Reclusive game designer Tim Price has been hard at work in his shed producing the latest update to his High North arctic crisis matrix game.
This latest version includes a system of technological “investment cards,” ranging from military capabilities to shipping to green technologies, which players can acquire to affect their matrix game arguments or outcomes. If enough player investments are in the area of green technology, the pace of climate change could be slowed. However, if they invest elsewhere, the pace of climate change may increase still further…
The package contains an overview of the current situation regarding Taiwan and the East China Sea, some basic information on playing a matrix game, briefing documents maps, basic event cards, and counters. The game is configured for six players (or team): China and the People’s Liberation Army, Taiwan, the United States, Japan, and Australia.
One needs nothing more than a computer, printer, imagination, and an understanding of matrix games to design matrix game scenarios like this. If you’re looking for additional resources and guidance, however, there is always the Matrix Game Construction Kit (MaGCK).
When Tim Price isn’t dragging his better half around castles, he designs matrix games. His latest, KMAC-YOYO, looks at the future of Central Asian geopolitics in the wake of the Taliban take-over in Afghanistan.
The game is designed for 6 players: the United States, Russia, China, India, Pakistan, and Iran. The package comes with a scenario description, briefing sheets, asset and capability markers, and maps. It also comes with basic instructions on how to play a matrix game, with references to additional online resources.
Tim Price—reclusive starship designer, small-holder, zombie survivalist, and lock-pick—has put together an online version of his recent Bandera Russo-Ukranian conflict matrix game for PAXsims readers, using Google slides. The link to access these is below, but first you need to read these instructions verrrrry carefully.
Go to the Google slides at the link below.
Do not move, alter or edit anything on this slide deck in any way!
Instead, pull down the File menu and make a copy of the presentation for your own use (see below).
Close the original set of slides.
Do whatever you want with the copy!
Using Google slides, any number of users can view the deck, move tokens, and so forth. It’s also easy to clone tokens if you need more, or make up new ones.
Permission is hereby granted to print copies of the game, counters and maps, for educational, professional, or recreational purposes, without restriction (provided you aren’t using them to plan an attack against a neighbouring country or annex part of its sovereign territory.)
Back in mid-October, I co-designed and ran a “contested US election” matrix game for The New Yorker Radio Hour in which we examined what could go wrong after election night. Due to an unexpected problem the segment never aired, but it was a terrific game. So, with polls starting to close and as everyone waits for the actual American election results to come in, I thought I would say a little about it.
As the 3 November U.S. presidential election approaches, the country faces an unfamiliar danger. While Americans have grown used to a certain level of rancour in these quadrennial campaigns, they have not in living memory faced the realistic prospect that the incumbent may reject the outcome or that armed violence may result. That has changed in 2020 because of the emergence of risk factors that would spell trouble in any country: political polarisation bound up with issues of race and identity; the rise of armed groups with political agendas; the higher-than-usual chances of a contested outcome; and most importantly President Donald Trump, whose toxic rhetoric and willingness to court conflict to advance his personal interests have no precedent in modern U.S. history. The risk of unrest may ebb and flow as the final days of the campaign unfold, but it is almost certain to remain, and it will increase if either side forms the impression that the vote has been rigged.
Our scenario envisaged a tight race in which much depends on the counting of mail-in ballots—something that advisors to the Trump campaign acknowledged to the New York Times was a distinct possibility:
Trump advisers said their best hope was if the president wins Ohio and Florida is too close to call early in the night, depriving Mr. Biden a swift victory and giving Mr. Trump the room to undermine the validity of uncounted mail-in ballots in the days after.
In his last days of campaigning, Mr. Trump has essentially admitted that he does not expect to win without going to court. “As soon as that election is over,” he told reporters over the weekend, “we’re going in with our lawyers.”
Trailing consistently in the polls, Mr. Trump in that moment said out loud what other Republicans have preferred to say quietly, which is that his best chance of holding onto power at this point may rest in a scorched-earth campaign to disqualify as many votes as possible for his Democratic opponent, Joseph R. Biden Jr.
