association (2012), the best way to check for any suspicious moles on your body is to do a skin self-examination where the ABCDEs (Asymmetry, Border Irregularity, Color Variegation, Diameter, Evolution) of melanoma. The first sign of melanoma is often a change in the size, shape, or color of a mole.

Figure 1: Checklist created by the American Skin Association (2012) that demonstrates how the ABCDEs of Melanoma can be used to evaluate one’s skin

What are the different types of Melanoma?

According to the American Skin Association (2012), “Melanomas fall into four basic categories.” The most common type is Superficial Spreading Melanoma, which is seen in about 70% of all cases and primarily in young people (American Skin Association, 2012). In this case, “melanoma travels along the top layer of the skin (Epidermis) for a fairly long time before penetrating more deeply” (American Skin Association, 2012).  The second type of melanoma is Lentigo Maligna, which is mostly found in elders due to “ chronically sun-exposed, damaged skin on the face, ears, arms and upper trunk” (American Skin Association, 2012). The third type of melanoma is Acral Lentiginous melanoma, which “usually appears as a black or brown discoloration under the nails or on the soles of the feet or palms of the hands” (American Skin Association, 2012).  It is more commonly found among African-Americans and Asians (American Skin Association, 2012). The final type of melanoma is Nodular Melanoma, which is “usually invasive at the time it is first diagnosed” (American Skin Association, 2012).  It is usually black, but occasionally is blue, gray, white, brown, tan, red or skin tone (American Skin Association, 2012).

How is Melanoma staged?

According to the National Cancer Institute (2015), Melanoma is divided into five stages based on the depth of the primary tumor and how far along the cancer has spread from its starting point.

Stage 0 (Melanoma in Situ)

Stage 0 begins with the discovery of abnormal melanocytes that are found in the Epidermis (the outermost layer of the skin) (National Cancer Institute, 2015). These abnormal melanocytes can potentially become cancerous and spread into nearby tissues (National Cancer Institute, 2015).

Figure 2: Stage 0 (Melanoma)

Stage I

During stage 1, cancer is detected in the melanoma, which is divided into two stages, IA and IB (National Cancer Institute, 2015). In stage IA, the tumor is not more than 1 millimeter thick, with no ulceration (National Cancer Institute, 2015). In stage IB, the tumor is either not more than 1 millimeter thick and it has ulceration; or more than 1 but not more than 2 millimeters thick, with no ulceration (National Cancer Institute, 2015).

Figure 3: Stage I (Melanoma)

Stage II

Stage II is divided into stages IIA, IIB, and IIC (National Cancer Institute, 2015). During stage IIA, the tumor is either more than 1 but not more than 2 millimeters thick, with ulceration; or more than 2 but not more than 4 millimeters thick, with no ulceration (National Cancer Institute, 2015). In stage IIB, the tumor is either more than 2 but not more than 4 millimeters thick, with ulceration; or more than 4 millimeters thick, with no ulceration (National Cancer Institute, 2015). In stage IIC, the tumor is more than 4 millimeters thick, with ulceration (National Cancer Institute, 2015).

Figure 4: Stage II (Melanoma)

Stage III

In stage III, the cancer may have spread to one or more lymph nodes (National Cancer Institute, 2015). It could also be located in a lymph vessel between the primary tumor and nearby lymph nodes (National Cancer Institute, 2015). The cancer may appear more than 2 centimeters away from the primary tumor (National Cancer Institute, 2015). Very small tumors may be found on or under the skin, not more than 2 centimeters away from the primary tumor (National Cancer Institute, 2015).

Figure 5: Stage III (Melanoma)

Stage IV

During stage IV, the cancer has spread to other places in the body, such as the lung, liver, brain, bone, soft tissue, or gastrointestinal (GI) tract (National Cancer Institute, 2015). The cancer may have also spread to places in the skin far away from where it first started (National Cancer Institute, 2015).

Figure 6: Stage IV (Melanoma)

What are the treatments available?

