The students acquired knowledge on diabetes by imitating

An imitation game on type one diabetes was implemented as a part of the pedagogical development of the Imitation Game method in the Know your neighbour -project.

The judge of the game, a type one diabetic, posed five questions or cases for the participants. Two of the participants were type one diabetics, and they attended individually. The imitators were students aged approximately 15 to 17, and they participated in groups of 3 or 4. Both of the student groups were studying a human biology course, and the game was a part of their course. The idea of the game was to examine how an exact subject on the human biology course can be transformed into a learning experience through empathising.

The game was carried out by using an asynchronous mailman method. In this method the judge first came up with five questions, cases or scenarios which were emailed to the participants. The type one diabetics both answered as themselves. The students received the questions in class. They read articles and forums on the internet in order to come up with reliable answers.

After the game the students commented on the answering process: “It was part easy, part difficult. The answers easily became too analytic and long”, “It was difficult: without one´s own experience or perceptions the form of the text was too much like a study book”, “Answering was difficult because I don´t know any diabetic very well so I didn´t exactly know how to answer. It was easy to find information on the internet”.

The anonymous answers were gathered in a sheet which was opened to the judge. There were 15 participants altogether, which makes a total of 75 answers. The judge was instructed to evaluate each answer according to how likely they think someone with type one diabetes would answer in such a way. Every answer was commented, and thus judged whether it was written by a diabetic or an imitator, and also given a point from one to five to describe how certain the judge felt about their evaluation. After going through all the answers the judge gave their final judgement and comments on each participant.

The judge took into consideration the knowledge and experience reflected in the responses as well as the terminology and language used. The judge describes the evaluation process: “Participating was interesting. The questioning itself was thought-provoking, because you understood how much tactile knowledge you have on something, in this case a condition. I tried to come up with questions on situations diabetics often encounter, but whose complexity doesn´t easily open up to a person who doesn´t have this condition. The questions were actually very revealing and the diabetics were quite easy to differentiate from the imitators. Even though many of the students gave it a good effort. Quite possibly it was namely the effort that gave them away: either there was too much of it, or too little. The diabetics themselves talk about the condition less scientifically than the imitators”.

The conclusion of this imitation game was that the judge recognised both the diabetics, and none of the imitators succeeded in fooling the judge and whilst were recognised as imitators.

After the judgement all the participants received the judges comments and also all the responses of other participants. The students went through the material in class and commented: “Participating was interesting. I got a lot of new information on diabetes and also information on how to act in everyday situations”, “The imitating deepened the learning process. In our group we shared our knowledge and points of view, this way we learned about finding the truth and could edit our response to be as genuine as possible”.

The diabetics evaluated the usefulness of participating: “This was fun! I really had to give thought to the formulation of the response because I wanted to summarize and be brief”. Also the pedagogical aspect was acknowledged, “The students really had to get to know the subject deeply. I assume that those who put effort into the game really learnt from the experience.” Both the diabetics thought the answering was easy based on one´s own experience.  

How would you answer the judges question:

“You are going backpacking to Thailand for a month. Your diabetes is treated with multiple daily injection. What kind of challenges will you face with the preservation and adequacy of the medicine? How will you solve these challenges?”

How would you judge these responses: who is a diabetic and who is imitating?

  1. The temperature in Thailand is often over 30 degrees centigrade and the insulin starts to lose its effect. Over 50 degrees centigrade will destroy insulin immediately. Insulin is usually kept in a fridge. While backpacking that is not always possible so I would bring a small cool box, of course with coolers. This way the insulin stays cool while walking. On the trip it would be easiest to use prefilled pens but if I had lots of them, the preservation would be a challenge. On the other hand, you might be able to get insulin easily in pharmacies in Thailand so you wouldn´t need to carry lots of them from home.
  1. Travelling is the lamest thing. Insulin and the libre-sensors must not freeze nor can they be kept in over 20 degrees centigrade for a long time. None of these can be placed in the aircraft hold but should be taken to the cabin. You would have had to think about the acquiring of the instuments and medicine about six months prior to the trip since you can´t get them for more than three months at a time – so this amount will be enough for a two month journey, if you have had a possibility to get them at least a month prior to the trip. In Thailand you have to keep the medicine in a fridge or in some kind of cooler all the time. There are those designed especially for medicine. Even the cool bags need cold water from time to time in order to work so you really want to use all the cold you can find when backpacking.
  1. I will arrange the injection in some kind of a medicine box and remember to take enough insulin and clean needles with me.

All the questions, responses and judgements with comments in the sheet in Finnish

The blogpost on the experiment is published on the Diabetesseura T1D blog on 15.6.2018,


Tiina Airaksinen, development manager, tiina.airaksinen(a)

Heikki Koponen, game pedagog, heikki.koponen(a)


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