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An Enthusiast’s Guide to Tabletop Simulation: From Idea to Implementation

Dr. Mark Parson BSc MBBS FRCA �KSS Anaesthetic Registrar currently working in Kings College Hospital, London

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Any anaesthetic doctors?

I need your help (not scary)

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Declaration

Not expert
I have received:

Funding from NAPGET

New Anaesthetic Postgraduate Education Trust, Consultant funded pot of money for UHSx Anaesthetic Trainees

Received games from ‘Focus Games’
Received grants for various other research projects completely unrelated to TTX

‘The Bleep Test’

Not for profit
Donations go towards:

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Contents

What is tabletop simulation?
Why am I here?
Quickfire DIY Prototyping Tips
Intellectual Property - aaaaaaaaaaggggghhh
Let's play
Questions
Questionnaire

I will have a couple of slides to take

photos of which contain concise summary

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Contents

What is tabletop simulation?
Why am I here?
Quickfire DIY Prototyping Tips
Intellectual Property
Let's play
Questions
Questionnaire

I will have a couple of slides to take

photos of which contain concise summary

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Contents

What is tabletop simulation?
Why am I here?
Quickfire DIY Prototyping Tips
Intellectual Property
Let's play
Questions
Questionnaire

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What is Tabletop Simulation?

Tabletop vs Table Top vs TTS vs TTX

“Scenario-based activity that utilizes physical objects (character pieces/representations, game board, cards, dice, chips, coins, spinners, etc.) with or without role-play or a storyline/narrative that facilitates learning, discourse, and discovery”

Sanko J. How to use table-top simulation games as part of simulation-based education [Internet]. Healthysimulation.com. 2023 [cited 2024 Jul 27]. Available from: https://www.healthysimulation.com/52915/table-top-healthcare-simulation/.

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What is Tabletop Simulation?

Lo-fi

Burgeoning

Renaissance

Accessible

Disaster healthcare

“intellectual level wherein knowledge of medicine is important”

What is simulation based medical education?

“any educational activity that utilises simulation aids to replicate clinical scenarios”1

What is tabletop simulation?

“a scenario-based activity that utilizes physical objects (character pieces/representations, game board, cards, dice, chips, coins, spinners, etc.) with or without role-play or a storyline/narrative that facilitates learning, discourse, and discovery”2

Currently often described as a 'Burgeoning field'

Seems current resissance in Leisure game board industry → ?Internet fatigue

Majority of TTX has been used in disaster healthcare – this is changing currently

High accessibility and low development overheads

Different to maniquinne based sim - Reduced emphasis on novel technologies, alongside low clinical and environmental fidelity

However, this is not new -

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Contents

What is tabletop simulation?
Why am I here?
Quickfire DIY Prototyping Tips
Intellectual Property
Let's play
Questions
Questionnaire - let's PDSA this!

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Why am I here?

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Contents

What is tabletop simulation?
Why am I here?
Quickfire DIY Prototyping Tips
Intellectual Property
Let's play
Questions
Questionnaire

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Idea development

Develop a Clear Concept
Consider the Endgame

Who are you doing this for? Self vs Company

Intellectual Property
Play Other Games
Prototype Early and Often

Mechanics
Theme/Aim

Focus on Education, Game Balance and Learner ‘Engagement’
Playtest with Different People
Write Clear, Concise Rules
Design for Accessibility

?complexity for complexities sake
?disabilities/neurodivergence/color blindness/etc

Component Design

1. Start with a Clear Concept
Define your core idea: Is it strategy, cooperation, storytelling, simulation?
Target audience: Kids, adults, professionals (e.g. medics), casual gamers, hardcore gamers?
Game goals: What do players do, and how do they win/lose?
🎮 2. Mechanics First, Theme Second (or Vice Versa)
Mechanics-driven: Start with how the game works (e.g., worker placement, dice-rolling, resource management).
Theme-driven: Begin with a strong story or setting and build mechanics to support it.
Do whichever feels most natural, but ensure they support each other well.
🧩 3. Prototype Early and Often
Use simple materials like paper, tokens, or online tools (e.g. Tabletop Simulator, CardCreator).
Don't wait to make it look pretty — test the mechanics first.
Iterate rapidly.
🧠 4. Focus on Balance and Engagement
Balance: No one strategy should always win; roles/players should feel equally empowered.
Engagement: Minimize downtime; ensure players feel like their choices matter.
Introduce tension and meaningful decisions.
🔁 5. Playtest with Different People
Start with friends/family, then test with strangers or target audience groups.
Watch how they play: Do they struggle with rules? Get bored? Feel confused?
Take feedback seriously but don’t try to please everyone.
📜 6. Write Clear, Concise Rules
Make the rulebook easy to read, with examples and diagrams.
Assume the reader has no prior knowledge.
Include a one-page "Quick Start Guide" or tutorial round.
🎨 7. Design for Accessibility
Consider color blindness, font readability, and physical usability.
Avoid excessive complexity unless your audience loves that.
Use icons and visuals to support text where possible.
📦 8. Think About Components
Use affordable, durable, and thematic components.
Design the board, cards, tokens, and pieces with functionality first, then aesthetics.
Include a practical way to store and sort everything.
💡 9. Learn from Other Games
Analyze popular board games: What works? What doesn't?
Borrow proven mechanics, then twist or combine them in fresh ways.
Understand pacing, flow, and how they maintain player interest.
🧑‍💻 10. Consider the Endgame
Is this a self-published passion project or will you pitch it to publishers?
Learn basic production costs, timelines, and Kickstarter/crowdfunding if applicable.
Build a print-and-play or demo version for feedback and promotion

