Omni Know-How
March 27, 2025
Over the past three decades, video game designers have distilled how to maximize player engagement and learning by strategically triggering reward centers in the brain. By carefully balancing satisfaction vs. frustration over time, and timing the frequency of rewards with the rhythms of the brain, a well-designed game can maximize the release of neurochemicals (like dopamine) over time and maximize engagement.
This yields the indirect consequence of increasing player skill - as dopamine is extremely effective at cementing learning by reinforcing neural pathways used to achieve the reward. See previous post: The Neuroscience of… Angry Birds
“Game loops” is an architecture that is used extensively in successful video games to do just that. Game designers and neuroscientists alike know that the most effective way to maximize dopamine release (and therefore learning) is to provide small rewards at a high frequency, building up to larger and larger rewards at lower and lower frequencies. When combined with social mechanics (such as competition and collaboration), the effectiveness is further amplified.
A Consumer Example: Farmville
When considering the most fun activities upon which to base a game, farming does not come to mind. And yet, 100s of millions of people have played Zynga’s Farmville for years… They’re on Farmville 3 (?) by now, not to mention the countless hugely successful “Farmville-inspired” games like Hay Day and others in the now-established genre of farming games.
Why?
Well-designed game loops.
The vast majority of a player’s time in Farmville is spent repeatedly planting seeds and harvesting crops (small rewards).
Eventually, the player accumulates enough crops to “graduate” to the next loop - buying and selling crops for equipment and cash (bigger rewards).
After accumulating enough resources, the player can finally expand her farm - decorating it and customizing it so that she can show it off to her friends on Facebook and earn social proof (the biggest reward).
Medical Example: Top Derm
Most of Level Ex’s games utilize a hierarchical game loop architecture as well. Sometimes those loops exist within one play session, whereas sometimes they can span many months of gameplay.
In Top Derm, for example, dermatologists play through sequences of prompts – sort skin images into categories, match diseases with treatments, etc. These second-to-second prompts the innermost loop.
Prompts combine into rounds. Rounds combine into challenges. Challenges into case packs.
As players complete challenges, they earn expertise that expands their expertise loop and unlocks new packs (middle loops).
Replay allows players to earn higher scores, experience points (XP), achievements, AMA category 1 CME credit (which provides the real-world value of bringing you closer to renewing your medical license), and make other middle-loop progress that unlocks additional content.
Eventually, players earn coveted outer-loop rewards like specialty-rank badges that earn social status in the community.
Loops at all levels have been added to the game over time.
In future blog posts, we’ll explore both the design of individual game mechanics (inner loops like diagnosis), as well as how the ‘game loop’ architecture is applied to different Level Ex games and game modes - like Top Derm and our peer to peer games, played at conferences and speaker dinner programs.