Despite early detection, which overall the best treatment for increasing one’s chances of survival, there are several forms of treatment that are recommended to patients with Melanoma depending on which stage they encounter (American Skin Association, 2012). Surgical excision is the first step in treatment for all stages of melanoma (American Skin Association, 2012). Based on the pathological features of the tumor, it is removed completely along with surrounding normal tissue (American Skin Association, 2012); this reduces the chance of leftover cancer cells in the skin. Margins for the excision is determined by the tumor invasion (American Skin Association, 2012). This procedure is done using local anesthesia by a dermatologist or a surgeon as an outpatient procedure (American Skin Association, 2012). Usually, complete surgical excision of the melanoma is the only treatment needed for people with early-stage melanomas (thinner melanomas that have not spread to the lymph nodes) with regular follow-up visits with a dermatologist (American Skin Association, 2012).

How can I prevent melanoma?

Sun Protection is believed to be the easiest and most effective way to diminish the risk of melanoma and skin cancer overall (American Skin Association, 2012). It is recommended that one avoids sun exposure between 10.a.m to 4 p.m, when the sun is at its strongest (American Skin Association, 2012; Lange et al., 2007). It is also recommended that one applies a generous amount of broad-spectrum sunscreen (with UVA/UVB protection and 15+ SPF) all year round to all exposed skin (American Skin Association, 2012; Lange et al., 2007). It is important that one apply sunscreen 20-30 minutes before heading outside and that he/she apply it every two hours (American Skin Association, 2012). In addition to sunscreen, one should also wear protective clothes such as hats, long sleeves, long pants, and sunglasses (American Skin Association, 2012; Lange et al., 2007). One can also conduct his/her own self skin examination, which should be done every 6-8 weeks from head to toe (American Skin Association, 2012). The main objective of the self skin examination is to look for any suspicious moles using the ABCDEs method (American Skin Association, 2012).

Who is at risk for developing melanoma?

Although everyone is at some risk for having melanoma, several factors can increase one’s chances even further (American Skin Association, 2012). The most serious risk factor is sun exposure since both “UVA and UVB rays are dangerous to the skin, and can induce skin cancer, including melanoma” (American Skin Association, 2012).  In addition to UVA & UVB rays, “blistering sunburns in early childhood increase risk, but cumulative exposure also is a factor” (American Skin Association, 2012). Another risk factor are moles especially for those who have more than 50 moles or have irregular and unusual looking moles (dysplastic nevi). Family History can also be a key factor (American Skin Association, 2012). Anyone who has a first-degree relative (mother, father, siblings, and/or children) that was diagnosed with melanoma has a greater chance (50%) at developing melanoma compared to those who have no family history of melanoma (American Skin Association, 2012). Those who have very fair skin and a compromised immune system are also at a higher risk of being diagnosed with melanoma if the proper skin care and sun protection precautions are not met (American Skin Association, 2012).

iii. Target Audience/ Learner Characteristics:

The target audience for this design will be teens (male and female) ages 15-18 (older adolescents) who reside in NYC, are frequent PC gamers, particular those who are interested in action-adventure, role-playing and/or multiplayer online games, and have some knowledge about sun protection and skin cancer prevention.

The reason for why I chose to focus on this particular age group is because although teens and young adults become more and more aware of the importance of sun protection and the dangers of skin cancer each year, they continue to fail in taking action and advocating change against poor skin care habits. In spite of the fact that there has been “nearly 30 years of public health messages, the skin cancer diagnosis rate continues to rise, and people are still failing to use or inconsistently using sun-protective measures” (Day et al., 2014). “Although the solution to reducing skin cancer rates appears straightforward (i.e. reducing UVR exposure)”, the dedication to change certain behaviors (e.g. skin care and sun protection) proves to be an on-going challenge. According to a 2009 Institutional Review Board-approved, 22-question survey that was administered anonymously to more than 450 students (ages 14–18) in grades 9 through 12 at two high schools in New York and New Jersey,  60 % of teens thought that being “tan” was a desirable and attractive physical feature among adults (Ashinoff et al., 2009). Although 50% of students were aware of what a melanoma was and the damage excessive sun exposure can have on their skin, 54% of students mentioned that “they would continue to tan as adults” (Ashinoff et al., 2009). Therefore, for this project, I want to design an innovative, creative approach that will encourage teens ages 15-18 to learn more about the dangers of skin cancer and therefore, hopefully take skin cancer prevention and sun-safety precautions more seriously at an earlier age.

