Review of the game Re-Mission created by Hope Lab
Rating: 
The Story
The year is 2027. Due to significant improvements in Science, nanobots are used to fight cancer. The player takes on the role of Roxxi – a humanoid nanobot who is charged with fighting cancer cells, protecting the good cells and being involved in managing the treatment -related adverse effects.
Roxxi – the miniscule humanoid nanobotPlay begins by porting Roxxi into a cancer patients body for her first mission. Once the cancer has been defeated, the mission is complete and the player can play another mission. There are 20 missions in total. Each mission takes place inside the body of different cancer patients. The cancer patients are male and female, from different parts of the United States and have different types of cancers and therefore require different forms of treatment. All patients are adolescents and young adults.
Why has the game been created?
Research indicates that adolescents and young adults are less likely to adhere to self-administered cancer treatments such as oral chemotherapy. The game aims to help young people with cancer feel like they have power over the disease in an effort to increase treatment adherence. It was created with support from medical staff with knowledge of cancers and their treatment.
Did the game achieve its goal?
According to the research study that was conducted alongside this game, an increase in adherence to self-ministered cancer treatments of the adolescents and young adults who played the game increased. Self-efficacy and knowledge of cancer and its treatment also increased.
Interestingly, there was no increase in self-reported measures of adherence, stress, control or quality of life.
This indicates to me that when evaluating the effectiveness of serious games, subjective self-assessment by the player may not be the best measures to use. This may be because the game player is not always aware of what they are learning within the game – the learning is implicit. If the learning were overt, maybe the game would not be quite as fun? If it is important that the learning be explicit to the player, perhaps extra activities need to be conducted outside of the game as a supporting mechanism to the game-play?
After having played the game myself, I think it would help you feel better about your treatment and give you a better understanding of the side effects and their treatments. I don’t think the game alone would effectively educate you about your cancer treatment – however, this is not the main purpose of the game. The game would be a good reinforcer for concepts introduced by the doctor.
About the Game & Game Play
Re-mission is a 3D, third-person shooter PC game developed for adolescents and young adults with cancer. The game is made available through hospitals and can also be downloaded for free from the internet.
The game is a one-player game. However, there is limited two player functionality. Two players can play simultaneously using one computer. When playing in two-player mode, there are two arcade-style missions that can be played. The two-player functionality seems to be an after-thought and as such is not as immersive as the rest of the game.
Check out this youtube video for an introduction to Re-mission.
Culture built around the game
In an effort to embed the game inside a larger culture, there is a supporting website with information about cancer and a large amount of user-created content. Sections of the website featuring user-created content include:
- What’s up doc? – a space where kids with cancer can have their questions answered by professional medical staff
- Top 10 lists created by members - top 10 lists are compiled after kids with cancer share their responses to a variety of stimulus questions like “When you visited the hospital, what are some nice things the hospital staff did for you or other patients?” and “What foods made / make you nauseous during treatment?”
- Art & Poetry - below is a sample art piece
user-created art work sample from the re-mission website
This community to share user-generated content was an excellent addition to the game although it looks like it is no longer being maintained. The most recent entry in the Art & Poetry section was Feb 2008. The community section of the site looks as though it was be fairly carefully moderated – which can stifle creativity but given the age group the game is aimed at and the sensitivity of the subject matter – this was probably both wise and necessary.
