Project Hospital: a realistic take on hospital simulation

Interview with Jan Beneš

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Project Hospital[1] is a game developed by indie studio Oxymoron games (Prague, Czech Republic). In it, you build and manage every single detail of your own hospital – and you can diagnose and treat patients as well! Launched in 2018 on Steam, the game features a wealth of real-world-based medical expertise, equipment and diseases and injuries, counting with an in-depth diagnosis process.

To understand how all of this is possible in a game, the Journal of Geek Studies interviewed Jan Beneš, lead programmer at Oxymoron games. We uncovered the story behind Project Hospital, which you can read below.

Q: There are a few hospital and “medical” sim games around, but Project Hospital is a fresh and more down-to-Earth example of this subgenre. How the idea for this game came to be?

A: The story began like this: a small group of developers met in early 2016 to discuss starting a new studio and hopefully agree on the first project. Most of us are now team members or co-founders of Oxymoron games and as it turned out, Project Hospital was definitely a good choice of a game that we’d be both able to create with a team of 2–4 people and which would find its place on the market thanks to the combination of theme and realistic settings. The original pitch itself came from Roman, who then took the role of lead designer and main artist on the project.

Q: Have you or anyone in the team worked in a hospital before?

A: Actually yes, one of our designers has some experience from medical school combined with an internship in a hospital, and while he took a different career path later, his familiarity with the field was essential when choosing and creating content for the game.

Q: Did you contact staff from hospitals (admins, nurses, physicians, etc.) for advice when developing the game?

A: When we announced that the project was in development, quite a few real-life doctors and professionals in the medical field got in touch and we spent a lot of time discussing different topics in a private section of our forums. This really helped, for example, with choosing the best terminology for different aspects of the game and to some extent to see if we can get away with some of the necessary steps needed when transforming a very complex topic into a game, while advertising the realistic settings.

Q: How much realism did you set out to include in Project Hospital and how this realism was balanced with gameplay and entertainment?

A: The foundations based on real-world medicine gave us clear boundaries, but to create an engaging game, gameplay must come first. To be more specific, this means choosing a correct level of simplification and turning complex material into rules like “examinations uncover symptoms”, “uncovering enough symptoms leads to a clear diagnosis”. In the next step, it was necessary to adjust a lot of values to create interesting cases for the players to solve — for example, the occurrence rate of certain symptoms in different diagnoses was needed to be set in such a way that would limit cases where it’s immediately clear what the patients are suffering from after first examination.

The process was a bit easier on the side of hospital management — and while this wasn’t the actual goal and we carefully balanced the economy aiming for a challenging experience — it turns out that the simulation is actually very close to the American healthcare system[2], which is both fascinating and pretty scary.

Q: So, let’s delve into some of that gameplay now, shall we? What is the players’ actual goal in Project Hospital?

A: In our elevator pitch for Project Hospital we always mentioned that the game would allow players to focus on different aspects, whether it is the building part with all the little details, managing a huge hospital and making it as efficient as possible, or taking care of individual patients. The latest version of the game still follows these rules as far as possible and on top of that, for players looking for more structure, we added a short campaign with some interesting tasks to undertake.

Q: Does the game allow specialization in particular subfields of medicine? Like making your hospital a reference in ophthalmology‎ or oncology, for instance.

A: The content is indeed structured into individual departments and you can focus on any of them in any particular build, as well as running only a clinic. The five main fields available in the base game include for example cardiology, neurology and orthopaedics, with more planned for future DLCs and more also getting added by the community thanks to mod support. Oncology would be an example of a field we didn’t select ourselves, but has been already added to Steam Workshop.

Q: From what we’ve seen, there are different objectives to be met, like solving complex cases, keeping staff and patients happy, and make profit with your hospital business. Is there a trade-off between these objectives in the game?

A: The game generally rewards you for taking good care of your employees and patients alike, so there should be no conflict between being a good manager and helping your staff with complicated cases when needed. For the players who want to focus on one specific goal, the game tries to help by making almost every aspect automated to some extent. Not interested in building? Try one of the pre-built hospitals or place whole rooms using the collection of prefabs. Not up to dealing with individual patients? Hire experienced staff and let them do their job.

Q: One cool thing in Project Hospital is to solve difficult cases. When doing so, the player is unknowingly making use of decades of real medical research. Is there a nod in the game towards scientific research and how medical knowledge evolves?

A: From this point of view we use one snapshot in the development of modern medicine — the systems are already pretty complex and quite demanding for new players, so for example researching new and more effective types of medicine didn’t become a priority. There’s definitely enough challenge already in finding the correct diagnosis, uncovering all potentially dangerous hidden symptoms and treating the patients on time.

Q: Unfortunately, there is a current trend of once-eradicated diseases making a resurgence. So, when you’re dealing with an infectious disease in the game, is there any discussion or statement about prevention, vaccination, etc.?

