The 2018 Game Developer's Conference will feature an exhibition called Alt.Ctrl.GDC dedicated to games that use alternative control schemes and interactions. Gamasutra will be talking to the developers of each of the games that have been selected for the showcase. You can find all of the interviews here.

Vaccination is a cooperative game where one player scans a body for bacteria, relaying that information to the player with the injector who must use the right vaccine to cure it. By working together, they can keep their poor, Operation-like patient healthy despite the sicknesses that are ravaging them.

Gamasutra spoke with Katy Marshall and Alex Johansson, creators of Vaccination, to learn about how they split up the tasks of scanning and injecting, how working together made their game feel more fun, and the challenges of turning medical examinations into entertaining play.

What’s your name, and what was your role on this project?

Marshall: I'm Katy Marshall, the artist, designer, and maker of the custom controller.

Johansson: I'm Alex Johansson, designer and programmer of the game.

How do you describe your innovative controller to someone who’s completely unfamiliar with it?

Marshall: It’s a game that requires players work together, and their aim is keep the patient alive for as long as possible. One player has the role as ‘The Scanner’, using the monitor and and the joystick controller to ‘scan’ the patient's body for bacteria. The other player is ‘The Injector’ and they position themselves with the ‘injector’ in front of the patient and the vaccines. The Scanner relays information on the whereabouts of the bacteria to the The Injector so that they can wipe them out with the correct vaccine.

What's your background in making games?

Marshall: Originally (and mainly) the art and graphics side, though recently I’ve been working a lot more in the interactive design area, especially with physical installations and custom controllers.

Johansson: I’ve been making flash games for 5-6 years, iOS apps for the last 2 years, and custom controllers for 3. Previously, I worked in education, but decided to get some games under my belt!

What development tools did you use to build Vaccination?

Marshall: For software, I used Adobe Illustrator and a little of Adobe Photoshop. I designed and created the art, in-game assets, and developed the custom controller files with Illustrator, and any images that needed converting into pixels I transferred over to Photoshop. For 3D objects, I used AutoDesk’s TinkerCAD. TinkerCAD is a wonderfully simple, friendly, and free software to use for 3D modelling for 3D printing, I used it to design and develop the injector component which was 3D printed.

Other tools and machines I have used for Vaccination are laser cutters, a CNC machine, and soldering.

Johansson: The software that was used  to create the game was Stencyl, a drag and drop tool used for the jam submission, but also for the final game! Quite similar to scratch, but with extra options to export.

What physical materials did you use to make it?

Marshall: I used various wood, acrylic perspex, plastic (3D printing filament(PLA)), metal and electronic components (buttons), and, of course, the Makey Makey. There was also a joystick component that was used for the scanner controller.

How much time have you spent working on the game?

Marshall: Hard to say what the sum total has been so far, as I have been working on it here and there since it was first developed back in September 2016! In that time, I’ve made over 10 versions of the project, and there’s currently 2 copies at different festivals around the world. I do plan to work on it a little more before GDC, testing out some new features and hopefully refining the design on the controller again before we fly out.

How did you come up with the concept?

Johansson: At the time I came up with the idea, I’d been working with two other artists (Tyler Giordano and Alex Borovski) on a game called Space Ragers, a muppet boxing game. The game used cloth-based materials for the puppets, so I was intrigued to see what other interface designs I could come up with, one of which was a squishy patient that you were injecting with needles to stop an infection spreading in a tower-defense format. After witnessing how quickly the puppets degraded in combat (What happens when you smash two controllers into one another for 30 hours), I changed the material type, but the concept was there!

Marshall: We were also inspired by classic childhood games, most notably Operation, and we wanted to explore what it was about them that we remember enjoying so much and to see if we could recreate that. Which we hope we have.

What thoughts went into turning medical care into a fun game for two?

Marshall: The first prototype was designed over a weekend game jam, ALT CTRL JAM, and because of that there were a lot of limitations on what we could get done. It was original one player, with the patient's body taking up the whole screen and the controller bed was a 10th of the current size. We got the overall mechanics to work, but the gameplay was off and the graphics quality was minimized for efficiency.

I was very vocal with Alex (Johansson) about wanting the graphics to be better - he’s normally happy to leave them quite pixelated whereas I’ve been moving more into vector art. One of the ways we were able to achieve a medium was by “zooming” into the body and with that it added another layer of gameplay. This did mean that the single player would now need to scan the body with arrow keys and then use the custom controller - which at this point was just the patient, the vaccines, and the injector.

Even though it wasn’t an intense game, it still felt like putting a lot on a first-time player and would be more frustrating than fun. The way we were able to fix that was by splitting the custom controller between two players, and with the added asymmetrical gameplay that encouraged communication, we were able to get it back to being and entertaining game.

What drew you to have one player examining the body while the other administered medicine? What did that co-op (with different activities) add to the experience of Vaccination?

Marshall: As mentioned in the previous question, having a single player manage both roles of scanner and injector, especially with unfamiliar controllers, felt like too much. I’m also of the strong opinion to keep things simple; the less explanation someone needs, the better. Once we broke down the game down into short sentences, the focus of the game was as follows: keep your patient alive, looking out for bacteria and vaccinate said bacteria. Those last two are the main tasks of the game, and making them into roles was just how it developed. We both feel that playing a game with (not against) your friend/s is more often than not going to be a good game - though this does rely heavily on good communication!

What made you create the unique interface for Vaccination? How does it teach players how to play at a glance?

Johansson: What’s quite nice about the controller is from the offset, the layout is quite approachable - most kids growing up will have experimented with toy injectors in doctor kits or used them in science class. Despite the bizarre concept of the game, most players pick up the game quickly because of the controllers. Having played the game with just a keyboard, I guarantee the injector makes it a whole world easier.

How do you think standard interfaces and controllers will change over the next five or ten years?

Johansson: I recently did a talk in Sarajevo about this! I think the biggest change will come the way of the Labo - using custom interfaces to enhance the experience of playing games. I also think there’s a lot of potential in how VR could be enhanced with custom interfaces and installations, deepening the immersion with 1 to 1 matching interfaces.