Likes and dislikes summary
| Game Aspect | What I liked | What I disliked |
| Wider culture of the game | The provision of a companion website to provide more support for adolescents and young adults with cancer. | Unfortunately the companion website appears to be no longer updated. |
It attempts to relate to both genders by:
|
||
| Statistics are kept of hit rates. Some players may replay particular missions in an effort to increase their player statistics. | ||
| Game play | The keys to be used in the game could be configured. Not all keys were necessary when learning how to play the game although they would probably be used to master the game. | The keys to be used on the computer keyboard to control the character are reasonably complex to remember (more than 10 keys on the keyboard as well as the mouse can be used in gameplay). I think this game may be easier to play using something like an Xbox controller. |
| The game has some cheat codes embedded for people (like me) who don’t have great hand-eye coordination. Whenever I played, I turned on invulnerability and unlimited ammo. | ||
| There are some two-player missions. | Two-player features are tokenistic – they seem like an add-on after the fact. | |
| There are two optional tutorials and 20 missions which provides quite a bit of gameplay. Each time you complete a mission for the first time, a new mission is unlocked. | You have to complete the missions in order. In a way this is good, as they get harder the further you go. However, if you are looking forward to playing out a scenario inside someone who has the same cancer as you, it may take you a while to unlock this mission. | |
| The game is a third-person shooter (as opposed to a first-person shooter). This helps you identify more with your character, Roxxi. | The game is a third-person shooter (as opposed to a first-person shooter). Having the back of the character at the front of the screen can make it more difficult to aim at targets correctly. | |
It is easy to know what you are expected to do:
Smitty provides verbal advice throughout the mission. |
||
| If your sound is off, you can still play the game as all text is subtitled. | ||
| Voiceovers, sound effects and graphics are high quality. The game is played inside the human body and you can definitely tell that it is inside the human body but it also has a similar feeling to being in space. I guess, for a miniscule nanobot, the human body would feel like outer space. | ||
| The game gives good aural and visual negative feedback for both positive and negative occurrences. | ||
| The main decision systems at play are about ammo and energy conservation versus destroying the enemy. If the player doesn’t stop and get a power-up or an ammo top up at the required times, the mission will have to be restarted. However, every second the cancer cells are not destroyed, they keep multiplying thus making the player’s job more difficult. | Decision system is not complex – for 90% of the game, you mostly just have to go and shoot cancer cells (this is to do with the game genre). | |
Game provides challenge – cancer systems get harder to fight ad require greater accuracy as the player progresses through the levels. This encourages the player to pay attention to the current micro challenge with the macro challenge being at the back of the mind. Type of challenge used within the game:
|
Only small amount of conflict (ammo / multiplying cells). | |
| Narrative | The cut-scenes within the game were high quality (great graphics, audio and script) and humorous. The cut-scenes always took place between Roxxi and her mentor, Smitty. | Although the cut-scenes are reasonably short, you cannot escape out of them even if you’ve entered the mission before. |
| No patients die in the game. If you do not manage to defeat the cancer before the Roxxi’s power runs out, she will power down and give you the opportunity to play the mission again. | There is little uncertainty in the game – you know that if you keep shooting the cells, eventually you will defeat them. | |
The characters are easy to identify with as the game follows a typical super-hero narrative structure. The characters featured are:
|
The game is USA-centric – all cancer patients are from the USA. | |
| Each mission mixes treatments with ways to combat the side-effects of the treatment (eg. Release 8 relax taps to facilitate deep breathing) | ||
| Narrative structure – follows typical super-hero narrative structure but has the right balance of gameplay and narrative. |
References and Links
Kato, P.M., Cole, S., Bradlyn, A.S., Pollock & B.H. 2008. “A Video Game Improves Behavioral Outcomes in Adolescents and Young Adults with Cancer: A Randomized Trial” in Pediatrics 122 (2): e305. (2008)
Accessed from http://pediatrics.aappublications.org/cgi/reprint/122/2/e305 on 1/9/2009
Straylor. 2009. Re-Mission – A video game for kids fighting cancer (youtube video).
Accessed from http://www.youtube.com/watch?v=CBfKo3FsC-Q on 1/9/2009
Hopelab. 2009. Re-Mission: a game for young people with cancer (website)
Accessed from www.re-mission.net on 1/9/2009
Image Attributes
http://www.flickr.com/photos/musigny/148258023/ (used under Creative Commons Licensing)
http://www.re-mission.net/site/community/ap.php?sid=61&id=2 (Used for review purposes. If you are the copyright holder of this image and wish it to be removed, please add a comment to this blog entry.)
Tags: cancer, game review, re-mission, serious games