If there is a clear-cut outcome on Tuesday night that could not plausibly be challenged via legal action, all of the planning on both sides could become moot. But if there is no decisive result, the following days would likely see an intensifying multifront battle fought in a variety of states.
After months of claiming that any election outcome other than a victory for him would have to have been “rigged,” the president used his final days on the campaign trail to cast doubt on the very process of tabulating the count, suggesting without any evidence that any votes counted after Tuesday, no matter how legal, must be suspect.
We weren’t the only ones to game out what could go wrong in the election, of course. The earlier work of the Transition Integrity Project has already been discussed at PAXsims.
The game ran over two days. On each day there were two matrix turns planned, for a total of four (November 4, November 9, November 16, and mid-December). In practice we abandoned matrix game procedures for the last turn, and free-styled it in a lively series of moves, countermoves, and open discussion.
There were six main sets of actors:
Donald Trump (including the Trump Administration, Mike Pence, and the Trump/Pence campaign)
Joe Biden (including Kamala Harris and Biden/Harris campaign)
The Republican Establishment (Republican Members of Congress, Republican Governors, Republican state legislators, former Republican elected officials)
The Democratic Establishment (Democratic Members of Congress, Democratic Governors, Democratic state legislators, former Democratic Elected Officials)
The Extra-Establishment Right (QAnon conspiracy theorists, militia members, Proud Boys, right-wing social media trolls, OAN, InfoWars, police unions, etc.)
The Extra-Establishment Left (Black Lives Matter activists, Antifa activists, left-leaning celebrities, progressive social media, etc.)
In addition, two other actors could take actions when called upon or otherwise appropriate, as well as contribute to the broader discussion:
The Courts (Supreme Court of the United States, other federal and state courts)
The Military (Joint Chiefs of Staff, State Adjutants General, senior military commanders, intelligence community)
All were played by New Yorker writers or others with appropriate expertise. Adjudication used the assessed probabilities, whereby after an action had been proposed by a player and discussed, we polled participants (via a Zoom poll) for their view of the likelihood the action would be successful. We used this to establish a probability against which we then rolled percentage dice. Since all of our participants could reasonably claim to be subject matter expertise on the game topic, it worked very well.
The scenario described a very close election, in which everything hinged on the outcome in Pennsylvania.
The early count had Trump ahead, but mail-in ballots were still being counted and these were breaking two-to-one for the Biden campaign. It seemed likely—unless something happened—that the Democrats would eventually come out on top.
This is, of course, the worst possible scenario, which is exactly why it was the one we gamed. A unambiguous Biden or Trump victory wouldn’t pose the same risks to political stability.
The briefing sheets all outlined essentially the same situation, but were very much tailored to the world-view of the actors. The Biden briefing, for example, noted:
Once again, polls underestimated public support for President Trump. In late October, moreover, the President announced a successful COVID-19 vaccine—though the medical establishment is divided on whether the vaccine in question is efficacious enough for widespread distribution. In several states, voter suppression tactics by Republican-led administrations may have cost the campaign tens of thousands of votes. As a result of all this, the Presidential election has proven to be much closer than expected.
On election night the Biden/Harris campaign lost in both Arizona and Florida, and won only narrowly in Wisconsin and Michigan.
Pennsylvania has emerged as an electoral battleground.
In Pennsylvania, the President is currently ahead. However, according to the Pennsylvania Supreme Court, mail-in ballots can still arrive for three more days (until Nov. 6th). Between COVID safety precautions and teams of lawyers challenging every ballot, a long count awaits.
Pennsylvania’s election was beset with irregularities. On election day and during the counting, groups of (often heavily-armed) Trump “poll watchers” have intimidated voters and officials alike. We’ve heard unsubstantiated reports about missing mail trucks, which some on the right have fixated on as proof that mail-in voting was somehow rigged.