Socially, older adolescents become aware of their ability to make meaningful contributions to society (Search Institute, 2007; Groff, n.d.). They begin to desire respect and being treated like adults (Search Institute, 2007; Groff, n.d.). Therefore, they become more focused on making serious commitments and personal goals such as taking on community service projects, leadership roles and more work responsibilities (Search Institute, 2007; Groff, n.d.). They begin to search for intimacy and therefore, start to pursue romantic relationships and test sexual attractiveness (Search Institute, 2007; Groff, n.d.). Older adolescents also start to “spend less time than they used to with their families”  and spend more time with friends or alone (American Medical Association, 2001). In addition, They become more driven to make close friends that share the same  interests or attributes as them (sports, arts, etc. ) (American Medical Association, 2001).

Emotionally, older adolescents become more confident and begin to gain more autonomy (Search Institute, 2007). Attaching themselves to people and things they highly value and respect plays a critical role to their development (Search Institute, 2007; Groff, n.d.).. They begin to embrace their individuality and enjoy their own unique traits despite their ongoing struggle of seeking praise and approval from their peers and friends (Search Institute, 2007; Groff, n.d.). They also begin to develop their own set of values and beliefs, “take on multiple roles and responsibilities, search for potential career possibilities, and initiate and carry out their own tasks without the supervision of others”(Search Institute, 2007; Groff, n.d.). On the other hand, older adolescents at this stage tend to take fewer risks in their relationships and friendships (Search Institute, 2007; Groff, n.d.). They “are more self-assured and better able to resist peer pressure than younger teens” (American Medical Association, 2001). They begin to focus on gaining control over more aspects of their life (American Medical Association, 2001). Old adolescent tend to be “excited and at the same time overwhelmed by the possibilities for their future (college, work, or military)” (American Medical Association, 2001). Like adults, older adolescents tend to experience depression” (American Medical Association, 2001). They also become more aware of their sexual orientation (homosexual, heterosexual, bisexual, etc.) (American Medical Association, 2001).

During this age range, older adolescents undergo a lot of changes both physically and mentally. As their brains begin to reach their full potential, so does their ability to make “positive choices, have healthy relationships, regulate their emotions and reactions, and plan ahead” (Search Institute, 2007). Teenage girls ages 15-18 have usually reached full physical development while teenage boys are close to completing their physical growth (American Medical Association, 2001). Teens ages 15-18 are known for reaching their peak of sexual maturity. Although they “tend to develop a more realistic view of limits to which body can be tested”, older adolescents at this age range still continue to be concerned about their body image (Search Institute, 2007; Groff, n.d.). Many teenage girls at this age range are concerned with the way they look and are dissatisfied with their bodies and their weight; therefore nearly half of all high school girls diet to lose weight (American Medical Association, 2001). Around ages 15 or 16, teenage boys' voices will lower,  facial hair will begin to appear, and their height and muscle mass will continue to grow (American Medical Association, 2001).                                                Intellectually, older adolescents ages 15-18 will begin to master abstract thinking and have the the ability to “imagine impact of present behavior on the future” (American Medical Association, 2001). They can consider and understand multiple perspectives and develop their own theories on how certain things happen (Search Institute, 2007; Groff, n.d.). However, they still want to make their own interpretations based on what they see, feel, and experience (American Medical Association, 2001). At this age range, teens are able to solve problems more efficiently, learn to appreciate the opinions of others, and understand the long-term effects of their decisions (Search Institute, 2007; Groff, n.d.). On the other hand, older adolescents tend to use these new skills inconsistently and therefore, continue to do things without thinking first such as frequently questioning and challenge school and parental rules as well as lose  patience with meaningless activity (Search Institute, 2007; Groff, n.d.; American Medical Association, 2001). Their organizational skills begin to improve and as a result, enable them to do multiple tasks simultaneously such as school, outside activities, and work (Search Institute, 2007; Groff, n.d.; American Medical Association, 2001) . In an attempt to answer the questions "Who am I?" and "What should I be?" teens ages 15-18  also begin to “listen to new music, try out clothing fashions, and begin to explore jobs, religion, political issues, and social causes” (American Medical Association, 2001).

iv. Project Goal and Objectives

Goal 

Student will work, both collaboratively and individually, to learn, take action and fight against Melanoma.