A: This is definitely an interesting topic, but has mostly fallen out of scope of the main release — that said, we’ll still have opportunities to tackle some of these aspects in the future and it’s true that with the recent news regarding the coronavirus outbreak[3], we’ve been even getting similar requests from the player community.

Q: Do you think there is an educational potential for Project Hospital?

A: In a way, Project Hospital contains a pretty extensive encyclopedia of medical conditions, symptoms and diagnostic methods. While, for example, a lot of the probabilities in the background are balanced more towards generating interesting cases than strictly following reality, there’s a lot to learn from the game.

And while we can’t really share more details at this moment, a couple of institutions have been evaluating the game for the use in training (I guess more for managers than doctors, but still…).

Q: So far, have you received feedback from the medical community? What has that been like and how does it differ from regular player feedback?

A: We’re amazed how big a part of the player base are actual doctors or people with doctors or nurses in their family — and an obvious observation, their real-world experience indeed makes it much easier for them to get into the game.


About the Team

Oxymoron games is an indie game studio based in Prague, founded by a small group of Czech industry veterans. They have experience both at home and abroad, having worked on various game genres and interesting titles like Mafia II & III, Quantum Break, Top Spin 4 or Euro Truck Simulator. In 2016, they finally found themselves at the right place in the right time to have a shot at becoming independent. After the successful release of their first game, Project Hospital, they’re currently working on more content and supporting their player base, while preparing for future adventures.


[1] You can find it at http://www.oxymoron.games/

[2] See also Boudreau, I. 2009. ‘Project Hospital’ is a great way to understand our broken healthcare system. Available from: https://www.vice.com/en_us/article/wjvxk5/project-hospital-is-a-great-way-to-understand-our-broken-healthcare-system (Date of access: 19/Feb/2020).

[3] The virus has now been named COVID-19. See more at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019

Mondo Museum: a sim game to build your own world-class dream museum

Interview with Michel McBride-Charpentier

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Mondo Museum is an upcoming simulation game developed by Viewport Games[1] where you can build your dream museum. Equipped with dinosaurs, Books of the Dead, classical paintings, and space-age stuff, Mondo Museum has something for everyone. The game will be soon published by Kitfox Games and is already listed on Steam.

The Journal of Geek Studies interviewed designer/programmer Michel McBride-Charpentier to understand how such a wonderful game like Mondo Museum came to be. You can read the full interview below.

Interview

Q: There are lots of sim games around, but as far as we know, there has never been one about curating and running a museum. So how did you get that idea?

A: After the announcement, a few people have said they’d also had the idea of a “SimMuseum”, so I don’t think it’s a wholly original concept. I’m actually really surprised nobody else has made a game like this since the idea first popped into my head over a decade ago and I’ve spent the last 5 years really expecting one to drop on Steam at any moment.

The idea, like most good ones, came to me through synthesizing a lot of different interests I’ve developed over my life: visiting a wide variety of museums in school and later as an adult, a love for Maxis and Bullfrog management games, and a personal desire to create work that is educational and engages players with systems thinking without being a dry capital-letters Serious Game.

Q: Do you have any particular type of museum you enjoy the most? Or an all-time favourite museum?

A: Museums that contain a wide variety of exhibits that have no apparent relation to each other are always the most fun for me to visit. For example, The Met in NYC which has collections ranging from Ancient Egypt to medieval European armour to Rembrandt paintings. The Royal Ontario Museum in Toronto is also in this vein, with dinosaur skeletons and fossils next to Chinese sculpture.

Asking for my favourite is an impossible question, but I’ll use this opportunity to shout out the Noguchi Museum in Queens, NYC. It’s entirely focused on the life and work of Japanese-American sculptor/designer/landscape architect Isamu Noguchi. Walking through those galleries and the sculpture garden for the first time sparked a real appreciation for abstract sculpture I never had before, and he instantly became my favourite artist of the 20th century.

Q: Did you bring into Mondo Museum some of your personal experience or preferences?

A: Choosing which collections to include at launch was definitely driven by my personal preferences. When I was a kid I wanted to be an Egyptologist and archaeologist, so including an Ancient Egypt collection was an obvious choice. Many of the things that invoke a sense of wonder in kids but are often lost as we become older are represented, such as dinosaurs, space exploration, and the geology of the Earth.

Q: Have you or anyone in the team worked in a museum before?

A: C.J. Kershner is writing the exhibit item descriptions and the few characters who are directors/curators of other museums, and has many years of experience volunteering at the American Museum of Natural History as an info desk attendant (so obviously had to know a lot about the workings of the museum from the visitor’s perspective), and as an explainer for a live exhibits team.

Q: So, let’s turn to the game now. What is the players’ goal in Mondo Museum? Are there different scenarios and objectives to be met?

