Reflexive Thematic Analysis is an increasingly popular method of qualitative analysis in many disciplines, including HCI. However, previous work has questioned the quality of its application, often finding it misunderstood and misapplied. To establish a snapshot of current practice in HCI, we performed a scoping review to examine 147 CHI papers from a single year that purported to use the method. Markers of good and poor practice were assessed based on writings and guidelines by the method’s originators. Similar to reviews in other domains, we found widespread issues such as methodological incongruence, insufficient detail, and poorly conceptualised and reported themes. Despite this, we highlight encouraging pockets of good practice. We conclude that HCI researchers should engage more holistically with Reflexive TA, and question whether it is always the most appropriate choice of method. To this end we offer several recommendations for improvement.

In the standard interaction model of clinical decision support systems, the system makes a recommendation, and the clinician decides whether to act on it. However, this model can compromise the patient-centeredness of care and the level of clinician involvement. There is scope to develop alternative interaction models, but we need methods for exploring and comparing these to assess how they may impact clinical decision-making. Through collaborating with clinical, AI safety, and HCI experts, and patient representatives, we co-designed a number of alternative human-AI interaction models for clinical decision-making. We then translated these models into ‘Wizard of Oz’ prototypes, where we created clinical scenarios and designed user interfaces with different types of AI output. In this paper, we present alternative models of human-AI interaction and illustrate how we used a co-design approach to translate them into functional prototypes that can be tested with users to explore potential impacts on clinical decision-making.

Recent research has begun exploring games as a medium for reflection due to their affordances as interactive systems of challenge. However, little effort has been put into (1) synthesizing insights across studies and disciplines and (2) translating the academic work on reflective play into practical takeaways for game developers. This article takes the first steps toward summarizing existing work on reflective play and translating insights for practical implementation by identifying key game elements present in games that evoke reflection. We divide these elements into five approaches: Disruptions, Slowdowns, Questioning, Revisiting, and Enhancers. Finally, we provide an actionable supplement for practicing game developers to apply these concepts to their games.

The potential benefits of playing video games during times of difficulty have been increasingly recognised by researchers yet little is known about how particular aspects of games may relate to different forms of coping. An exploratory survey of 130 participants and content analysis identified 31 game aspects, across 6 categories, that were beneficial or detrimental to players. Our findings illustrate that games can support a range of coping strategies, including emotion-focused, avoidance, and meaning-focused coping. We also identify how specific aspects of games relate to different coping strategies during times of personal difficulty. For instance, emotion-focused coping was most commonly linked to challenge game aspects, where overcoming difficulties allowed players to experience positive emotions such as competence. The findings of this study provide valuable insights into how games may be able to facilitate a range of coping strategies during tough times.

Playing digital games can be an effective means of recovering from daily work strain. However, limited research has examined which player experiences contribute to this process, limiting the ability of players to select games and play them in a manner which helps them recover effectively. Hence, this paper reports a mixed-methods survey study investigating how a recent post-work recovery episode was impacted by immersion: a player experience which has been implicated in theoretical accounts relating games and recovery. We found that particular dimensions of immersion, such as cognitive involvement, support specific post-work recovery needs. Moreover, participants report not only experiencing benefits in a passive manner, but actively optimising their levels of immersion to achieve recovery. This study extends previous research by improving our understanding of how digital games support post-work recovery and by demonstrating that immersion is key in determining the restorative potential of digital games.

Low mood and depression are one of the most prevalent mental health problems [2]. Video games are cheap, accessible and show promise in improving people's mental and emotional wellbeing. The amount of research focusing on gaming and wellbeing has increased over the last couple of years, but there is a distinct lack of research focusing on player preferences, attitudes and what factors they identify as helpful or harmful. This qualitative study used a semi-structured interview format to ask 18 participants with persistent low mood about what they liked to play, what aspects of games they found appealing and how they felt about their gameplay in order to better understand the interactions gaming can have with a low mood population. Through reflexive thematic analysis, 5 themes were found: 1) Finding consolation in predictable experiences, 2) Finding a focus in engaging games, 3) Gaining a sense of success, 4) Valuing games and what they can offer and 5) Exacerbating the negative aspects of gaming. These themes are discussed in terms of the current literature, as well as potential future directions and applications of this work.

Video games are increasingly designed to provoke reflection and challenge players’ perspectives. Yet we know little about how such perspective-challenging experiences come about in gameplay. In response, we used systematic self-observation diaries and micro-phenomenological interviews to capture players’ (n=15) lived experience of perspective challenges in purposely sampled games including Hatoful Boyfriend, The Stanley Parable, or Papers, Please. We found a sequence of trigger, reflection, and transformation constituting perspective-challenging experiences, matching Mezirow’s model of transformative learning. Most of these were game-related or ‘endo-game’, suggesting that medium self-reflection could be an overlooked part of everyday game reflection and appreciation. Reflections were accompanied by a wide range of emotions, including frequent epistemic emotions, and emotions could change drastically even during short gameplay experiences. Actual perspective change or transformation was rare. We construct a model of granular types of triggers, reflections, and transformations that can aid reflective game design.

Do people use games to cope with adverse life events and crises? Research informed by self-determination theory proposes that people might compensate for thwarted basic psychological needs in daily life by seeking out games that satisfy those lacking needs. To test this, we conducted a preregistered mixed-method survey study (n = 285) on people’s gaming behaviours and need states during early stages of the COVID-19 pandemic (May 2020). We found qualitative evidence that gaming was an often actively sought out and successful means of replenishing particular needs, but one that could ‘backfire’ for some through an appraisal process discounting gaming as ‘unreal’. Meanwhile, contrary to our predictions, the quantitative data showed a “rich get richer, poor get poorer” pattern: need satisfaction in daily life positively correlated with need satisfaction in games. We derive methodological considerations and propose three potential explanations for this contradictory data pattern to pursue in future research.

Educational games have long been seen as having great potential, but evidence for their effectiveness is mixed, suggesting deficiencies in our theoretical understanding of learning in games and associated design principles. The principle of "Intrinsic integration" of learning content with game mechanics (Habgood and Ainsworth, 2011) increases learning in educational games, but the theoretical mechanisms behind the principle are unclear, leading to implementation issues. In response, we performed a pre-registered study (n=210) to test possible motivational, cognitive load or attentional mechanisms for moderating learning at an abstract learning task within an educational game similar to Pacman. Learning was higher in the intrinsically integrated version with no significant effects of motivation or cognitive load leading to the conclusion that intrinsic integration increased learning via an attentional mechanism where players only pay attention to features needed for the game task and ignore task-irrelevant information. We discuss theoretical implications for game learning as well as insights for designers of educational games.

Reflection is an important precursor to attitude and behavior change, but existing advice on designing for reflection in games is mixed and requires further empirical investigation. We report on the design and evaluation (n=32) of a game to prompt student reflection on work-life balance. Participants played as themselves or a third person character (Alex). An inductive qualitative analysis of post-play interviews, and a follow-up one week later, resulted in four themes relating to how gameplay facilitated reflection: making (sensible) consequences visible; it's like MY life; the space between Alex and I; and triggers in everyday life. A deductive qualitative analysis also indicated that while both games resulted in different forms of reflection for the majority of players, those who role-played as Alex appeared more likely to experience higher levels of reflection. Through exploring the ways in which the two versions of the game succeeded, and failed, to support reflection, we highlight the importance of providing a relevant context to players (so the game feels close to their experience), and allowing them to role-play as someone other than themselves (but not too close).

This article aims to provide an account of the use of reflexive photography in capturing player creativity in practice and present a guide to how game design can support player creativity. While previous literature has examined some aspects of player creativity in digital games, there remains a dearth of work, which examines how design elements of games contribute to creative behavior. Using a reflexive photography method with photo-elicitation interviews, this study identifies eight design affordances for player creativity in digital games and outlines the effectiveness of the reflexive photography method within the context of digital games. The identified design affordances related to the degree of flexibility of the game structure (e.g., open versus linear), narrative exploration, extent and diversity of game variables, opportunities for content creation, environmental interaction and exploration, avatar customization, progression, and replayability. Implications for the design of games that support creativity are discussed.

HCI has become increasingly interested in the use of technology during difficult life experiences. Yet despite considerable popularity, little is known about how and why people engage with games in times of personal difficulty. Based on a qualitative analysis of an online survey (N=95), our findings indicate that games offered players much needed respite from stress, supported them in dealing with their feelings, facilitated social connections, stimulated personal change and growth, and provided a lifeline in times of existential doubt. However, despite an emphasis on gaming as being able to support coping in ways other activities did not, participants also referred to games as unproductive and as an obstacle to living well. We discuss these findings in relation to both coping process and outcome, while considering tensions around the potential benefits and perceived value of gaming.

Games are normally considered to be "fun", though recently there is growing interest in how gameplay can promote empathy and encourage reflection through "serious experience". However, when looking beyond enjoyment, it is not clear how to actually evaluate serious experience. We present an evaluation of four games that were submitted to a student game design competition; the competition challenged teams to design a game that inspired curiosity around human error and blame culture within the context of healthcare. The entries were judged by a panel of six experts and subjected to a round of play testing by twelve participants. Methods included gameplay observation, questionnaires, post-play interviews and follow-up email questions. We discuss the utility of these methods, with particular emphasis on how they enabled a consideration of the immediate and longer term impact of serious experience on players.

Game developers have to ensure their games are appealing to, and playable by, a range of people. However, although there has been interest in the game-play experience, we know little about how learning relates to player involvement. This is despite challenge being an integral part of game-play, providing players with potential opportunities to learn. This article reports on a multiple case-study approach that explored how learning and involvement come together in practice. Participants consisted of a mix of gamers and casual players. Data included interviews, multiple observations of game-play, postplay cued interviews, and diary entries. A set of theoretical claims representing suggested relationships between involvement and learning were developed on the basis of previous literature; these were then assessed through a critical examination of the data set. The resulting theory is presented as 14 refined claims that relate to micro and macro involvement; breakdowns and breakthroughs in action, understanding, and involvement; progress; and agency, meaning and compelling game-play. The claims emphasize how players experience learning via breakthroughs in understanding, where involvement is increased when the player feels responsible for progress. Supporting the relationship between learning and involvement is important for ensuring the success of commercial and educational games.