From a tackle in a football game to a fall on an icy
sidewalk or a car accident, the dangers of traumatic brain injury are real and
sometimes even fatal. To help educate students about traumatic brain injury and
heighten their awareness and ability to make informed decisions, Project NEURON at the University of
Illinois developed The Golden Hour.
The Golden Hour — named for the critical time period after a traumatic injury
when swift and apt medical treatment has the greatest potential for saving a
patient’s life — is an educational computer game that immerses students in a
medical case study that takes place in this decisive timeframe.
Players must save the life of a patient, Quinn Shepard, who has suffered a
traumatic brain injury. To succeed, they must learn and apply neuroscience
concepts and use sound reasoning skills to properly diagnose and treat the
The Golden Hour is an engaging case-study-based tool that helps students
learn science content and practices. As such, The Golden Hour and associated
curriculum materials connect to a number of the ISTE Standards:
Standards for Students
- Use models and games to explore complex systems and
- Collect and analyze data to identify solutions
and/or make informed decisions.
- Exhibit a positive attitude toward using technology that supports
collaboration, learning and productivity.
Standards for Teachers
- Engage students in exploring real-world issues and
solving authentic problems using digital tools and resources.
- Design or adapt relevant learning experiences that
incorporate digital tools and resources to promote student learning and
- Provide students with multiple and varied formative
and summative assessments aligned with content and technology standards and
use resulting data to inform learning and teaching.
- Address the diverse needs of all learners by using learner-centered
strategies providing equitable access to appropriate digital tools and
Playing the game
The Golden Hour consists of three main scenes in which players work with
medical professionals to assess, diagnose and treat a patient with a traumatic
Players work with an emergency medical technician (EMT) who is responding
to a call about a patient who has suffered a head injury in a bicycle
accident. Under the EMT’s guidance, players assess the patient’s vitals by
checking his ABCs – airway,
breathing and circulation. Players then must evaluate the severity of the
patient’s head injury by using tests for the Glasgow Coma Scale
(GCS). Using this method, players find that the patient’s GCS score
indicates he has a moderate brain injury.
After transporting the patient to the hospital, the next challenge is to
correctly identify the brain injury type and location using a CT scan. Players
work with a CT technician who orients them to key structures of the brain and
their functions and explains how to identify different types of brain injuries
on a CT scan. In studying the patient’s CT scans, players identify a subdural
hematoma — a pool of blood between the dura mater and the brain — on the right
temporal lobe of the brain.
After proper diagnosis, players decide that surgery is the next step. Now
they must remove the hematoma that is damaging the brain’s right temporal
lobe. Guided by the neurosurgeon, players prepare and disinfect the area, cut
through the layers of tissue and bone around the brain to the site of the
injury, and remove the pooled blood.
Assessing student learning
After each of these scenes, the game assesses students’ understanding of
neuroscience concepts and their ability to write sound scientific explanations.
Students must complete medical reports, discuss findings with the lead physician
and write medical recommendations for the patient.
The reports are based on those used in medical settings and designed to get
students to think about and record the medical actions they took as well as the
findings they collected. After submitting an accurate and complete report,
students must discuss their findings with the lead physician, Dr. Picotte, to
determine the next medical steps.
The dialogue sequences with Dr. Picotte were developed around the claim,
evidence and reasoning (CER) framework for constructing scientific explanations.
It works like this:
Dr. Picotte asks players variations of the following multiple-choice
- What are the next steps for the patient?
- What findings support this decision? (evidence)
- How does your evidence support your claim? (reasoning)
If the player selects the correct answer, the game advances. If not, the
player gets feedback about why that may not be the best answer and gets another
opportunity to answer the question. The focus, therefore, is not on getting the
right answers but on how to think carefully and critically about the questions
and on why some explanations are better than others.
In Project NEURON classrooms, the format of these dialogues with Dr. Picotte
spurred thoughtful conversations among students as they worked in pairs to play
the game. The right answer is not always clear, which encourages students to
discuss the options with each other and articulate their reasoning as they
defend their answers.