Objectives

• Students will be able to complete daily quests together throughout the game where they have to recall and explore the initial stages of Melanoma.
• Students will be able to learn key skin care terminology and topics (UVA, UVB, Epidermis [E-Zone], Dermis [D-Zone], Subcutaneous Layer [S-Zone], SPF) that can be applied both in the game and in their everyday lives.
• Students will be able to invite his/her friends/peers in the game to join his army/rebellion team.
• Students will be able to  receive new rewards (game points), inventory, and badges after completing additional tasks outside the game (appears on the game’s website) such as:

• Liking a particular skin cancer organization’s social media platform (Facebook, Twitter, Instagram, etc.)
• Donating to an organization that focuses on skin cancer treatment/prevention
• Visiting a particular website that discusses Melanoma
• Joining a Facebook or Meetup group that focuses on organizing community service opportunities for those interested in raising money of skin cancer treatment/prevention

v. Context/Setting

The overall learning will take place in a PC game environment that would require users to login into a game server using their own credentials (username and password) and have access to the internet (wifi or wired connection). This environment does not require any additional hardware or software. It will have IT support located on the Help section of the game’s website, which will include pre-made Q&A questions, tutorials (videos and screenshots), the game manual, and

1. what hardware/software/IT support/connectivity is available in this environment?
2. when/where/how learning will take place
3. social features (ex: community/organization)

vi. Landscape Audit

The following is a list of existing products that are currently being implemented to address the topic of cancer to the general public. This list focuses on games, both web-based or mobile. 

1. Is that skin cancer?

http://www.purposegames.com/game/is-that-skin-cancer-game

Is that skin cancer? is a simple online timed guessing game designed by purposegames.com in 2006 to inspire users to learn how to identify the main signs of melanoma using the ABCDE rule. The main objective of this game is to find which images represent a physical sign of melanoma. The main pros of this game are that it is rule-based (has a clear objective and set of rules), responsive (provides the player with immediate feedback - no or yes), and cumulative (allows the player to assess their progress in the game through the use of a visual (progress bar located at the top).                                                                                 Despite these successes, this game had several downfalls in regards to its design and engagement level. In terms of its design, the game consist of only a wide display of scattered, disturbing images of moles and potential melanomas with the addition of a one sound effect that occurs when the player clicks on a particular image. It does not have a storyline or narrative that the player can interact with and potentially learn more about the images he/she are seeing. The layout and the overall interaction of the game is not only disorganized but it invites the player to randomly click on each image until he/she reaches the goal of the game. It leaves no surprises for the player nor an effective or memorable educational message that the player can take with them after playing it. This game environment also does not provide its players with the ability to collaborate with others.

2. Play to Cure: Genes in Space

http://www.cancerresearchuk.org/support-us/play-to-cure-genes-in-space

Play to Cure™: Genes in Space, developed by Dundee agency, Guerilla Tea, alongside Cancer Research UK’s scientists, was the first free mobile app designed to have its users play a critical role in the analytical process of collecting real genetic data and the mission of beating cancer sooner (Halliwell, 2014). The main objective of this game is to collect a fictional substance dubbed Element Alpha, which represents genetic cancer data, the key that might underpin certain types of cancer (Halliwell, 2014). Some of the tasks the users are expected to fulfill include mapping a route through the densest areas of Element Alpha, flying through space collecting as much Element Alpha as you can, avoiding and shooting asteroids to get to the next level of Element Alpha collection, and upgrading their spaceship to become more powerful by trading Element Alpha for additional points (Halliwell, 2014).

The main pro of this game is that it is a fun and engaging casual mobile game that anyone (children, teens, and adults) can play. It is rule based, responsive, and cumulative as well. It also gives its players a meaningful role by making their game experience and overall achievements in the game purposeful. The idea that their success in the game will result in discovering key data that can help fight against the dangers of cancer gives the players a strong motivation factor to play more. The downfall of this game revolves around its lack of educational value. Although the players are playing a game that can contribute to the progress of cancer research, they are not being taught anything in regard to the topic of cancer (what is cancer? how does it happen/ what are its negative effects?). They are not even aware of what type(s) of cancer the scientists are doing research on. By having no knowledge on the main topic at hand, the players are unable to take action. Instead, the main outcome that the players gain from this game is shooting multiple asteroids in a space-like environment. In addition, like Is that skin cancer?, this game environment also does not provide its players with the ability to collaborate with others.

3) DermoScan

DermoScan is a smartphone app created by Researchers at the University of Houston that is believed to detect melanoma even better than one’s doctor (Price, 2014). The objective of this app is to take a photo of one’s oddly-shaped mole in order to have it analyzed by the app to determine if it might be cancerous (Price, 2014). Price (2014) states that the app apparently can “ identify skin cancer roughly 85 percent of the time (meaning there is still a 15% chance of it being wrong), making it just as effective as visiting a dermatologist and even better at diagnosing melanoma than the average primary care physician.” The main pro of this app is that it has a clear objective and set of tasks that any smartphone user can do in a short period of time. The app can also be used by the user at any given point and provides an immediate solution to a serious dilemma. The main downfalls of this app are that it is not targeted for teens ages 15-18 and it does not provide its user the ability to collaborate and/or learn from others.

2. Solution

9. Design

For my thesis project, I wanted to design an interactive environment where users would be able to work collaboratively and learn as a team the negative effects of skin cancer, specifically melanoma. As you can see in the landscape audit listed above, currently there are no computer-based games designed for teens ages 15-18 who are frequent PC gamers that addresses the issue of skin cancer in a fun and engaging manner while meeting the main characteristics that makes a game an effective educational environment (rule-based, responsive, challenging, cumulative, fun/engaging). Therefore, my mission is to design Skin Invasion, an educational, narrative-based computer game that is part action-adventure and part multiplayer online battle-based (The Last of Us meets League of Legends). Its main objective is

to provide users with the opportunity to work collaboratively to learn, take action and fight against the negative effects of Melanoma.  

ii. Rationale for design

According to the Entertainment Software Association (2015), 155 millions Americans are playing video games. There is an average of two active gamers “in each game-playing U.S. household” (Entertainment Software Association, 2015). Forty-two percent of Americans are playing video games on a regular basis (3 hours or more per week) (Entertainment Software Association, 2015). Twenty-six percent of Americans who play video games are under 18 years of age and thirty percent are between the ages of 18-35 (Entertainment Software Association, 2015). Although the majority of gamers are male (56%), women ages 18 or older now represent a significantly greater portion of the game-playing population (33%) than boys age 18 or younger (15%) (Entertainment Software Association, 2015).                                                 According to the Entertainment Software Association (2015), of the most frequent game players, 29% currently pay to play video games online. Forty-seven percent of the frequent game players believe that computer and video games “provide more value for their money compared to DVDs (28%)”, going to the movies (14%) and music (12%) (Entertainment Software Association, 2015). Sixty-two percent of the most frequent gamers use a PC (personal computer) to play their games compared to a dedicated game console such as  XboxOne or PS4 (56%) or a smartphone (35%) (Entertainment Software Association, 2015). The most frequent gamers also spend an average of 6.5 hours per week playing with others online and 5 hours per week playing with others in-person (Entertainment Software Association, 2015). Social games [online games that allow or require social interaction between players] (31%) and Action games (30%) are two of the top three types of video games that the most frequent gamers play most often (Entertainment Software Association, 2015).                                                                 As stated by Barbara Chamberlin, the Project Director at the New Mexico State University Learning Games Lab, “Games offer immediate feedback, you can see your progress, you can try something and be frustrated but later learn more… that’s why game play is so engaging to us” (Entertainment Software Association, 2015). In addition to Barbara Chamberlin’s statement, Neil Howe, the president of LifeCourse Associates and leading researcher on millennials, believes that  “Millennials are putting [video games] at the center of their entertainment preferences, but it is a new kind of gaming that is more social, interactive and engaging” (Entertainment Software Association, 2015).

iii. Theoretical Foundations

Constructivism

According to Ackermann (2004), constructivism provides children with the opportunity to be “the builders of their own cognitive tools, as well as of their external realities.” Therefore, by creating activities that inspire students to acquire their own sense of knowledge, they will be able to see that knowledge is an experience that is “actively built, both individually and collectively” and is “both construed and interpreted through action, and mediated through symbol use” (Ackermann, 2004).  Like Vygotsky, Ackermann (2004) emphasizes on the idea that knowledge is also “progressively shaped and formed through people’s interactions/transactions.”