A legal challenge about whether these ballots (which are expected to strongly favor Biden) can be counted is on its way to the US Supreme Court.
The Republican-controlled Legislature in Pennsylvania has said that unless a winner is declared by December 1st, it will award the state’s electors to Trump (one full week ahead of the deadline to name electors). State Democratic legislators have threatened to relocate to West Virginia to prevent a quorum. Pennsylvania Governor Tom Wolf (D) has vowed that Pennsylvania will not name electors until the full election results are certified by Secretary of State Kathy Boockvar (D).
President Trump is ahead in the national vote by a small fraction. However that lead will certainty be reversed as mail-in ballots in places like California get counted.
Democrats seem to have narrowly captured the Senate, but three races are essentially too close to call. The new majority will not be seated until January 3rd. Democrats have kept control of the House.
Amy Coney Barrett has not yet been confirmed by the Senate. Barrett has cleared her hearings in a party line vote. Mitch McConnell has vowed that she will be confirmed by the Senate.
Encouraged by the President, right-wing activists and militias have mobilized, with some arguing that force might be used to prevent a peaceful transfer of power. Several liberal justices have requested enhanced security measures in view of this growing threat.
The number of COVID-19 cases is sharply on the rise once more. Some 300,000 Americans are projected to die by February, a total which could rise to half a million if the President and some Republican governors are successful in further easing restrictions, mask mandates, and other public health measures. Expert consensus is that, despite the premature President’s vaccine announcement, widespread vaccination will not be possible until the late summer.
Conversely, the Trump briefing spun the situation as a Trump victory that would be stolen away through absentee ballots. For its part, the Extra-Establishment Right briefing warned:
America now faces perhaps its greatest DANGER since the Revolution. The Deep State and communist agitators are CONSPIRING to overturn the election results. The President has signalled that he needs OUR HELP to defeat this conspiracy. #WWG1WGA … We have information that the Democrats plan to flood the count fraudulent Biden mail-in ballots, previously harvested by their activists. Before the election, Antifa anarchists stole several mail-trucks containing blank ballots. Local officials in some Democratic-controlled districts also rebuffed poll-watching and ballot security measures undertaken by patriotic groups of Americans freely exercising their 2nd amendment rights. Clearly they had something to hide.
As previously noted, we ran this as as a matrix game over Zoom, with a deck of Google slides used to update the players with the current vote count, news stories, legal deadlines, and other information. Using Google slides in this way it was possible for me to share them with the players, while other members of support team modified future slides behind the scenes to reflect new developments. You can see them here:
In the past, I’ve found matrix games a bit ponderous online—people simply just aren’t as efficient at online discussion and you lose the ability to easily have multiple side conversations during game play. I must say, however, that the team put together by The New Yorker were outstanding. I think this had a lot to do with most of them being journalists, and most having substantial television or radio experience—a setting in which you rarely have more than a minute to answer any one question and only six or seven minutes in the entire segment to get your broader analysis across.
The game started with President Trump complaining vociferously about mail-in ballot “fraud,” a narrative that was much amplifed by the Extra Establishment Right (including faked videos of supposed wrong-doing). The courts were not very responsive to such complaints, however, seeing no evidence of widespread or systematic abuse and preferring to leave the status quo intact in the midst of vote-counting.
The White House escalated by ending federal law enforcement to (federal) post offices and mail sorting centres in Pennsylvania for “security” purposes and seize ballots and look for evidence of the alleged fraud. It was a bit late, however—but this point almost all the ballots were at (state/county) counting centres. Moreover, the (Democratic) Governor of Pennsylvania responded by deploying Pennsylvania State Police to vote-counting locations. As tensions rose the Extra-Establishment Left organized peaceful candlelight vigils. These soon grew to a national campaign.
As the vote started to shift decisively to the Biden campaign, Pennsylvania Republicans considered assigning their own set of electors for the Electoral College. That initiative was unsuccessful, however, with too many members of their own party finding it a step too far. Had they been successful, the Democratic establishment was thinking of responding in kind in other states.
