The document outlines a design brief for a serious game about fetal bradycardia. It describes a team of 7 students who will design the game for Dr. Sarah Janssens. The game aims to teach players to systematically assess and identify potential causes of fetal bradycardia and take appropriate actions. It will include 6 scenarios covering the 6 main causes of fetal bradycardia. Players will receive patient information and make treatment decisions, getting feedback on their performance to improve their skills in managing this condition. The brief provides examples of how the game could be structured and presented to players.

1. 2130GFS Serious Games Design Brief:
Team:
● William McDonnell_s5094382
● Michael Nguyen_s5094648
● Rattakris Paeratakul_s5021443
● Tumi Sveinn Snorrason_s5084671
● Marco Galdamez_s5093325
● Jacob Brett_s5016834
● James Santos_s5087286
Aim and Goals:
To design and develop a serious game for Dr Sarah Janssens of Mater Hospital surrounding Fetal
Bradycardia and the appropriate steps to combat it.
The game is to teach players to perform a systematic assessment to identify the potential cause of
fetal bradycardia and combat it. The game is to be focused on the subject matter and the games goal
and not to be based around entertainment, though it will be made to engage the player to learn and
pay attention.
Constraints:
- The game must cover the 6 causes of fetal bradycardia and in a specific order
- Players need to be shown information appropriate to fetal bradycardia
- It is needed to be assumed the players will have knowledge needed to treat fetal bradycardia
- The players must know where they failed a portion of the game
Game Features:
The players are to receive 6 scenarios each covering 6 different cases of fetal bradycardia. Each
scenario will have the history of the patient and 5 other information sections (Airway, Circulation,
Drugs, Abdomen, Pelvis).
The player will need to go to each information section and read the information given (e.g. Airways:
the patients airways are clear and breathing). The game will then present the player with a decision-
making mechanic to choose their actions in association with the information (e.g. Give Oxygen/Don’t
Give Oxygen).
At the end of each scenario the player will be presented with their score and where they went wrong.
If they did not complete the scenario 100% they will not be allowed to pass to the next scenario. After
completing 100% of a scenario the player will be allowed to continue to the next scenario.
Concept Art:

2. The following concept art are to demonstrate possible UI’s we may use to make the game. These are
preliminary designs for the game and are subject for change in the future based off client, player, and
technical feedback.
Concept 1: Show all information on the clipboard and information changes dependent on which tab is
selected.
Concept 2: Information appears in the middle of the screen when a question tab is selected. Some
information such as logs are found on the clipboard.

3. User Interface Proposal:
(See attached picture for reference)
The idea behind the User Interface (UI) is to use visual elements that medical professionals are
familiar with and making it clear enough for those without any experience in this medium to realize
where to start and what to do without explicitly telling them. The main elements are:
1. The menu buttons at the bottom of the screen, which are lined up in the correct order and
look like medical folders. All of the buttons except the first one are grayed out at the
beginning, while the first one is pushed slightly up to make it more prominent. After the player
finishes a section, that corresponding button becomes greyed out and the next one becomes
“active”. The buttons will be large enough to be noticed right away.
2. The question screen which pops up in the center of the background picture and disappears
once all of the questions in that section have been answered.
3. The side panel, which gives the player background information on the patient, a log of the
player’s decisions and looks like a clipboard. The log takes the form of an empty bullet points
list, which gets filled out progressively as the player makes decisions and allows them to track
what they have done. At the bottom of the side panel is a heart rate monitor, as well as a
button for restarting the game, quitting it and repositioning the patient.
a. Having the reposition button be to the side and not at the bottom of the screen both
emphasises the fact that it can be done at any time, as well as acting as a test of how
much attention the player is paying to the game. That is, that they’re not just going
through the motion of doing everything in one static order over and over again.
4. The background picture which shows an operating table and all of the relevant equipment for
the scenarios.
a. An extra addition to the background picture could be animated components like lights
and sounds, which could serve to make the game feel less like a test and more like
an actual game.

4. 5. The summary screen, which pops up on the screen in case of either failure or completion of
all of the sections. This screen would contain some text describing what happened to the
patient as a result of the player’s actions, as well as giving them a summary of wrong choices
and a corresponding score.
a. The screen would also have the two buttons from the side panel (restart game and
back to menu) at the bottom, giving the player a quick way to redo the test or choose
another scenario.
The proposal aims to make the most vital parts of the game (section buttons and question screen) the
most prominent elements on the screen at all times, using as many familiar elements as possible in its
design.
Gameplay Example:
The following is an preliminary example of what information and choices the players will be given in
Scenario 1. Each of these sections will be presented through their individual tabs in the game
(reference the concept art). Other scenarios will differ with what information and choices the player
will receive, and is subject to change.
Question? = Correct Answer
History:
Patient’s first pregnancy, progress is slow.
Airway:
The patient’s airways are clear and patient is breathing normally.
Options:
Apply Oxygen?
Don’t Apply Oxygen?
Circulation:
Pulse 80
BP 85/58
Fluids 125ml/hr
Options:
Fluid Bolus 500mls stat.
Supply Fluid?
Don’t Supply?
Drugs:
Synto 4u/min
Epidural 1 hour ago
Options:
Should you stop Syntocinon?
Stop Syntocinon?
Don’t stop?
Uterus:

