The immunity game: conceptual learning through learner engagement.

Conceptual Learning Through Learner Engagement Immunity affects the health and well-being of all individuals. For this reason, few would argue that this concept is foundational to nursing practice. However, it is complex, and finding ways to teach this concept to undergraduate nursing students in a meaningful way is challenging. Learning is most effective when students are actively engaged, when learning incorporates emotion (Zull, 2004), and when learning activities are perceived as useful and purposeful by students (Tanner, 2007). This article describes an immunity game—a fun, inexpensive, and purposeful student-centered learning activity that integrates the concept of immunity in a clinical context. In this game, students analyze an encounter between a client and potential immunological threat, and they consider the outcome based on multiple variables. To develop this game, two sets of game cards are needed. One set of cards (client cards) describes the immunologic status of individuals (one individual per card). Client information includes age, immunizations, health status, environmental factors, and behaviors. The second set of cards (pathogen cards) describes an immunologic threat (Figure). To begin the game, each student gets one card (pathogen or client). Students holding a pathogen card take on the role of the immunologic threat written on their card. An effective way to visually identify students holding pathogen cards is to ask them to wear cone-shaped party hats. Not only is this fun, but it actually offers an enhancement to this role identity. The objective of students holding pathogen cards is to “attack” students holding client cards by seeking out and presenting their card to a student not wearing a cone hat (the client). The point of learning occurs during the pathogen–client encounter. Students consider the effect of the pathogen on the client (based on characteristics described on their cards) and discuss the likely consequences of the encounter. Students must decide what the likelihood and extent of exposure would be, and whether the client has adequate immunologic integrity to withstand the pathogen threat or will succumb to infection. If students are unable to reach a decision, the instructor (acting as a facilitator) helps students think through the encounter. If needed, students are encouraged to use references to make their decisions. If the pathogen is likely to overtake the client, the pathogen wins; if the client is likely to resist the pathogen, the client wins. If an encounter could go either way, a coin toss is used to determine the winner—reinforcing the notion that at times, an encounter can go either way. Winners collect the game cards of the losers and continue in their original roles for another encounter with another opposing student. Students who lose the encounter follow their victor to the next encounter, thus staying actively involved in the discussions. The amount of time devoted to this game is controlled by the instructor; it can continue until either all clients or pathogens have been eliminated or the designated time has passed. During the game, all students are out of their seats interacting, problem solving, and negotiating. The level of energy in the classroom is truly amazing. A debriefing session following the game allows for further conversations and dialogue between students and instructor. Feedback from students is overwhelmingly positive, and the activity is consistently listed as one of the notable learning activities in the end-ofsemester course evaluation. Students like this learning activity because it forces them to apply concepts of immunity to real-life situations. It drives home the importance of immune status to infection risk and highlights Figure. Sample game cards. HIV = human immunodeficiency virus; MRSA = methicillinresistant Staphylococcus aureus. S y L L A b u S S e L e C T I O N S I n n o v a t i v e L e a r n i n g A c t i v i t i e s