February 6, 2023

Zmoji: Gamifying a Stressful Practicum to Engage Generation Z

This real life story is a translation of a text first published in Eductive’s French edition.

In the 3rd year of the nursing program, students must complete a practicum in medicine and surgery. This practicum is demanding: the step is quite high between the medicine and surgery practicum in the 2nd year and the one in the 3rd year. This practicum is stressful for the students and this sometimes leads to a decrease in motivation. That’s why we wanted to turn this practicum into a happening, a positive event.

Generation Z

To find a course of action, we started by researching our students; young people from generation Z (born between 1995 and 2010). We wanted to reach them, to adapt our teaching to their needs and their reality.

Our thinking process took off when we attended the talk given by Carol Allain [in French] at the colloquium of the Association des enseignantes et enseignants en soins infirmiers des collèges du Québec (AEESICQ) [in French] in June 2019. We then read Carol Allain’s book: Génération Z, l’humanité numérique en place [in French] (Château d’encre, 2019).

We understood that:

  • Generation Z likes speed, change and creativity. They like to multitask, but for shorter and shorter periods of time.
  • Lectures are less and less suitable for Zs. They like to exchange ideas with a teacher who acts as a coach.
  • For Zs, fun is part of a healthy work ethic. They want to have fun.
  • The Zs want to be the actors of their learning.

That’s where we got the idea for the Zmoji game. In this process, we were inspired by a talk by Shawn Young, president and co-founder of Classcraft, that we attended at Cégep du Vieux Montréal in 2019.

The Zmoji game

Zmoji is a game we designed ourselves for our students.

As part of the 3rd year medicine and surgery practicum, we each supervise about 6 students in the practicum setting (3 days a week for 5 weeks). Each small group of 6 becomes a team for the game. Usually there are 5 or 6 competing teams.

Each team chooses a name. Each student receives an avatar that will allow them to find their way around the scoreboard without having to write down their names.

Six small images placed in 2 rows of 3. The first image shows an illustration of a nurse wearing a white cap with a red cross, a white blouse and a white skirt. The character has an oversized head with 2 black eyes, a smiling mouth, visible red cheeks, but no nose. The second image shows a yellow smiling face, in the manner of classic emoticons, wearing a white cap marked with a red cross and holding a syringe in its single hand (it has no body). The third image is very similar to the second, but the emoticon is angry, threatening. The fourth image is the bust of a male character with yellow skin and short brown hair wearing a stethoscope around his neck, over a white lab coat. The fifth is Bart Simpson dressed as a doctor (white coat, stethoscope, headlamp). The sixth is an emoji with a wide smile wearing big sunglasses. It has no body, but 2 floating hands giving the thumbs up.

6 of the avatars that can be used by the students

Each week, students are presented with a list of challenges (posted in the team room in the practicum setting). Students earn points each time they complete a challenge. Some challenges are individual, others must be completed collaboratively. There are approximately 5 challenges per week. The points are individual but also contribute to the team score.

The challenges are varied.

  • Some of them lead students to consolidate theoretical concepts:
  • answer a question related to the objectives of the practicum
  • gather the material to be used to take a blood sample
  • etc.

Some challenges are aimed at developing attitudes:

  • arrive on time for the practicum
  • submit the requested documents on time
  • help a teammate
  • arrive at the practicum with a smile (!)
  • etc.

Each week, the students with the most points earn a “Zenitude” to use the following week. A “zenitude” could be, for example, permission to hand in an assignment a little later or VIP access that allows having the medication to be given to a patient validated before everyone else.

At the end of the session, the team with the most points wins the “Zenitude Grand Prize.” Each member of the winning team can choose a prize from different options:

  • have the right to retake a lab test
  • have the 1st choice for their practicum setting in the next session
  • etc.

Zmoji’s spin-offs

We are thrilled because Zmoji has helped us achieve our goal. Because of the game, students say to themselves, “The practicum is a happening… If I don’t go, I’m missing out!”

Previously, with a traditional approach, the formative meetings we had with the students we were supervising sometimes made them feel like they were constantly being evaluated. The integration of Zmoji makes the atmosphere more fun, less stressful.

