Values Game for Medics

What is the Values Game for Medics?

The Values Game for Medics is a teaching aid for initiating dialogue that presents serious issues in an interactive format. The game develops players’ self-reflection and ability to provide arguments and justifications and facilitates cooperation and the achievement of consensus even in case of disagreements when dealing with value dilemmas.

The aim of the game is to uncover values that underlie work in healthcare and to bring them from the abstract level into the context of daily work experience. The game develops medics’ readiness to discuss conduct in various work-related situations and possible value conflicts.

The board game is played by a small group of colleagues; the aim of the group is to solve various tasks, including value dilemmas taken from medics’ daily practice.

The Values Game for Medics is meant for use during training courses in medical ethics and in doctors’ and nurses’ professional education.

The game is in Estonian.

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Testimonials

The Values Game for Medics is a collection of tasks prepared by a group of experts, including medical doctors, on the basis of situations from daily practice. It uncovers value judgements behind different solutions to the same problem. These generally serious issues are intentionally presented in a playful form in order to encourage dialogue and avoid conflict during the discussion. Also intentionally, there are no “shortcuts” among the solutions, just like in real life it is often impossible to make the unambiguously best decision.

- Mart Einasto, member of the Executive Board of Tartu University Hospital

The Values Game is a board game in the course of which players discuss situations that arise in our work where it is sometimes difficult to find the right solution or course of action. Our own feelings may be ambivalent or colleagues may disagree due to differences in value judgements or personal attitudes. The game is gripping and a lively discussion develops in the process. It never feels boring—it is exciting to discuss with colleagues which decision would be the best and to attempt to understand why we sometimes think differently.

- Helle Karro, Head of the Women’s Clinic

The Values Game is a good teaching aid for groups from various disciplines and work collectives, including the management. The game helps to perfect several skills that we all need daily if we want to provide care and support to our patients and colleagues.

- Tiina Freiman, Chief Nurse of Tartu University Hospital, member of the Ethics Committee

The methodology of the game

The Values Game for Medics consists of descriptions of situations that contain medical ethics dilemmas to be discussed by teams of four to six players.

All situations are described in such a way as to present a dilemma—a situation of choice between several possible courses of action. Dilemmas have long been used for teaching ethics, making those facing a dilemma think about the circumstances of the case, possible alternative solutions and their consequences. The method of the game also makes players think about their personal preferences, the solutions their colleagues expect from them and the ways similar situations are resolved in real life.

The description of each situation is supplemented with the descriptions of six possible courses of action to choose from, none of which is perfect. The pre-given options help to give structure to the discussion inspired by the dilemmas because they bring to the fore:

• Different values inherent in the situation. As every option reflects somewhat different values, presenting the players with a number of options enables them to see more clearly possible conflicts between these values as well.
• Variety of principles of conduct in the situation. These are the general guiding principles or maxims that shape our choices. The most famous among those principles is “Do not do unto others what you would not have them do unto you“, but in ethics there are numerous other principles. Choosing between different options enables one to ask oneself what the different principles of conduct that could guide one’s actions are. What are the different options one could choose from when searching for the solution?
• Differences between virtue ethics (What are the agent and the agent’s motivations like?), deontological ethics (What is the universal norm?) and consequentialist ethics (What are the possible consequences of the action? Which of them are preferable?)

• The issues of loyalty and conflict of interest that arise in connection with different options. Thinking about loyalty makes one ask questions such as “Who is going to benefit most if I choose this option?” and “Whose well-being is the most important for me?”

   

The making of the game – who and how?

In order to create the game, the Centre for Ethics of the University of Tartu established a working group that included, in addition to the staff of the Centre and consultants from Implement Inscape LLC, experts representing  teaching staff from the Faculty of Medicine of the University of Tartu, Estonian Bioethics Council, the Ethics Committee of the Tartu University Hospital and the Research Ethics Committee of the University of Tartu, and other recognised experts in the field of medical ethics. The working group was active during the years 2013 and 2014. The situations described in the game are based on real-life cases that were gathered and presented by the medical ethics experts who participated in the development of the game.

The members of the working group (in the alphabetical order): Katrin Elmet, Naatan Haamer, Halliki Harro-Loit, Marten Juurik, Ruth Kalda, Aime Keis, Triin Käpp, Laura Lilles-Heinsar, Kristi Lõuk, Heidy Meriste, Triin Paaver, Mari-Liisa Parder, Andres Soosaar, Kadri Simm, Margit Sutrop, Ekke Sööt, Tiina Talvik, Arvo Tikk, Oivi Uibo.

The game was tested by students of the Faculty of Medicine of the University of Tartu and members of the Ethics Committee of the Tartu University Hospital.

The development of the game was supported by the Council of the Gambling Tax, the Faculty of Medicine of the University of Tartu, the Centre for Ethics of the University of Tartu and the Ethics Committee of the Tartu University Hospital.