5. 4:10 soft bt
Options:
Give Terbutaline 250mcg sc?
Don’t give Terbutaline 250mcg sc?
Vaginal Examination Findings:
4cm Dilated, Station 2
Options:
Apply FSE?
Don’t Supply FSE?
Options that are always Available:
Reposition. (Player can reposition the patient as many times as they wish however if the player
chooses not to reposition the patient that fails the scenario.)
Menu (Returns to menu screen)
Restart (Allows player to retry scenario)
Fetal Bradycardia Information (Sarah Janssens Notes):
Information given by Dr Sarah Janssens to help design and develop the game. Features information
about Fetal Bradycardia, individual cases, and proposed examples for the serious game.
What is Fetal Bradycardia and why is it important?
Fetal bradycardia describes a condition when an unborn baby has an abnormally low heart rate for
longer than five minutes. It most commonly occurs in labour, and will sometimes resolve either
spontaneously, or with treatment of the underlying cause. Some fetal bradycardias do not resolve,
and require immediate delivery of the baby by caesarean section or assisted vaginal birth (for
example forceps) to prevent the baby from suffering from a lack of oxygen which may lead to brain
damage or death. While in many cases the cause of a fetal bradycardia may be unknown, there are
various conditions which can lead to a fetal bradycardia, some reversible, others not. The usual cause
is conditions which limit blood supply to the baby – leading to a slowing of the baby’s heart rate – this
compound the lack of oxygen to the baby’s brain and a vicious cycle ensues.
Causes of fetal bradycardia:
1) Post epidural – usually within an hour of epidural. Aetiology not completely understood.
Thought to be related to a drop in maternal adrenaline levels leading to increase maternal
oxytocin production – which leads to increased contraction of the uterus
2) Head compression – sometimes if the baby is low in the pelvis and about to be born, the heart
rate is low due to compression of the head which stimulates a neurological response to slow
the heart rate
3) Over stimulation of the uterus – too many contractions can leader to a lack of oxygen to the
baby – and a slowing of heart rate
4) Cord compression – compression of the baby’s umbilical cord – usually in itself doesn’t cause
a bradycardia, or if it does, will resolve with repositioning of the baby. If the cord comes
through the cervix however, this is called “cord prolapse”. Now the cord is squashed between
the baby’s head and cervix and the bradycardia won’t get better with repositioning
5) Placental abruption – this is where the placenta separates from the wall of the uterus – again
baby gets deprived of oxygen

6. 6) Uterine rupture – the scarred uterus comes open during labour. The baby and the umbilicial
cord are expelled into the abdominal cavity – very very bad. Needs immediate caesarean
section and repair of the uterus.
Learning objectives:
By the end of the activity, the student will be able to
1) Perform a systematic assessment to identify the potential cause of a fetal bradycardia
2) Institute appropriate therapeutic measures to improve fetal oxygenation and optimise
outcome
Learner group:
Obstetric doctors and midwives (all levels) caring for women in labour.
Principles
Learners will be presented with a case of fetal bradycardia. To achieve a good outcome for the baby
they will be expected to:
- Assess “Airway, Circulation, Drugs, uterus and pelvis” in a systematic way.
- Elicit the appropriate clinical information
- Institute correct management for the case
- Avoid harmful management strategies.
Management options:
Reposition (can be used as many times as
required)
Site IVC and take bloods
Terbutaline 250mcg sc Fluid bolus 500mls stat
Stop Syntocinon Apply FSE (fetal scalp electrode)
Deliver by Caesarean Section Deliver by instrument
Apply oxygen
Cases and details
Team
role
Information 1 2 3 4 5 6
Post Epi fully hyperstim cord Abruption rupture
History History primiparou
s slow
progress,
syntocinon
epi
primiparo
us spont
labour 7cm
Multi IOL,
arm synt epi
Multi spont
labour,
SROM,
decels
Multi, spont
labour, 6cm
1 hour ago
VBAC IOL
syntocinon,
4cm
Airway Clear and
breathing
Clear and
breathing
Clear and
breathing
Clear and
breathing
Clear and
breathing
Clear and
breathing
Circulati
on
Pulse 80 80 80 80 120 130
BP 85/58 110/75 110/75 110/75 110/75 85/58
Fluids 125ml/hr nil 125ml/hr nil nil 125ml/hr
Drugs syntocinon 4u/min nil 8u/min nil nil 16u/min
Epidural I hour ago nil 4hours ago nil nil nil
Abdome
n
Uterus 4:10 soft bt 4:10 6:10 tonic 3:10 soft bt Tonic, very
tender
Rigid
abdomen,
Pelvis Vaginal
examinatio
n findings
4cm dilated,
station-2
Fully
dilated
station +2,
OA
6cm dilated
station
spines
5cm dilated
station
spines,
cord
prolapse
Fully dilated
station +2,
150mls fresh
blood
5cm dilated,
station -4 poor
application,
100mls blood