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Game Development Arc

Alpha Test

Beta Test

I played the game

My Wife Played

Showcase at RSCH Educational Day

Showcase to St Georges Hospital, London

Two other Trainees Played

My Extended Family Played on holiday

My Wife left the room "This is stressing me out, its too much like work"

Need to be able to write the rules down
Needs to ‘feel’ like a game

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Prototyping for Beta Testing -

Cards

Important Bits to think about

Unique Identifier on Each of Cards

Easy to reference e.g. issues/modifications/etc.
All cards in ‘20’s’ - mean something

Prototype on different colour card for each card type

e.g. Bleep and SHTF
Saves printer ink and time

Make ‘Player Aid’ Cards

Quick rule reference
No-one reads the rule book

Making

Design using ‘mail merge’

Only put critical stuff on at start
Design comes later

Print out Cards (165gsm card)
Laminate
Guiletenne
Corner chop

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Making a board - Paper Print vs Vinyl Sticker

PLAN

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Making a board - Paper Print vs Vinyl Sticker

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Making a board - Paper Print vs Vinyl Sticker

Buy a board
Get vinyl sticker printed
Watch this video: https://www.youtube.com/watch?v=LI6NP6Ssx2Y

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Prototyping Gear: Quick Reference

Stuff to aquire/beg/borrow

165gsm coloured card - perfect snap for playing cards when laminated
Laminator and laminating sheets
Corner cutter - Kadomaru PRO
Spraymount - be careful - not contact adhesive-globby; aim for permanent; dont buy cheap
Metal Ruler ?60cm - depends on game size
Very sharp knife and scissors
A4+ guillotine - depends on game size

Handy tutorials

Prototyping Game Cards Guide - ‘mailmerge’-type technique https://docs.google.com/document/d/1MfCkGvnrQaWaniY_fmEj_1It-Z2eKH0-IPaK2j59fxc/edit?usp=sharing
Vinyl sticker to board game board (centre hinge method) - https://www.youtube.com/watch?v=LI6NP6Ssx2Y

Things to buy?

Game boards - charity shops/Amazon
Finally printing prototype - Boardgamemaker.com

Felt pens, sticky notes a printer and paper - all you need to get started

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Contents

What is tabletop simulation?
Show how I came to tabletop simulation
Quick how to make/DIY-type guide with specific learning points for prototyping
Intellectual Property
Let's play
Questions
Questionnaire

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Intellectual Property

Difficult
Talk to people early
General principles seem to be:

NHS usually retains IP for innovations created by employees as part of their work
Staff can be rewarded or involved in commercialization outcomes
Policies vary by Trust, so local IP policies should always be consulted

Even if you have done this in your own time with your own money

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Contents

What is tabletop simulation?
Show how I came to tabletop simulation
Quick how to make/DIY-type guide with specific learning points for prototyping
Intellectual Property
Let's play
Questions
Questionnaire

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What is ?

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Set-up

Introduction
Objective
Set-up

1) Game board - unfold and lay this out on the table face up
2) 4x ‘Doctor’ miniatures - Place 3 of these in the hospital corridor and one of these on the ‘Consultant-on-Call’ space
3) 72 Bleep Cards - place on Bleep Cards area on game board
4) 36 SHTF cards - place on SHTF card area on game board
5) Place clock on 20:00 hour spot on timeline
6) 3x dice (D5, D10, D20) - place these next to the board
7)‘Player Aid’ cards - gameplay order reminder cards. Distribute these out to the learner(s).

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Gameplay Overview - Start Point 4

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More Gameplay

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Contents

What is tabletop simulation?
Show how I came to tabletop simulation
Quick how to make/DIY-type guide with specific learning points for prototyping
Intellectual Property
Let's play
Questions
Questionnaire

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Promotion

Free if doing things for free….

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Questions?

Please fill this out this workshop feedback

Email: mark.parson2@nhs.net

Cards to look at from boardgamemaker.com
Dice for a donation
Email me for a chat/workshop
is for sale

https://forms.gle/Sw8nkKdttaNLzvwX8