A: There’s a sandbox mode where the end goal, or how to achieve the highest prestige ranking, is mostly up to the player to define. There is a task/objective system that provides short-to-medium term goals, such as unlocking new items or receiving more funding.

As for scenarios, the current plan is to have those, though what exactly they will look like is still undecided. A campaign where you move between different museums with unique challenges and constraints is the goal, but will likely only come in an Early Access update.

Q: From what we’ve seen, the game includes all types of museums: natural history, technology, archaeology, anthropology, art, etc. How did you manage to gather all these different areas of study and interest into a single package?

A: As I mentioned above in what my favourite types of museums to visit are, it’s not uncommon for real museums to display a wide variety of collections under one roof. But we go one step further, and let players mix and match items from any collection. The challenge was in selecting items that complement one another and allow players to discover these relationships between items. One example is how in the Ancient Egypt collection there’s an astronomical chart, and tools for observing the stars, that can be combined with items from the Space Exploration collection to create a kind of “Astronomy through the Ages” combo. Right now I’m explicitly defining these combos, but might try out a more free-form tagging system, where for example any item tagged “Tool” could be placed in an exhibit hall with others that share that tag.

Q: And now perhaps the most important question of all: does Mondo Museum include exhibits of the giant squid (Architeuthis dux) or the colossal squid (Mesonychoteuthis hamiltoni)?

A: “The Ocean” is on a shortlist for collections to include in a future content update, but if you’re really desperate to see some horrors of the deep, mod support means if a player can make a 3D model of one then it will be very easy to put in the game.

Q: Did you bring in any museum staff as consultants while making the game?

A: No real consultants other than C.J., but if anyone is brought in will likely be to review specific collections for cultural sensitivity issues we might have been oblivious to. For example, someone recently brought up the debates museums have around the subject of human remains when making exhibits about ancient burial practices and so on, which I hadn’t considered before. That kind of insight is really helpful (in our case, this helped me decide to only have mummified animals because a) they’re actually pretty cute while human mummies are pretty gross and b) a human mummy is kind of unnecessary since the real interesting artefact/art is the coffin and sarcophagus).

Q: There is a lot of discussion today around ownership and repatriation of artefacts, especially in archaeology and anthropology[2]. It is a tough subject, but does Mondo Museum tackle it in some sense?

A: Absolutely, and it’s core to the politics of the game. I didn’t want to recreate the systems of colonialism and looting that resulted in many museums in the West originally acquiring their collections. Mondo Museum takes place in a more just and utopian world, where all items have been repatriated (or never left in the first place). The way you unlock new exhibit items is by satisfying the conditions of visiting directors/curators from these museums around the world, who will then effectively give you permission to display parts of their collections.

Q: The game focuses on the exhibitions, which are the public face of museums. Will there be any mention to the vast collections of objects and specimens museums have and of all the research (scientific and otherwise) that is done based on these collections?

A: The research and archive aspect of the game is still a work in progress (there are researcher staff you hire who can improve the quality of your items/the understanding visitors get from it in a sort of abstract way), but I like the idea of the item we have created that is on display representing a lot of associated items that don’t have 3D models but you need to manage to some extent. I’m trying to keep the scope achievable for the moment, but big updates are planned throughout Early Access.

Q: Do you hope the players will learn something with Mondo Museum or maybe spark their interest to visit a museum?

A: I really do hope it encourages players to go to museums if they haven’t been in a while, or maybe since a school field trip. Hopefully the game will give everyone a deeper appreciation of the work behind creating an exhibit that makes sense to the public, or consider what curation decisions they might have done differently to tell a different story.

Q: Do you hope museums worldwide might learn something from Mondo Museum?

A: The people running modern museums are generally doing a really good job in engaging visitors these days, so I’m not expecting to reveal anything they don’t already know. Maybe there could be more museum activities for adults, and not just kids or currently enrolled students. I’m targeting an audience of all ages, and there’s been a lot of interest from adults intrigued by the game. Curator talks, seminars, group tours, opening parties, etc., are fairly common, but I’d love to see more creative activities and workshops designed with adults in mind, since there’s clearly an adult audience for “playing” with museums.


ABOUT THE TEAM

Michel McBride-Charpentier is Mondo Museum’s designer and programmer; the other team members are Genevieve Bachand (artist), Farah Khalaf (producer), C.J. Kershner (writer), and Rhys Becker (artist). Viewport Games is a small studio based on Montréal, Canada. Kitfox Games, also from Montréal, is an independent games studio focused on creating intriguing worlds to explore.


[1] Be sure to visit their website [https://mondomuseum.com/].

[2] See, for instance: Woldeyes, Y.G. 2019. Repatriation: why Western museums should return African artefacts. The Conversation, 15/May/2019. Available from: https://theconversation.com/repatriation-why-western-museums-should-return-african-artefacts-117061


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