by Diana Jones

Diana Jones is a graduate student in Educational Technology at San Diego State University. She is a veterinarian and taught veterinary students at Mississippi State University College of Veterinary Medicine.


Instructional Objective

Learners will have fun overcoming one of the big obstacles of their education. After playing HeadGames several times, the learners will be able to memorize some facts that are important in performing a neurological examination. The game reinforces the connection between the number of the nerve and its name, function, and location. Ultimately, information will be retained long enough to be used during a neurological exam later in the curriculum and after graduation. It is easy to remember the numbers but much more difficult to remember the facts associated with nerves 1 through 12.


The learners are first year veterinary students. Other veterinary students could use the card games to review prior to diagnosing clinical neurological cases. Veterinary students study the nervous system in detail in preparation for using the information to diagnose and manage neurologic disorders. They also learn numerous other medical and surgical facts, principles, and procedures important in clinical diagnostic problem-solving. These adult learners spend hours memorizing details.


A game is an appropriate format for this situation because it provides repetition of the associations between the related facts. A game is motivational and enhances the tedious process of memorization. Card games are portable, playable anywhere, and playable within short periods of time. These card games are no exception. The solitaire game could be played while students are on night shifts monitoring animals. The rules are familiar and facilitate first-time players.

Rules/Description of Playing

The 48 cards model a regular 52 card deck. There are 12 numerical values in each of 4 categories. The cards can be used to play solitaire or rummy. The first HeadGame is easier to play and modeled after Clock Solitaire. The second HeadGame, 500 Rum, is more difficult to play but still fun and educational.

HeadGame 1: Clock Solitaire
The game is played in the following manner:


  1. Deal the entire pack face down in 12 piles in locations similar to the numbers on a clock face.
  2. Consider each pile to have the number corresponding to the clock face number.
  3. Turn over the top card of the pile in the 12 o'clock position.
  4. Place the card face up under the pile it corresponds to in the clock position.
  5. You can leave part of the card showing for future reference.
  6. Turn over the top card of the pile where you placed the card.
  7. The game continues in this fashion until the pile you have placed a card under lacks a card to turn over. This will happen when the 4th twelve card is found. At this point, you would have won if all cards were face up.

HeadGame 2: 500 Rum
The game is played in the following manner:


  1. The object of the game is to make melds of related cards to earn points and to be the first to reach 500 points.
  2. Deal seven cards to each player.
  3. Place remaining cards face down. Turn the top card over to begin the discard stack.
  4. The player to the dealer's left goes first.
  5. Pick up a card from either the discard or face down pile. A card from the discard pile must be used immediately in a meld. If >1 card from the discard pile is selected, the bottom card lifted must be melded.
  6. During a turn, lay melds of cards on the table. A meld is either 3 cards of the same value or sequential cards in the same category. Players may lay cards that complete a meld started by another player. Players may retrieve (out of turn) a playable card discarded by another player or a meld evident in the discard pile.
  7. Each turn must end by discarding a card.
  8. Play ends when a player discards their last card.
  9. Points equal the meld card values minus the held card values.

TIPS for 500 Rum:

First time play: Play with cards face up on the table instead of in your hand.

Use reference sheets.


Second time play: Hold cards in hand. Use reference sheets only to verify opponent's melds.


Other HeadGames
The deck could be used to play various other simple games.


Go Fish

Crazy 8's


Klondike Solitaire


Card Design

The cards are the same size as a regular deck and have a picture of the brainstem on the back. There are 4 categories of cards; name cards (red), number cards (red), picture cards (black), and function cards (black). The 12 picture cards show the brainstem origin and the site of insertion on the head. The 12 function cards state the main actions of the nerve.

Design iterations:

  2. The first cards were all the same color. Two colors were necessary to play Klondike solitaire.
  3. Revisions were made to allow visualization of pertinent information at the corners of cards during rummy and at the tops of cards in face up piles during rummy or solitaire.
  4. The first number cards had Cranial Nerve # at the top of one end. The revised card had # Cranial Nerve so it would show the # in the top left corner. The subsequent revision included # Cranial Nerve at the opposite corner of the card to avoid having to turn the card right-side up. The final revision displayed Cranial Nerve # up the top of the sides so the # was at the corner next to # Cranial Nerve. The number value of fanned melded cards was easier to see.
  5. The first name cards had the name at the top of one end. The revised cards had the name twice at each corner; at the top of each end and up the sides.
  6. The first function cards were dysfunction cards. The description of nerve dysfunction included fragmented sentences filling the whole card. The revised cards, function cards, had distinguishing text in each corner and bulleted points in the center.
  7. The first picture cards had one big picture of a brainstem and a nerve extending to the site of action. The revised card depicted the site of action in each corner with a nerve connecting each one to the brainstem in the center of the card.

Deck Design

The deck has 48 cards including four categories of 12 sequentially valued cards. The 1 to 12 cards in each category are equivalent to 2 through King in a regular deck.

Sample Cards

Number Card Name Card


Picture Card Function Card

Back of card

Design Process

I started by considering my audience and their needs. Veterinary students are repeatedly overwhelmed with facts to memorize. All students regardless of their career track must know the critical facts. Years later, students use their knowledge to solve diagnostic challenges. Students use rote memorization to "know it for the test" but their memory is fragmented when applying the knowledge to real-life situations. Some facts, such as the list of cranial nerves, are never retained in long-term memory.

Neurology is a difficult subject and requires the memorization of vocubulary and complex processes. Initially, I considered putting the cranial nerve number value on each card, but this would allow learners to play without learning the content.

I thought the game was too hard. I tested the prototype with a veterinary technician, Lynne. She said, "Beginners need a cheat sheet." I tested the prototype with a solitaire addict, Jimmie, who lacked medical knowledge. She said, "It would work fine as a solitaire game but would be hard as a rummy game." She thought it would be good, when you first start, to have someone around who knew the information. Another veterinary technician, Angie, said she had to review her Roman numerals to play. I tested the prototype with someone, Doug, who knew little about card games or medical terminology. He said, "The content is very difficult." He added, "Lay people could play this game if you let them read some information first." I observed that novice players preferred to create rummy melds using number cards because it was easier than using the other cards.

The beta testers helped with the card interface. Doug recommended using fewer words and keeping cards as simple as possible. The dysfunction cards were changed to function cards to keep concepts simple. Everyone recommended cheat sheets, one with functions and another with pictures, names, and numbers.

I also considered a solitaire game that taught the anatomy of the horse's lower leg. The categories would include nerves, tendons, bones/joints, and arteries/veins. The value would increase from distal to proximal such as Phalanx 1, 2, and 3, Sesamoid bones, Metacarpal 3, 4, and 5. The anatomy was too complex to fit clearly into an order based on sequential location. I considered using the neurologic pathways of the body but felt this game was unsuitable for similar reasons.


Ellington, H., Addinall, E., & Percival, F. (1982). A handbook of game design. (pp. 19-46) London: Kogan Page.

Oliver, J., and Lorenz, M. (1983). Handbook of veterinary neurologic diagnosis. (pp. 42-74) Philadelphia: W. B. Saunders.

Morehead, A. H., Frey, R. L., & Mott-Smith, G. (1991). The new complete Hoyle revised. pp. 42, 70-71) New York: Doubleday.

Last updated by Diana Jones on September 30, 1996.

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Educational Technology 670, Fall 1996.