Designing an Engaging and Informative Application About First Aid: Gamification and Humor as Design Elements in a Serious Game

  • Nicolai Foldager
  • Hans Hansen
  • Mikkel Skovsmose Tewes
  • Thomas BjørnerEmail author
Conference paper
Part of the Lecture Notes of the Institute for Computer Sciences, Social Informatics and Telecommunications Engineering book series (LNICST, volume 195)


This study aimed at developing an engaging and informative application within first aid and CPR for people who are already certified in first aid. The paper outlines discussions within definitions of serious games, humor, gamification and engagement. Further we suggest specific elements for implementation and evaluation of humor and gamified elements. Two prototypes were developed: one with gamification elements and one without. A between-group design was used, in which two different groups tested one prototype each. Data were gathered through data logging, in-depth interviews (with use of a verbal numeric rating scale) and observations of participants’ facial expression. The Facial Action Coding System (FACS) was used for analysis. The results showed very little difference between the gamified and non-gamified version. Important elements within gamification are focuses and thoughtfulness within the implementation of challenge, rewards, achievements, feedback and the overall visual theme.


Serious game Gamification Enjoyment Humor Engagement Qualitative Observations 


  1. 1.
    Wissenberg, M., et al.: Association of national initiatives to improve cardiac arrest management with rates of bystander intervention and patient survival after out-of-hospital cardiac arrest. JAMA 310(13), 1377–1384 (2013)CrossRefGoogle Scholar
  2. 2.
    Committee on the Treatment of Cardiac Arrest: Strategies to Improve Cardiac Arrest Survival: A Time to Act. National Academies Press, Washington, D.C. (2015). Current Status and Future Directions, Board on Health Sciences Policy; Institute of MedicineGoogle Scholar
  3. 3.
    Zichermann, S.C., Cunningham, C.: Gamification by Design. O’Reilly Media Inc., Sebastopol (2011)Google Scholar
  4. 4.
    Burke, B.: Gamify: How Gamification Motivates People to Do Extraordinary Things. Gartner Inc., Brookline (2014)Google Scholar
  5. 5.
    Schønau-Fog, H., Bjørner, T.: “Sure, I would like to continue”: a method for mapping the experience of engagement in video games. Bull. Sci. Technol. Soc. 32(5), 405–412 (2012)CrossRefGoogle Scholar
  6. 6.
    LeDoux, J.E.: A neuroscientist’s perspective on debates about nature and emotion. Emot. Rev. 4(4), 375–379 (2012)CrossRefGoogle Scholar
  7. 7.
    Lee, M.: Ticky ends: employing thinly-sliced narratives in serious games for mobile platforms. Int. J. Multimedia Ubiq. Eng. 9(10), 349–362 (2014)CrossRefGoogle Scholar
  8. 8.
    Yannakakis, G.N., Hallam, J.: Real-time game adaptation for optimizing player satisfaction. IEEE Trans. Comput. Intell. AI Games 1(2), 121–133 (2009)CrossRefGoogle Scholar
  9. 9.
    O’Brien, H.L., Toms, E.G.: The development and evaluation of a survey to measure user engagement. J. Am. Soc. Inf. Sci. Technol. 61(1), 50–69 (2009)CrossRefGoogle Scholar
  10. 10.
    Quesenbery, W.: The five dimensions of usability. In: Albers, M.J., Mazur, M.B. (eds.) Content and Complexity: Information Design in Technical Communication. Lawrence Erlbaum, New York (2003)Google Scholar
  11. 11.
    Sweetser, P., Wyeth, P.: Gameflow: a model for evaluating player enjoyment in games. Comput. Entertain. 3(3), 1–24 (2005)CrossRefGoogle Scholar
  12. 12.