7. Case 1 primiparous
slow progress,
syntocinon epi
Score 1 Score 0 Fatal error
Airway Clear and
breathing
Apply oxygen X
Pulse 80 Fluid bolus
500mls stat
X
BP 85/58
Fluids 125ml/hr
syntocinon 4u/min Stop
syntocinon
X(fatal if
omitted)Epidural I hour ago
Uterus 4:10 soft bt Give
terbutaline
X
Vaginal
examination
findings
4cm dilated,
station-2
Apply FSE X
Reposition X
● This is a tricky scenario where I think we could “end” the game after the FSE goes on by
telling them that the heart rate has recovered. Of all the scenarios only 1 and 3 would get
better if they were treated appropriately, all others require delivery by CS or instrument.
Case 2 primiparous
spont labour 7cm
Score 1 Score 0 Fatal error
Airway Clear and
breathing
Apply oxygen X
Pulse 80 Fluid bolus
500mls stat
Site IVC and
take bloods X
X
BP 110/75
Fluids nil
syntocinon nil
Epidural nil
Uterus 4:10 Give
terbutaline
X
Vaginal
examination
findings
Fully dilated
station +2, OA
Deliver by
instrument
Deliver by CS
Apply FSE
X
X
X
Reposition X
Case 3 Multi IOL, arm
synt epi
Score 1 Score 0 Fatal error
Airway Clear and
breathing
Apply oxygen X
Pulse 80 Fluid bolus
500mls stat
Site IVC and
take bloods
X
X
BP 110/75
Fluids 125ml/hr
syntocinon 8u/min Stop
syntocinon
X
Epidural 4hours ago
Uterus 6:10 tonic Give
terbutaline
X(fatal if
omitted)
Vaginal
examination
findings
6cm dilated
station spines
Deliver by
instrument
Deliver by CS
Apply FSE
X
X
X
X
Reposition X
Case 4 Multi spont Score 1 Score 0 Fatal error

8. labour, SROM,
decels
Airway Clear and
breathing
Apply oxygen X
Pulse 80 Fluid bolus
500mls stat
Site IVC and
take bloods
X
X
BP 110/75
Fluids nil
syntocinon nil Stop
syntocinon
X
Epidural nil
Uterus 3:10 soft bt Give
terbutaline
X
Vaginal
examination
findings
5cm dilated
station spines,
cord prolapse
Deliver by
instrument
Deliver by CS
Apply FSE
X(fatal if
omitted) X
X
Reposition X
Case 5 Multi, spont
labour, 6cm 1
hour ago
Score 1 Score 0 Fatal error
Airway Clear and
breathing
Apply oxygen X
Pulse 120 Fluid bolus
500mls stat
Site IVC and
take bloods X
X
BP 110/75
Fluids nil
syntocinon nil Stop
syntocinon
X
Epidural nil
Uterus Tonic, very
tender
Give
terbutaline
X
Vaginal
examination
findings
Fully dilated
station +2,
150mls fresh
blood
Deliver by
instrument
Deliver by CS
Apply FSE
X(fatal if
omitted) X
X
Reposition X
Case 6 VBAC IOL
synto, 4cm
Score 1 Score 0 Fatal error
Airway Clear and
breathing
Apply oxygen X
Pulse 130 Fluid bolus
500mls stat
Site IVC and
take bloods
X
X
BP 85/58
Fluids 125ml/hr
syntocinon 16u/min Stop
syntocinon
(fatal if
omitted)Epidural Nil
Uterus Rigid abdomen, Give
terbutaline
X
Vaginal
examination
findings
5cm dilated,
station -4 poor
application,
100mls blood
Deliver by
instrument
Deliver by CS
Apply FSE
X
X
X
Reposition X
Commented [1]: “vaginal birth after Caesarean section”