Case Study: Training Challenge –

Covering 18 Topics in 45 Minutes

The Training Situation
SightLife, the eye bank for which I work, is dedicated to eliminating corneal blindness
within our lifetime. In order to do this in India, there will need to be 100,000 corneas
available for transplant every year (last year there were approximately 25,000 corneas
available for transplant). It’s a big goal, and in theory, the eye banks of India are
aligned with this goal.
But what does rapidly growing in order to help support 100,000 transplants actually
mean? What will it take to actually get there? What policies, procedures and practices
need to be in place? There’s a lot that will need to happen in order to move this from a
big idea to a concrete reality.

The Training Challenge

Each year, we hold a meeting with eye banks in India to discuss these challenges.
There are so many areas to focus on that we normally only pick one or two. The
problem with this is that some eye banks aren’t ready for the topics we pick, some eye
banks are in the midst of dealing with the topics we pick, and some eye banks have
already found some solutions and ways to address the areas we focus on.

The other challenge is that this meeting is only one day long, and there are many other
items we need to accomplish in addition to educational and professional development
sessions.

This year we were left grappling with a question: how could we address everyone’s
learning needs, bring all of the issues and challenges we’ll face in order to reach
100,000 transplants per year (we identified up to 18 key challenges, although there are
probably more) and do all of this within a 45 minute block of time?

The Training Solution

Taking inspiration from The Game of Life, Monopoly and a few other family board
games, our L&D team set out to create a game in which we could cover a broad range
of discussion topics in small groups, allowing more experienced eye banks and people
with more specialized roles to share their experiences with others at their tables.
Furthermore, we wanted to simulate the idea that every eye bank in the room would
need peak performance if we were to collectively achieve the goal of 100,000
transplants. At the end of the game, we would add up the total number of corneas that
each small group had earned in order to see if our combined effort would be good
enough.

The board game we created would require small groups made up of meeting attendees
from various eye banking roles to come together and respond to a series of “challenge
cards”. Some of these challenges could actually be perceived as a good thing on the
surface (such as a change in organ donation laws making it easier for organ donation
to take place), but if the eye bank isn’t prepared, could represent a tragic waste of an
opportunity. Other challenges simply represented the need for eye banks to be
prepared with contingency plans if, for example, there was an outbreak of dengue
fever. A good answer (as decided by a table judge) would earn additional corneas for
transplant for the small group. An incomplete, unrealistic or non-specific answer
would lead to the small group losing corneas for transplant.
To simulate the time constraints that exist for this overarching goal of 100,000
transplants (the goal is to achieve this number by the year 2020), participants would
roll a die and advance along a game board that looked like a calendar, making their
way towards December 2020. The goal was to earn as many corneas for transplant
before December 2020.

Lessons from the Implementation

As soon as participants were broken into small groups, the room was abuzz with
conversation. In five years of helping to organize this particular meeting, this was as
engaged as I’d ever seen every single participant.

At some points, senior surgeons were offering answers, and at other points those
senior surgeons listened as much more junior eye bank administrative staff offered
their expertise in order to earn the group more corneas.

The Training Results

As the game ended, I collected final tallies for the number of corneas each group had
earned through their responses to the challenge cards.
Something interesting happened as I was asking meeting participants to stop playing
the game so that we could de-brief. Some participants didn’t want to stop playing, and
others accused them of “cheating” in order to get a higher cornea total. I found this
interesting because no single group alone was going to achieve 100,000 transplants all
by themselves. It would require the maximum number of corneas from a collective
group effort, yet some people in the room wanted to “win” individually as opposed to
achieving the collective goal.

I tallied the final number and it appeared that, as a group, we came up just short of
100,000 transplants. I asked a co-worker to re-count the tally to be sure we hadn’t
missed anything as I led a de-brief of the activity. Once my de-brief finished, my co-
worker informed me that we had indeed missed one small group’s cornea total. It
turned out that it was the small group with the least number of corneas at the end of
the game. Yet, that group’s modest contribution was what ended up putting the entire
roomful of teams over the 100,000 mark. Collectively, we had achieved our goal!

On the end-of-day evaluations, this activity received some of the highest Likert-scale
evaluation scores, and perhaps more importantly many of the concepts were
mentioned as key takeaways in the open-ended evaluation questions.

Table judges took notes during the session and we have followed up by sending an
“answer key” to all participants after they returned home from this meeting, which
offer some of the answers to challenges they may currently be facing or may face in
the future.

Following the session, the head of one large eye institute in attendance approached me
and said: “That game was truly awesome. I had no idea we could cover so many
topics and have such good conversation in such a short period of time!”