Game of Stools — making C. difficile training more fun and effective

Clostridium difficile infection is one the commonest HCAIs and the game is designed to provide effective training of frontline healthcare staff

Playing the game: Game of Stools grabs the attention and informs staff about C.diff.

Focus Games and Betsi Cadwaladr University Health Board (BCUHB) in Wales have launched Game of Stools: The Clostridium difficile Training Game.

Clostridium difficile (C. diff.) infection is one of the most common healthcare associated infections. Good infection prevention practice is key to reducing infection rates, and effective training of frontline healthcare staff will help improve infection prevention practices.

Game of Stools is a fun, engaging and informative training board game, to help staff improve their knowledge and skills in both preventing and treating C. diff. infection. In a recent trial, at BCUHB, Game of Stools was played by 85 healthcare professionals, who completed both pre-game and post- game C. diff quizzes. Following playing Game of Stools, 98% of participants correctly answered more questions correctly, demonstrating a definite increase in knowledge. Many participants increased their score by up to 50%.

Developed by Gareth Pierce Jones, from the Infection Prevention and Control Team at BCUHB, Game of Stools helps players learn about:

  • Clinical factors
  • Risk factors
  • Transmission
  • Laboratory diagnosis
  • Management & treatment
  • Isolation precautions
  • Environmental cleaning

Pierce Jones, the creator of Game of Stools, said: “I had the idea of designing an educational game to teach healthcare professionals about C. diff. infection in a non-traditional but engaging way. BCUHB is committed to excellent infection prevention practices, and this is achieved through our continuing and determined focus on improving clinical practices and staff knowledge – Game of Stools is helping us to achieve excellent standards.”

Game of Stools aims to improve knowledge and confidence of staff, contribute to the prevention and management of C. diff., and generate discussion between players about how to improve infection prevention practices.

“I played the game and I have to say it was brilliant fun and very educational. I recommend everybody takes on the challenge,” said Gary Doherty, BCUHB Chief Executive.

Two players or teams compete against each other, asking and answering questions about C. diff. as they move round the board, trying to avoid ending up in isolation with life threatening C. diff. It is fun, it is informative and an essential training resource for staff and students in all frontline settings.

Dr Stuart D’Arcy, Consultant Medical Microbiologist, North Wales Microbiology and Health Protection, Public Health Wales, said: “For very busy staff with multiple calls on their time pulling them every which way, getting engagement... can be a deal breaking challenge to the success of any educational intervention... Gareth has overcome that problem by inserting the educational message into a well-established game format with a genuinely humorous twist... the combination of fun, interest, competition and humour delivers the teaching “holy grail” of audience engagement... A successful method of effectively engaging staff in practices that reduce the incidence of a disease.”

Game of Stools has now been further refined and published by educational games specialist Focus Games Ltd. For details visit