Given the failure of efforts in the Courts to stop the counting and with Pennsylvania Republicans unwilling to override voters, President Trump’s Twitter feed became even hotter and more voluminous. Police resources were increasingly overstretched by the need to safeguard vote counting centres and keeping an eye on vigils. There was some low-level violence and arson attacks, but the risk of something more serious couldn’t be discounted. As a result, Pennsylvania decided to call up some National Guard units to assist the police.
There was growing concern in the Pentagon about how this might all play out. Indeed, efforts had made to assure any military response would be slow and deliberate, stalling for time if necessary and trying to stay out of the political fray. Concerns grew further when the President started to tweet about federalizing the National Guard too, putting soldiers in the position of having their Commander-in-Chief seemingly at odds with their Governor. Pennsylvania National Guard commanders were careful in which units were called up and where they were sent, focusing on those that were known to have good discipline and calm, level-headed commanders—a tacit acknowledgement that some in the military might handle a fraught situation worse than others.
At this point, Russia dramatically stepped-up social media and other digital activities with the intention of further escalating tensions and possibly provoking more widespread violence. In response, the Pentagon took the decision to retaliate with limited offensive cyber attacks against certain Russian internet capabilities. The White House was not consulted in advance on this, with the Chairman of the Joint Chiefs arguing this was an immediate defensive response by United States Cyber Command that required no prior approval.
As tensions grew, the stock market started to tank. It also became apparent that the Supreme Court—even with the addition of Amy Coney Barrett—was not going to intervene in the election tally in the absence of actual evidence of fraud. With this, many key Republicans (including many major Republican donors) became concerned at the growing potential for violence, political chaos, and economic crisis . Some reached out to the Democrats to see whether Biden campaign might offer political inducements (such as a promise of no “court packing”) to secure Republican endorsement of the election process and outcome. Biden was under pressure from the left of his party not to agree, but he was inclined to hold firm anyway. He had very much stayed the course throughout, counting on the process to work while the Democratic Establishment mobilized legal and other resources to fight for every vote cast.
And so the game ended, with President Trump still tweeting angrily from his bunker beneath the White House, National Guard, federal law enforcement, and State Police deployed across Pennsylvania, sporadic acts of limited violence—but a transition to a new Biden presidency seeming largely assured.
Whether the political divisions and fractures caused by the process might afflict the United States in the coming years remained to be seen.
After it was all over, some participants said they felt reassured that the process and institutions had indeed worked. To me, however, it rather felt like careening down the hairpin turns of a steep and narrow mountain road in a car with no brakes. Sure, it’s great to arrive intact at the bottom of the mountain at the end, but it is also worth remembering how close you came to careening over the edge of cliff. There were several points in the game where things could easily become much worse.
In practical terms, it was one of the best matrix games I’ve taken part in: thoughtful participants, great discussions, and useful insight. At the time of writing this, I have no idea how prescient it might be—but let’s hope the actual days following November 3 are rather less contentious.
Comments Off on Transition Integrity Project: Preventing a disrupted presidential election and transition
Posted by Rex Brynen on 04/08/2020
As previously mentioned at PAXsims, the Transitions Integrity Project has conducted a series of matrix games on what could go wrong in the 2020 US election and a subsequent presidential transition. The games have been covered by the Washington Post, Boston Globe, NPR, The Atlantic, and elsewhere.
In June 2020 the Transition Integrity Project (TIP) convened a bipartisan group of over 100 current and former senior government and campaign leaders and other experts in a series of 2020 election crisis sce- nario planning exercises. The results of all four table-top exercises were alarming. We assess with a high degree of likelihood that November’s elections will be marked by a chaotic legal and political landscape. We also assess that the President Trump is likely to contest the result by both legal and extra-legal means, in an attempt to hold onto power. Recent events, including the President’s own unwillingness to commit to abiding by the results of the election, the Attorney General’s embrace of the President’s groundless electoral fraud claims, and the unprecedented deployment of federal agents to put down leftwing protests, underscore the extreme lengths to which President Trump may be willing to go in order to stay in office.
