Design Principles

Design Principles Used in SimStay

ConstraintA method of limiting actions that can be performed on a system


When one menu expands, the other menus fade back until the player either makes a valid selection, or selects the exit icon.

Exposure EffectRepeated exposure to stimuli for which people have neutral feelings will increase the likability of the stimuli.


Throughout the game, patients are encouraged to communicate with their healthcare providers. The theory is that by interacing in a virtual environment, they will be more likely to feel empowered to take part in their care. Asking questions or seeking education and additional resources.

ForgivenessDesigns should help people avoid errors and minimize the negative consequences of errors when they do occur.


If a player chooses the wrong language, the English translation of “Language” in the settings menu will always be available. This will allow the player to easily find the correct menu to reset the language.

When a player selects “Feedback” from the menu, they must choose “submit” after they type their full message in order to add an additional confirmation layer.

A player can reach the “help” menu from anywhere in the game. It can be reached through the splash screen and during gameplay.

HighlightingA technique for bringing attention to an area of text or image.


Highlighting is used throughout the game to bring a player’s attention to interactive items. There are various forms of highlighting, but the main form is motion.

Iconic Representationthe use of pictorial images to improve the recognition and recall of signs and controls.


The interface of the game will always include four icons for the player to choose from. These include an icon for email, information, menu, and settings. When menus are expanded, or a player is viewing a certain piece of information, the exit icon appears for the player to return to the interface after they are finished with that piece of content.

ImmersionA state of mental focus so intense that awareness of the “real” world is lost, generally resulting in a feeling of joy and satisfaction.

While one of the key components of this game is patient education and empowerment, another element is immersion. SimStay is intended to provide a space for a patient to interact with the hospital and staff in a non-threatening or intimidating way. It is a way for them to explore and escape their medical condition through gameplay. Regardless of the patient’s intention to use SimStay as a learning resource, there are elements that are meant to be fun and take the patient’s mind away from the stress of being hospitalized.

Modularity A method of managing system complexity that involves dividing larger systems into multiple smaller, self-contained systems.

While the game environment will be designed based on the hospital, the player is only exposed to one module at a time. This is to prevent the patient from being overwhelmed with choices, especially for those patients that may not have very much experience playing video games.

PrimingThe activation of specific concepts in memory for the purposes of influencing subsequent behavior.

Throughout the game there will be obvious priming to get the patient to become more open to communicating with their healthcare provider, but there will also be indirect priming using key phrases pulled from the HCAHPS survey. This will be used as a subtle prime that will hopefully improve HCAHPS scores once they have been discharged. For example, when asked about discharge and medication instructions, hopefully the inclusion of those words and directions to resources both online and offline will prime the patient to recall all of the communication they received during their admission. This will hopefully create a scenario in which the patient’s perception of their care is similarly aligned with the quality of their care.

Progressive DisclosureA strategy for managing information complexity in which only necessary or requested information is displayed at any given time.

The player is never presented with all of the game options or features at once. As the player navigates through the features of the game, they will be exposed to more features. The features shown to them will be based on previous interactions that show they are interested in certain aspects of the game.

Rosetta StoneA technique for communicating novel information using elements of common understanding.

One of the most prominent challenges in healthcare communication is translating medical jargon to layman’s terms. Most physicians and medical professionals think clinically, while the vast majority of patients will have a limited exposure to any true medical training. This communication gap can be improved through the use of SimStay in that they language used in the game is not overly clinical, but it is also approved and evaluated by clinicians. The best approach for developing this language is through a cooperative and collaborative approach that includes communication and medical professionals. The game developers will provide a blueprint and pre-developed health library complete with selections, but the localized content will be developed for each facility. This will also help the game align with any pre-existing messaging or communications the patients may have seen while in the community. Including marketing messages or specific messaging that may have been used for awards and achievements.

ShapingA technique used to teach a desired behavior by reinforcing increasingly accurate approximations of the behavior.

The first step for patients to receive any conceived benefits of SimStay will be for them to log into the game. For patients who are only in the hospital for a short period of time, only the most basic of functions will be presumably used, such as casual gameplay, or basic hospital exploration. For those who have spent more time in the hospital and have more interaction with the employees, hopefully they will begin to use functions that provide feedback to the hospital, or seek out additional information about the hospital and its leaders. For players who either have extended stays or are frequently admitted, the aim is for them to use the functions that promote patient empowerment and education, such as the support groups and health library.


Lidwell, W., Holden, K., Butler, J., & Elam, K. (2010). Universal principles of design: 125 ways to enhance usability, influence perception, increase appeal, make better design decisions, and teach through design. Beverly, MA: Rockport.

%d bloggers like this: