The Zombie Sepsis Game

The Zombie Sepsis Game

A long time ago in a school far away, I was that guy in the chess club who loved science. I also loved team sports and was fiercely competitive. A few years later I was sitting through undergraduate studies in vast lecture theatres struggling to absorb the details of the Kreb cycle. As a graduate medical student I was thrust into problem-based learning where small groups of us sat around a table tasked with teaching each other whilst we munched on carrot sticks dipped in hummus.

This team-based social learning style left a mark. It got me thinking. Why does education have to be boring? Why does it have to be hard? Why can’t it be interactive, immersive, competitive, cooperative, fun and more like a game?

Who isn’t thinking about zombies or sepsis at the coffee shop?

Who isn’t thinking about zombies or sepsis at the coffee shop?

The literature supports this [1]. Indeed “serious games” are rapidly emerging in medical education with growing numbers of case reports and systematic reviews about their use [2-5]. Games engage students. In addition to transferring knowledge there’s the chance to build teamwork, team cohesion and team spirit amongst a group of diverse professionals. Such experimental learning is attractive considering both the social context and emotional engagement inherent in play.

So what is required for an educational game? Olszewski et al. [6] suggest…

  1. Motivation to play

  2. Maximised learning

  3. Evidence of impact

Additional tips for the aspiring game designer are listed below [7]. #EM3 is already established at creating games (e.g. Cards Against Orthopaedics). However, if even an amateur like me can have a go then so can you!

Tips for producing “edutaining serious games” [7]

  1. Don’t memorise, make memories
  2. Challenge minds, not nerves – competition need not be stressful
  3. Don’t reinvent The Wheel of Fortune – use what already works
  4. Make it more than just a game – remember the objectives
  5. Think outside the trivia box – test more than just the facts
  6. Take action seriously – don’t downplay action-oriented games
  7. Ditch the buzzer – there’s not always a right answer
  8. Step away from the blackboard – let the contestants do the teaching
  9. Around the Room in 80 Seconds – promote positive peer-led learning
  10. Mind the gaps – fill in the cognitive holes
  11. Size up the crowd – not all groups are created equal
  12. Use feedback to feed-forward – learn while teaching

Given the challenge of “edutaining” a multidisciplinary group of learners including nursing students, junior doctors, senior paediatricians, experienced nursing staff and our wonderful play therapist – I chose to use a board game format that’s already well suited for a diverse group of players. Given the topic of sepsis, I chose the motivation of fighting zombies to stay alive.

How do I play?

Using the core board game Zombicide we developed our concept around, you are one of four survivors stranded in the middle of a zombie apocalypse. Your mission (if you choose to accept it) is to escape the zombie hordes and fight your way through to the other side of the city. To stand a chance you must find weapons earned, bizarrely, by answering questions on sepsis and infection. You have a choice of question types to choose from, including…

LOW DIFFICULTY – earns you one bullet and a pistol (can kill one basic zombie)

MEDIUM DIFFICULTY – earns you two bullets and a machine gun (can kill two zombies or one large zombie)

HIGH DIFFICULTY – earns you a rocket launcher (can kill a whole group of zombies)

SPOT THE DIAGNOSIS – earns you one bullet and a sniper rifle (can kill a zombie anywhere on the board if there is line of sight)


When not amassing an impressive armoury, you can spend your turns moving through the streets, breaking down doors and searching through buildings for more supplies. If you’re feeling generous you can even donate weapons to other survivors. You have four “actions” per turn. After each survivor has had a turn, it’s the zombies go. Each round more zombies spawn in the middle of the city. Existing zombies move towards any survivors they can see. If a survivor shares a “square” with a zombie for more than one move they are “killed” and return to the start.

Let the zombie killing spree (and learning) commence!

The Rules


No more than 4 teams

No more than 4 players per team

Each team controls one survivor, discusses actions and answers questions

Each team can either cooperate or do battle with each other

Each round dice are rolled to determine how many zombies are spawned

Four actions per turn (choose from choose a card/earn a weapon, use a weapon, move one space, break a door)

Zombies move one space each turn towards the nearest survivor

If killed you lose all your weapons and start again


The Results

Honestly, the first time around the groups were a little too large, the questions a little too wordy and the temptation too great for people to always gamble and pick the hard questions to get their mitts on a rocket launcher (in fairness, is there any other weapon you’d want if you were facing a zombie apocalypse?)

Teams worked together answering questions to survive the apocalypse

Teams worked together answering questions to survive the apocalypse


Positive feedback:

“Fun game, good questions, team effort, lots of laughs”

“Fun way to work through questions”

“Competitive throughout”

Negative feedback:

“Perhaps took focus away from the questions”

When asked what did you learn?

“A lot about sepsis recognition and management”

“Toxic shock syndrome is an entity to be remembered”

“Team work and coordination”

“A good variety of questions on rashes”

“To think outside the box”


Kind thanks to the fantastic paediatric A&E team for trialing this ridiculous idea and to Guillotine Games for their beautifully crafted Zombicide game we based our concept around.

Finally, I’m afraid I can’t promise that no zombies were harmed in the making of this blog. Go forth, battle zombies and fight sepsis!


  1. Gorbanev I, Agudelo-Londoño S, González RA, et al. A systematic review of serious games in medical education: quality of evidence and pedagogical strategy. Med Educ Online. 2018;23(1):1438718
  2. Akl E, Pretorius R, Sackett K, et al. The effect of educational games on medical students’ learning outcomes: a systematic review. BEME Guide No 14. J Med Teacher. 2010;32(1):16–27.
  3. All A, Nuñez EPN, Van Looy J. Assessing the effectiveness of digital game-based learning: best practices. Computers Educ. 2016;92-93:90–103.
  4. Abdulmajed H, Park Y, Tekian A. Assessment of educational games for health professions: a systematic review of trends and outcomes. Med Teach. 2015;37(Supplement):S27–S32.
  5. Wang R, DeMaria S, Goldberg A, et al. A systematic review of serious games in training: health care professionals. Simulation Healthc. 2016;11(1):41–51.
  6. Olszewski, Aleksandra E. MD; Wolbrink, Traci A. MD, MPH, Serious Gaming in Medical Education: A Proposed Structured Framework for Game Development, Simulation in Healthcare. The Journal of the Society for Simulation in Healthcare: August 2017 - Volume 12 - Issue 4 - p 240–253.
  7. Michael B. Pitt, Emily C. Borman-Shoap, Walter J. Eppich. (2015) Twelve tips for maximizing the effectiveness of game-based learning. Medical Teacher 37:11, pages 1013-1017.
  8. Kuzmicz JE. That’s “edutainment!”: reflections on teaching and learning. Can Fam Physician. 2008;54(2):257–258


I’m clearly not the first to use zombies in medical education…


After the successful zombie preparedness campaign in 2011, an overwhelming number of educators requested zombie-themed preparedness activities for school-aged children. This was created to help educators teach middle school aged children the basics of emergency preparedness and response using a fun, fictitious scenario.

What if you suddenly woke up in a dead world? How would you react? How would people around you react? And why is the apocalypse relevant today? Herman Geijer is an expert in surviving a zombie apocalypse. In his talk Herman uses zombies as a metaphor for any external threat to our existence.

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