In this project, I plan to incorporate constructivism by designing an interactive, narrative-based PC game that enables players to work collaboratively as a team to construct their own knowledge on the negative effects and overall dangers of having melanoma, poor skin care and lack of sun protection initiatives .

In support of Jonassen’s eight principles of guiding instructional design through constructivist practices, this design focuses on providing students with a real-world, case-based learning environment rather than predetermined instructional sequences, demonstrates the natural complexity of the real world, and supports collaborative construction of knowledge through social negotiation (Jonassen, 1994, p. 35). By utilizing these key principles, we are providing students with the opportunity to envision the act of learning as an active process that is driven by authentic tasks and life-changing experiences (Christie, 2005).

Activity Theory (AT)

One of the key theories we plan to incorporate into our design that falls under the category of constructivism is Activity Theory (AT). According to Hamid et al. (2010), Activity Theory (AT)  “provides an effective framework for understanding and describing the learning experience for students and teachers when using technology.” Using the AT model created by Engestrom (1987), the user, through the point of view of his/her characters, will be able to interact with the community, rules, and division of labour presented in the narrated-based PC game that is directed towards a goal (defeat Melanoma and the C-Squad as well as help the Shadows recover from their black patches) and is transformed into an outcome (to learn about the negative effects and dangers of having melanoma) (Hamid et al., 2010).  

As mentioned by Hamid et al. (2010), in our design, we wanted to incorporate  “goal-oriented appropriation”, the practice in which “a user finds a technology that can help him or her satisfy a need or aid in attaining a specific, defined goal.” In regards to the game, we hope that it serves as an effective, fun technological tool and resource that would help teens ages 15-18 learn more about the importance of sun protection and skin care.

Game-based Learning

Another theory we plan to incorporate into our design is Game-based Learning. Many researchers “such as Sardone and Devlin-Scherer (2010) have found that students can learn a variety of skills through game-based learning, which appears to enhance problem solving, critical thinking, and creativity for users” (Magnacca, 2013). In addition to providing educators with the opportunity to motivate students to learn important academic content through a rewarding and engaging environment, game-based learning can also “give children practice with eye-hand coordination; facilitate social interaction through multi player chat and voice over internet protocol, and develop skills including pattern and rule generation, hypothesis testing, and generalization” (Annetta, Mangrum, Holmes, Collazo & Cheng, 2009, p.1093).         Like Mayer & Johnson (2010) mentioned in their article, “Adding instructional features that promote learning in a game-like environment,” our mission is to design an educational computer game that promotes instructional objectives (encourage players to make desirable changes in their knowledge) and measure specific learning outcomes.

As Mayer & Johnson (2010) discovered while designing The Circuit Game, in order to create an effective, educational computer game, it needs to be rule-based, responsive, challenging, and cumulative. It also needs to have enough entertainment features to maintain the players' sense of motivation and enough educational features to provide appropriate cognitive processing during learning (Mayer & Johnson, 2010). These are key characteristics we hope to incorporate while designing our game.

Scaffolding

According to Obikwelu et al. (2012), “providing guidance to students has been necessary to enhance their learning experience”, especially when introducing students to a new instructional environment such as an educational, computer game. Therefore, in my thesis project, it is essential that scaffolding is incorporated into the overall game design in order to “provide clearly articulated goals and learning activities that are structured to enable our users to extend their existing levels of understanding or how Vygotsky would refer to as their Zone of Proximal Development. One way I plan on integrating scaffolding in my design is feedback. According to Obikwelu et al. (2012), “feedback  provides an opportunity to support children’s learning of unfamiliar educational content by ‘scaffolding’ them into successfully solving a problem.” Therefore,” to scaffold children’s performance and learning, feedback for each wrong answer should be designed to provide a bit of additional support for children as they continue to try to figure out the solution” (Obikwelu et al., 2012).