    Marczewski, A.: Even Ninja Monkeys Like to Play: Gamification, Game Thinking and Motivational Design. Gamified, Addlestone (2015)Google Scholar
  13. 13.
    Csikszentmihalyi, M.: The Evolving Self A Psychology for the Third Millennium. Perennial, New York (1993)Google Scholar
  14. 14.
    Csikszentmihalyi, M.: Flow: The Psychology of Optimal Experience. Harper Perennial, New York (1990)Google Scholar
  15. 15.
    Keller, J., Bless, H.: Flow and regulatory compatibility: an experimental approach to the flow model of intrinsic motivation. Pers. Soc. Psychol. Bull. 34(2), 196–209 (2008)CrossRefGoogle Scholar
  16. 16.
    Gardhouse, K., Anderson, A.: Objectives and subjective measurement in affective science. In: Armony, J., Vuilleumier, P. (eds.) The Cambridge Handbook of Human Affective Neuroscience, pp. 57–81. Cambridge University Press, Cambridge (2013)CrossRefGoogle Scholar
  17. 17.
    Weinberger, M.G., Gulas, C.S.: The impact of humor in advertising a review. J. Advert. 21(4), 35–59 (1992)CrossRefGoogle Scholar
  18. 18.
    Lazzaro, N.: Why we play games: four keys to more emotion without story. In: Game Developers Conference, 8 March (2004)Google Scholar
  19. 19.
    Dillon, R.: On the Way to Fun: An Emotion-based Approach to Successful Game Design. A.K. Peters, Natick (2010)CrossRefGoogle Scholar
  20. 20.
    Dormann, C., Biddle, R.: A review of humor for computer games: play, laugh and more. Simul. Gaming 40(6), 802–824 (2009)CrossRefGoogle Scholar
  21. 21.
    Carr, D.: Contexts, gaming pleasures, and gendered preferences. Simul. Gaming 36, 464–482 (2005)CrossRefGoogle Scholar
  22. 22.
    Wang, H., Shen, C., Ritterfeld, U.: Enjoyment of digital games: what makes them “seriously” fun? In: Ritterfeld, U., Cody, M., Vorderer, P. (eds.) Serious Games: Mechanics and Effects. Routledge, New York and London (2009)Google Scholar
  23. 23.
    Ritterfeld, U., Cody, M., Vorderer, P.: Introduction. In: Ritterfeld, U., Cody, M., Vorderer, P. (eds.) Serious Games: Mechanics and Effects. Routledge, New York (2009)Google Scholar
  24. 24.
    Rozin, P., Cohen, A.B.: High frequency of facial expressions corresponding to confusion, concentration, and worry in an analysis of naturally occurring facial expressions of americans. Emotion 3(1), 68–75 (2003)CrossRefGoogle Scholar
  25. 25.
    Cohn, J.F., Ambadar, Z., Ekman, P.: Observer-based measurement of facial expression with the facial action coding system. In: Cohn, J.A., Allen, J.B. (eds.) The Handbook of Emotion Elicitation and Assessment. Oxford University Press Series in Affective Science, Oxford (2006)Google Scholar
  26. 26.
    Bjørner, T.: Data collection. In: Bjørner, T. (ed.) Qualitative Methods for Consumer Research. Hans Reitzels Forlag, Denmark (2015)Google Scholar
  27. 27.
    Hayes, A.F., Krippendorff, K.: Answering the call for a standard reliability measure for coding data. Commun. Methods Meas. 1(1), 77–89 (2007)CrossRefGoogle Scholar
  28. 28.
    Oak, J.W., Bae, J.H.: Development of smart multiplatform game app using UNITY3D engine for CPR education. IJMUE 9(7), 263–268 (2014)CrossRefGoogle Scholar
  29. 29.
    Kelle, S., Klemke, R., Specht, M.: Effects of game design patterns on basic life support training content. J. Educ. Technol. Soc. 16(1), 275–285 (2013)Google Scholar

Copyright information

© ICST Institute for Computer Sciences, Social Informatics and Telecommunications Engineering 2017

Authors and Affiliations

  • Nicolai Foldager
    • 1
  • Hans Hansen
    • 1
  • Mikkel Skovsmose Tewes
    • 1
  • Thomas Bjørner
    • 1
    Email author
  1. 1.Department of Architecture, Design and Media TechnologyAalborg UniversityCopenhagenDenmark

Personalised recommendations