The game challenges students to work as a team to win. This leads them to develop collaborative skills that will be very useful on the job. The nurses in the practicum settings have commented on this. We had the chance to work in settings where some of our former students were staff members and they seemed a little jealous that they hadn’t played Zmoji during their studies!

Thanks to the game, the atmosphere during the practicum is more dynamic. The teams maintain a friendly competition, which is stimulating. Everyone wants to win a zenitude! We even notice that absenteeism has slightly decreased in the practicum: the students know that if they don’t show up, their team will have a smaller chance of winning.

Bonus: Zmoji doesn’t just appeal to young adults of Generation Z. Our older students have also been enthusiastically playing the game!

Involvement of the teachers

Since the implementation of Zmoji in 2019, we have not been the only teachers in charge of the course related to the 3rd practicum in medicine and surgery. Other teachers have supervised groups along with some of us. We introduced them to Zmoji and they participated with pleasure (and for the pleasure of their students!). It’s important that the teachers buy into the project and believe in it because running the game, in addition to all the other tasks associated with the course, requires a little extra work. On the other hand, the student teams are more dynamic and work better!

Regardless, in order to keep the task sustainable for us, we make sure that the students are the ones who are responsible for meeting the challenges. For example, we don’t remind a student that they haven’t answered a question yet: they have to come see us and ask us to provide the question.

A partnership with the Computer Science Department

Our project attracted the interest of the Computer Science Department and, just before the pandemic, a team of students were tasked with a project to develop an application for Zmoji. This application was to communicate challenges, manage the scoreboard, etc. Unfortunately, the project had to be put on hold at the beginning of the pandemic as the students’ work became too difficult to coordinate remotely. This session, we are testing a new large-scale project for our course!

An idea that can be easily adapted to a multitude of contexts

Zmoji has been a real success. It allowed us to receive the 2022 AEESICQ Margot-Phaneuf Award. However, the addition of a new practicum environment in our course made it too tempting for us to start a new project! We will tell you about it, in due course, in a future Real Life Story!

The Zmoji concept could easily be adapted to any other Nursing practicum. It’s just a matter of adapting the challenges for the students! In fact, the game could probably be used in many other courses in a variety of fields. Do you have any ideas on how to implement this concept in your own courses?

About the authors

Karine Beaudoin

Karine Beaudoin has been a nurse since 2006. She completed her Bachelor of Science in Nursing in 2015. Her clinical experience was built in several clinical settings such as medicine, surgery, emergency room, and recovery room. Being a college instructor also led her to develop her skills in mental health as well as routine care at the CLSC. She has started a graduate microprogram in Pedagogy and will start another microprogram in Advanced Wound Care this winter. 

The most important thing for Karine Beaudoin is to transmit her passion to students and to always keep her knowledge up to date. She is proud to be part of a team that has won several awards including the 2019 and 2022 Margot Phaneuf Awards [in French].

Josianne Gagnon

Josiane Gagnon has been a nurse since 2005. She completed her Bachelor of Science in Nursing in 2007. Since 2009, she has been teaching mainly in medicine-surgery and for the past 2 years, she has been the coordinator of the nursing department. She has started a graduate microprogram in College Teaching. She has collaborated in the development of several pedagogical projects that have received the Margot Phaneuf Award 

Nathalie Gagnon

Nathalie Gagnon has been a nurse clinician since 1993. She has worked in several health care settings, including CLSCs. Her work as a teacher has led her to become interested in college pedagogy. She has taken courses in a graduate microprogram in Learning Pedagogy. She is proud to be part of a dynamic team that contributes to the reputation of her CEGEP by obtaining several awards related to pedagogical innovation at the college. 

Hélène Turgeon

Hélène Turgeon holds a Bachelor’s degree in Nursing and a Master’s degree in Education. She has been teaching at Cégep de Shawinigan since 1991. She was co-recipient of the Margot Phaneuf Award [in French], presented by the Association des enseignantes et enseignantes en Soins infirmiers des collèges du Québec, in 2019 for the Laboratoire anatomique, phase 2 project and in 2022 for the Zmoji project. She also received an Honourable mention from the Association québécoise de pédagogie collégiale [in French] in 2020. 

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