Cognitive Theory of Multimedia Learning

Cognitive Load Theory is one of the fundamental theories used to integrate our knowledge of human cognitive structures and multimedia in structural design principles that are implicated specifically through words presented either in spoken or written form in addition to visuals (pictures or diagrams) (Mayer, 2005). Mayer (2005) states that the Cognitive Theory of Multimedia Learning revolves around the idea that people can learn more deeply from the integration of words and pictures than from words alone. Despite the dangers of extraneous overload, Mayer & Moreno (2010) mentioned the potential shortcomings that come from essential overload which occur when the essential material in a multimedia lesson is too complex, unfamiliar to the learner or presented at a fast pace (Plass et al., 2010, p. 135).                         “According to the Cognitive Theory of Multimedia Learning, three ways to handle an essential overload situation are to allow the learner to slow down the pace of presentation (i.e., segmenting principle), provide the learner with knowledge that reduces the need for cognitive processing of the presentation (i.e., pre-training principle), or off-load some of the visual information onto the auditory channel (i.e., modality principle)” (Mayer, 2005, p. 178). The rationale of multimedia learning is that words and pictures can complement one another and therefore, enhance human understanding when learners are given the opportunity to verbally integrate visual and verbal representations and build meaningful connections between them (Mayer, 2005). "The design of multimedia learning environments that promote meaningful human learning is an example of using computers to augment or aid human cognition ("enhance human performance on various cognitive complex tasks") (Mayer, 2005, p. 10). Since this game design will present an integration of both words and pictures (historical facts, charts, illustrations, etc.), it is essential to understand key principles and strategies that can be applied to this design in order to eliminate extraneous load from the game as well as enhance our learner’s cognitive capabilities of understanding the content that is going to be presented.

iv. Project Description & Visualization

Narrative of proposed solution/user scenario

The user begins by creating a login account and choosing whether he/she wants to play a male or female character and customizing it. Once they save their information, the player presses the play button and enters narrative mode. (Background: The user lives a small one bedroom apartment in a three story apartment building in NYC) The game begins as a first-person action-adventure game where the user is woken up by an alarm (9:45 AM). The user opens his/her eyes, and turns off the alarm. The user makes his/her way up from his/her bed (grunting and heavy breathing). As he/she makes his/her way to the bathroom, the user seems fatigued and struggling to stand straight. Once the user is on his feet, the player is told to navigate him/herself to the bathroom. He/she is taught the control buttons on a keyboard and have the option to change them by putting the game in pause mode, head into control settings, and changing the buttons.  The user also has the option to use a controller as well. Once the player is either comfortable with the control buttons provided or has finished changing the buttons, he/she can save the changes and return to play mode.

The atmosphere of his/her home remains dark and mysterious. Once the user reaches the bathroom door, you can see the shadow of the user through the bathroom mirror collapse on the floor. The game returns to narrative (story) mode while the user crawls his/her way to the bathroom sink and uses it as a handle to help/him/her up. The user eventually gets up and while staring at the sink in a daze, he/she begins to cough up a bit blood. The user then turns on the faucet and clean his/her mouth and face with warm water. The user looks up at the bathroom mirror and and there is a cloud of steam fogging up the user’s facial appearance. The user turns on the lights in his/her bathroom and cleans up the fog from the mirror, revealing his/her facial identity. He/she has a large, deformed black patch that covered his/her left cheek and reached towards his/her nose. The lights dramatically shut off and the light bulb breaks into pieces, causing the user to fall to the ground and emerge into complete darkness.

A light randomly appears coming from his/her bedroom and the sounds of a TV emerges in the background. The player is told to crawl his/her way to his/her bedroom. Once the player reaches the bedroom, the game returns to narrative (story) mode is mesmerized by what he/she sees on the TV. The news reveals that the government has been taken over by the C Force (symbolize Cancer ) and they are concerned about the sudden outbreak of people that have the same black patch that the user has. Due to their fear of a national epidemic, they have recently came to a decision to send out thousands of police forces (C-Squad) throughout U.S to capture and kill those they refer as the Shadows. The C-Squad will begin their mission in NYC at 10:00 AM. The TV suddenly shuts off and the user looks at his alarm clock noticing the time (10:05 AM). The user crawls towards his/her bedroom window after hearing several screams. The user reaches the window and pulls him/herself up to see several C-Squad members grabbing people from left to right from their apartments and from the streets and throwing them into their trucks. He/she sees a group of them enter his apartment building. The user hears rapid footsteps heading towards his bedroom. The user is told to head towards his bed. Once he/she reaches the bed, the C-Squad run towards his bedroom and the user is asked to press a button to hide under his/her bed covers.