In this report, TIP explains the basis for our assessment. Our findings are bolstered by the historical expe- rience of Bush v. Gore (2000) and other U.S. electoral dysfunctions. The closest analogy may be the elec- tion of 1876, a time of extreme partisanship and rampant disenfranchisement, where multiple states proffered competing slates of electors, and the election was only resolved through a grand political bargain days before Inauguration—one that traded an end to Reconstruction for electoral peace and resulted in a century of Jim Crow, leaving deep wounds that are far from healed today.
The full report from those games is now available (pdf):
UPDATE: If you are interested in the Transition Integrity Project, you’ll also be interested in The New Yorker election simulation—the scenario for which has turned out to be very close to the actual 2020 election, with much depending on the outcome in Pennsylvania.
Pete Pellegrino is a retired USN commander and former Naval Flight Officer, currently employed by Valiant Integrated Services supporting the US Naval War College’s War Gaming Department as lead for game design and adjudication and lecturing on game related topics for the department’s war gaming courses. In addition to his work at the college since 2004, Pete has also conducted business games for Fortune 500 companies and consulted for major toy and game companies.
Pete kindly provided PAXsims with permission to share this video. The views expressed are those of the author and do not represent the official policy or position of any agency, organization, employer or company.
The following article was written for PAXsims by Ben Taylor (Defence Research and Development Canada) and Benjamin Williams (Professeur des Universités, IAE & CleRMa, Université Clermont Auvergne). The views expressed are those of the authors and do not represent the official policy or position of any agency, organization, employer or company.
The authors met through a workshop on Wargaming the Pandemic hosted by the King’s Wargaming Network that was held 1-2 April 2020. BW gave a presentation in which he set out an idea for a matrix game on the COVID-19 crisis that could be supported by quantitative epidemiological and economic models. BT had previous experience with matrix games and offered to collaborate on the idea. This project is therefore itself a product of the COVID-19 crisis as the authors are unlikely to have met or to have found a common project to work on without it.
We decided from the outset that we wanted to design a game that tackled the COVID-19 crisis in a country from the point after the initial lock-down measures had flattened the curve. This phase would require a balancing act by political leaders as they face challenges on three axes: economic, social and healthcare. We termed these the three frontlines of the battle against COVID-19. Our aim was for a game that would sensitise decision-makers to issues that they might face and one in which choices would be constrained by the cross-coupling between the frontlines; for example that returning people to work in offices would likely increase the rate of infection, or that a renewed lock-down would lead to public discontent. We also wanted to introduce some quantitative models to help elaborate upon the consequences of player actions.
We also decided that we did not want to build a detailed game around a specific country. Rather we wanted a tool that could be customised to any country. That required the game to have a generic framework to which national specific details could be added. For development purposes we settled upon the fictitious country of Bretonia which has a government structure like Canada and the economy of France. Our generic framework envisaged four players to represent key elements of the country; the national government, the lower tier governments, the business sector and the public health system. A fifth player, termed “The Crisis”, represents all other domestic groups, external actors and anything else that could happen to challenge the other players’ efforts. An example of the customisation necessary comes from different national approaches to healthcare funding. In Canada healthcare is a provincial responsibility, whereas in France it is mainly funded by the national government through the social security system. This difference would have to be represented in the roles and responsibilities of the two government players.
One of the first steps in designing the game was to develop an influence diagram that showed how various parts of the economy, business, government finances, social attitudes, the healthcare system and the pandemic itself are connected. This provided the reassurance that everything that we wanted to be in scope was captured. The model also provided insight to where knock-on effects (positive or negative) might be felt, which would provide for consistent adjudication.