After working through this question-and-answer dialogue with Dr. Picotte,
players must write coherent scientific explanations that answer the question:
“What should be done next for the patient?” Drawing on their dialogue with Dr.
Picotte, they must employ the CER framework and include a clearly stated claim,
evidence from their report and sound reasoning to back up their decision. The
complete explanation is their medical recommendation for next steps for the
By the end of the game, students will have completed three reports and
written three medical recommendations, one for each scene of the game. Teachers
can use these artifacts to evaluate student understanding of neuroscience
concepts covered in the game as well as their ability to construct scientific
explanations and arguments based in evidence.
Teaching with The Golden Hour
There are several ways to use this game in the classroom. Students can play
the game with minimal instruction or it can be taught as part of either a
three-lesson unit or seven-lesson unit on traumatic brain injury.
Students need no prior knowledge of neuroscience to play the game on their
own because they learn about the topic as they work through the simulation. Even
the individual scenes can stand alone, so teachers who want to customize the
game can ask students to focus on specific sections.
To take a deeper dive into the content, educators can
find curricular materials on the Project NEURON website. The three-lesson
unit offers additional activities that support and expand on the
concepts presented in the game. The more robust seven-lesson unit offers a full
curricular unit on traumatic brain injury. Called “Why dread
a bump on the head?
," the unit covers concepts such as
causes and severity of brain injuries, structure and function of brain areas, CT
scans and different types of TBI, cell apoptosis and necrosis, and real-life TBI
data analysis. Within the unit, students play scenes of The Golden Hour
interspersed with other lesson activities and make connections between their
experiences in the game and concepts covered in the lesson activities. This
allows students to learn through the engaging format of a game while working
within the context of a larger detailed unit on the neuroscience of TBI.
The Golden Hour in the classroom
Educators have used the game in different levels of high school biology as
well as human anatomy and physiology. Feedback from teachers and students has
been positive. Students reported that they enjoyed learning through doing. For
example, some said that even though they had read about the Glasgow Coma Scale
in the student materials, actually evaluating a patient’s GCS score in the game
helped them to better understand how it is used and what it indicates about the
severity of a brain injury.
Within the units, teachers have incorporated the game in different ways. Some
educators split up the scenes to correlate with the lessons. For example,
students participated in hands-on activities in Lesson 1 and then applied and
extended what they learned through playing Scene 1 of the game. Other educators
had students play the three scenes in sequence as an application and review of
concepts after finishing the connected lessons.
In several classrooms, The Golden Hour game was the students’ first
introduction to the CER framework. Even with minimal instruction on the use of
CER as a framework for constructing scientific explanations, students were able
to complete the reports and explain their medical recommendations. Teachers felt
that the assessment sections of the game modeled the CER approach and provided a
defined structure and context that supported students’ first attempts at writing
a scientific explanation that incorporates a claim, evidence and reasoning.
For students, The Golden Hour provides opportunities to actively learn basic
neuroscience concepts connected to traumatic brain injury and how to construct
scientific explanations. For teachers, The Golden Hour is an opportunity to
leverage technology in the form of a computer game to teach and assess science
content and practices in context.
NEURON is an NIH-SEPA funded curriculum development group at the University
of Illinois in Urbana-Champaign. The project brings together scientists, science
educators, teachers and students to develop educational materials that connect
frontier science with national and state science education standards. Though the
project's main focus is the development of in-class curriculum units that
emphasize inquiry and active learning, they have also developed educational
videos and games, such as The Golden Hour. Project NEURON is funded by
the National Institutes of Health's Science
Education Partnership Award (Award Number R25OD011144).
Chandana Jasti, Ed.M., is a curriculum specialist for Project NEURON at
the University of Illinois, where she develops secondary science curriculum and
conducts teacher professional development. She enjoys working closely with
scientists, educators and students to create and share engaging ways to teach
and learn science.
Barbara Hug is
a clinical associate professor at the University of Illinois in the College
of Education. She is interested in the design of learning environments that
support teachers and students in the teaching and learning of complex scientific
concepts and practices. She is the principal investigator of Project