The user opens his/her eyes and sees that he/she are still under the bed covers. Assuming that it was all a dream, the user slowly begins to get out of his/her bed covers, only to see that he/she is no longer in his/her apartment. He/she realizes that he/she is lying down on a bunk bed located in a small isolated room on a moving vehicle that resembles a spaceship. He/she can stand up with ease, has different attire (warrior-type; armor) and while looking at his/her reflection on the window that his black patch was no longer visible. He/she is suddenly greeted by a warrior type character (opposite gender of the user) and charges to attack him/her when he/she is stopped by several guards. The new character warns the user that he/she is not trying to harm the character in any way. The user is still frightened, asking questions like: who are you? where are you taking me? what do you want from me? The new character introduces him/herself as (male: Alister [name meaning “defender of mankind”]; female: Alondra [name meaning “defender of mankind”]) and informs him/her that everything will be explain once they reach their destination. A large thomp occurs and Alister/Alondra states: we have arrived. The guards let the user go and Alister/Alondra states: Follow me! The player now begins play mode and can navigate out of the spaceship like vehicle.

The game returns back to narrative mode as Alister/Alondra introduces the user to the new destination (Soma: meaning “the body of an individual as contrasted with the mind or psyche”, described as the land of life and purity). Soma is divided into various territories. They have currently arrived to the territory called Niks (skin backwards), which is where the evil ruler, Melanoma, has taken over. Alister/Alondra reveals the main problem (the invasion of the evil ruler, Melanoma, throughout the and her plan to conquer Soma, beginning with Niks) and the user’s mission along with his/her army which is to defeat Melanoma and her army in order to gain back control of their territory and to save humankind. Alister/Alondra explains that their galaxy is divided into three zones: The E-Zone (Epidermis), The D-Zone (Dermis), and the S-Zone (Subcutaneous layer).                                                                                 The user will begin his mission from the bottom up. The user and his/her army must win four battles in order to move on to the next zone. Once they reach the E-Zone and win four battles, the final battle will be with Melanoma. If the user and his/her army defeat Melanoma, Alister/Alondra believes that Niks will be restored to its former glory, Soma will no longer be in danger, and he/she and the Shadows will be relieved of their black patches. The user will only be responsible for fighting in this area from 10am-4pm since that is when Melanoma’s army and her allies (The UVAs and the UVBs) are at their greatest potential. Alister/Alondra is automatically a member of his/her army. The user will have the choice to have a default army of 4 or invite his/her friends in the game to join his army. The user and his army will also have the chance to choose which class they would want to represent: (warrior, battle mage, archer, etc.) For each zone, the user will take part in four battles. After winning each battle, the user will gain new weapons and new armor that he/she can use both in Niks and in his/her hometown. For example, after winning their second battle in the S-Zone, an archer can earn SPF 15 arrows which allows him/her to use each arrow to attack 15 UVAs/UVBs at a time. The SPF levels of the arrows will increase as the team continues to win battles.                                                                 Before and after those times, the user returns back to his hometown. There, his/her mission is to build a rebellion team, fight against the C-Squad, and eliminate the C-Force. Alister/Alondra is already a part of the user’s team. He/she also has the option to have his/her friends join his/her team and meet new people from the Shadows throughout the game that he/she can recruit. Everytime the user returns to his/her apartment, he/she can see the progress of the black patch on his/her face by looking at the bathroom mirror (tell you the percentage of how much the black patch remains, how many wins/losses he/she encountered, etc.).                                After defeating Melanoma, the user and his army return to his hometown with high hopes that the Shadows are cured and the C-Squad is no longer in power. The game returns to narrative mode.  To their surprise, the C-Squad are still roaming around and the user and Alister/Alondra see a sea of Shadows dead on the streets near his/her apartment along with some of the Shadows that were part of his/her rebellion team. Out of nowhere a group of C-Squad officials capture the user and Alister/Alondra and throw them in a van. The user wakes up, confused and drowsy. He/she looks around the room with blurry vision. The user finally realizes that he/she is strapped to a hospital bed in a small, dark green, surgery room. He/she looks at his/her arm and sees a red circle followed by a large black patch, indicating a continuation/sequel.

Flow chart of game play

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