We also built a dashboard that displays selected metrics grouped across the three front lines, a macroeconomic model, a model of the infection and fatalities and a slide deck for displaying new stories each turn. This latter part of the game was developed to provide some humour, some cultural flavour and to allow attention to be drawn to specific sectors of the economy. We also prepared a number of bad news stories to be injected if any of the economic or social metrics approached worrying levels.
Many design issues common to matrix games apply equally to this game. Among those that we encountered are:
The advantages of having players who have played matrix games before.
The need for subject matter experts to support adjudication if the results are to be realistic.
The challenges for players to switch between role-playing and becoming engaged participants in adjudicating arguments.
Whether the players should be left to solve the basic problem of opening the economy without triggering a spike in infections, or to subject them to additional external challenges, and in the latter whether it is best to script the injects or to have them occur randomly (the answer of course is “it depends”).
The balancing act between allowing players to discuss the proposed actions in detail and curtailing discussion in order to speed up the game.
The game has been run twice with participants from Europe and Canada using a video conference link with supporting text chat facility, a Google slides deck to share news stories, and Google sheets to share the dashboard of metrics and to provide an online tool to capture the participants’ assessments of the likelihood of success of proposed actions. This setup worked very well and participants felt that they could communicate with each other and access the information that was required. There was agreement that the game largely felt right, but that play was slow. The supporting quantitative models were not used extensively. In particular the epidemiological model implemented according to formulation drawn from the literature produced counter-intuitive results and proved impossible to fit to the observed progress of the outbreak in Canada. This placed a particular burden upon the adjudicator to determine how to adjust the dashboard in response to player actions.
Our next objective will be to design a discussion-based game without the matrix structure in order to compare the utility of the two gaming techniques in addressing the management of the COVID-19 crisis.
Tim Price has been kind enough to pass on this report from a recent play of the Flattening the Curve matrix game.
Last night I managed to get 11 volunteers together to play a distributed version of the Flattening the Curve matrix game over Zoom. It was an interesting and frustrating experience, but I thought it might be worthwhile sharing it with you.
We used Zoom for the video chat. We felt it was very important to be able to speak and see each other and Zoom has a simple and intuitive mosaic screen setup that is particularly useful for the Facilitator. The surround to the image is highlighted to show the current speaker, interrupters are shown with a highlighted line under them, and their names appear under their faces (really very useful indeed). Of particular interest for running a Matrix Game, it is possible to sent private messages to named individuals using the chat function in the application. It was also stable for the 3hrs we played.
We used Google Slides for the game map (see here). With the map itself as the background image and a number of counters imported as images onto the map (and left outside the slide boundary), so everyone could see and collaboratively move the counters if necessary. It is useful to duplicate the last slide for every turn, so you have a record of the map after each turn, and that also allows a run through at the end as an After Action Review.
Finally, we used Mentimeter to be able to carry out the “Estimative Probability” method of adjudication.
When using Estimative Probability players or teams are asked to assess the chances of success of an argument, and these are aggregated to reveal the “Crowd Sourced” chance of success. In analytical games, this provides potentially valuable insight into how participants rate the chances of a particular course of action. Following discussion, players select the option on the Mentimeter slide which, in their view, best represents the probability of the argument’s success. These are displayed immediately to the Facilitator, but not to the players, so it is using hidden voting. It is generally felt that this is a more accurate method to leverage the work on Crowd Sourcing, as well as making the resulting probability more accessible and acceptable to the participants. The terms on the slide also reflected those commonly used in the intelligence community.
The advantage with Mentimeter over other poll and voting systems is that it is free, feedback is instant, and you can use a single slide for all the Matrix Arguments, because you can re-set the results each time. Of course, if you want to have a record of the results, you will have to buy the upgraded version, or save a screenshot each turn (which is a pain).
Running the Game
As is normally the case with video conferences, we had the usual difficulties getting everyone onto the Zoom, with sensible names displayed instead of “Owner’s iPad”, so the start was a little delayed. I had put out a Loom video with a short introduction about Matrix Games, but inevitably a few of the players hadn’t been able to view it, so we were delayed starting as I had to explain how the game would play.
As the game went on, I modified the map (based on some helpful collaboration with TNO in the Netherlands), to make it easier to follow. The revised map is here:
The game played perfectly well, but at a slower pace that if it had been face to face, and it was certainly more tiring for me as the Facilitator. The inter-turn negotiation between team members and other teams was carried out using Whatsapp: and Whatsapp Web so was private to the other players.
We were time limited and were only able to have 11 participants in the end – but it was mainly a trial to see if running a Matrix Game remotely is at all possible. We got a few insights from the game, one of which I will share – as we all go into working from home full-time and are switching to remote working, we end up downloading all sorts of software and applications that we would never have normally dealt with. This increases the threat surface for cyber-attacks by an order of magnitude, so correct digital hygiene is going to be as important as washing your hands.
Following the game, we quickly did a couple of polls, hopefully better informed by the experience of the game:
Each participant was asked to give me their MOST IMPORTANT thing that would happen over the next month (please note the definition of “thing” was left deliberately vague so the players could decide for themselves what it meant).
They were then asked to vote on which of these was the MOST LIKELY thing to happen.
Next, each participant was asked to give me their MOST IMPORTANT long-term consequence of Coronavirus.
They were then asked to vote on which of these was the MOST LIKELY thing to happen.
It is possible to run a Matrix Game remotely, but it is very tiring for the Facilitator and takes much longer than you thought it would.
The right choice of technology can make a real difference – so mandated standards and corporate choices may well have an impact on the experience. This means that practicing, as I was, while waiting for the corporate roll out of their platform of choice might end up especially frustrating, when I am unable to do something that I know a free app on the internet will let me. But downloading all those free apps and trying them out could be dangerous, because the bad guys are definitely out to get you…
Antoine Bourguilleau has developed a French translation and adaptation of Tim Price’s Flattening the Curve COVID-19 matrix game. In this revised version of the game, the UK and US actors are replaced by France and Germany.
Aplatir la Courbe contains an overview of the pandemic, guidance on running a matrix game, and briefings sheets for the major actors. For other game materials—notably the game display and markers—download the original (UK) version.
Chris Engle, the inventor of matrix gaming, has passed on some ideas for a COVID 19 general hospital simulation. We are pleased to post them below.
The world is facing a pandemic. It is testing our systems to the extreme. Maximizing utilization of resources is all important. This requires the following.
Pre-deployment of resources
Public policy to slow the spread of the illness
Maintenance of public order
Distribution of goods and services
Medical treatment as needed
Maintenance of front line essential workers
Evaluation of effectiveness and alteration of intervention
Data-based decision making on when to return to normal
It is a highly complicated situation that is in a constant state of flux. Simulating this in a timely meaningful way is a huge challenge.
What follows is a simple, inexpensive, easily run, quick to initiate simulation that might be helpful. The game is about a general hospital in a moderate sized city in Middle America: imagine it being in a city of 100 to 250 thousand people. Or it might be in one district of a much larger city. The players are healthcare providers, administrators, and other stakeholders. The game consists of play sessions of around 10 participants each engaging problems and solutions, and the problems that flow from them. Sessions last between 30 tp 120 minutes and can be done by phone, video, email, or in person. The game requires a facilitator/moderator/host who does not have to be an expert. Their job is to encourage people to participate.
The Matrix Game
General Hospital is run using a Matrix Game. This is a type of game that uses words and discussion rather than numbers and mathematical algorithms to track what happens, The approach has been used since the 1980’s as a planning/training tool in a variety of fields. Chris Engle, a psychiatric social worker, invented Matrix Games in 1988. Games consist of players making statements about what they think happens next in a given situation. They are narrating events, which they make up out of their imagination. The session is a conversation between participants. The outcome of sessions is a list of brainstormed problems and solutions, with some indication about which ones are more or less likely to happen. The complete rules of the game are as follows’ The host of the event starts the session by stating a problem. They then ask the players “What happens next?” The host then allows the players to speak. The host’s remaining job is to encourage people to speak, to recap what is said, to help players through the technical rules, to occasionally re-ask the question, and to wrap the game up on time. The players make things happen by jumping in as the spirit moves them to say what happens next. This might be an event, a plan, or another problem. Whatever the player says automatically happens, it is part of the story. Other players may jump in and add to this or they may alter it or even say that something else happens instead. These also automatically happen, and overwrite the first statement. If a player says something that people think is unlikely to happen they may ask the player to roll for it. The player must then roll a six sided die. On a roll of 1 to 3, the event does not happen and cannot be repeated in this game. On a roll of 4 to 6 the event does happen and cannot be overwritten, As many players as wish may ask a player to roll and the player must pass each roll to have their event happen. This is evidence or how unlikely people believe certain moves are.
The game ends when the starting problem is solved or when the players run out of time.
Dice rolls are never required and it is not uncommon for there to be sessions without any rolls. The ideas that players come up with will range far from their areas of responsibility and expertise. They will identify problems and interventions that touch on society at large. Some input will even be silly and fantastical. All this is allowed because with each statement, the players open up a little more which makes it possible for them to speak and share incites that will help. To this end, it is helpful for top leaders to say little or nothing in games since they may overly influence participants.
It is vitally important for time be given after each session for the players to talk about and summarize what they learned. This cements lessons. This can be done by the players talking to one another or by the game host recapping events and highlighting the important points. These recaps should then be passed back to the administrators and decision makers who sponsored the event so they can make use of the intelligence for planning purposes.
Any health professional or stakeholder in decision making can usefully participate in Matrix Game sessions. They do not need any simulation expertise or area knowledge beyond what they already have. All they need to know before the event is that they are going to participate in a low key, planning meeting that will give them deeper knowledge of the big picture of the present problem and how they fit into it.
Matrix Games are usually played in face to face sessions. But they work just as well as email/text messages. They also work in phone meetings or video conferences. The medium is unimportant, and because the game consists of conversations between players, there is no need for expensive computer programs or equipment. This approach can be implemented in a high tech city or a village with no paved roads. One advantage of using video or email is the potential to have a record of each game. These records form a data set that can be analyzed at a later date using computational models.
On Use of this Game
Permission is granted for any person, institution, or company to use this game and the Matrix Game approach in general for planning and training purposes. The only request is that they cite that Matrix Games were invented by Chris Engle in 1988. Please pass this document onto any and all people you know who might be helped by it.
Note for Facilitators
People are naturally shy when it comes to making things up. It is helpful to start the game by asking each player to say one thing that people in their role would do in the face of the presenting problem. Once that is done the ice is broken and the host can take a more backseat approach.
The facilitator is responsible for establishing and maintaining a good work environment. If players engage in abusive or intimidating behavior, it is the facilitator’s job to intervene and establish order. There can be no useful work accomplished without a good working environment. It is okay for participants to say little or nothing is a game. When they do this they are being the audience. They still learn from the event and may come up with the most useful observations during debriefing because they were looking at it in a bigger picture way.
The facilitator does not have to be an expert in technical subject matter. It is perfectly acceptable and expected that they will not know certain details. This allows them to model how to ask questions and listen to answers. The facilitator does need to be an outward going person who will engage the players actively. Aside from encouraging people, the facilitator is also a player. But they need to not take too much role in the game so that they do not unduly influence play. The facilitator needs to gather up all materials from the game and return them to the administrator who sponsored the event. This may involve writing a short report.
Lastly, end sessions promptly. Make certain there is time to do debriefing within the time of the meeting. Healthcare worker are very busy, especially now, and will appreciate meetings that end on time. Overstepping their time will reduce how much they take away from it. A good opening problem to start a game is: “The coronavirus is coming. We need to deal with it. How do we prevent a disaster?”