By Bianca Cardona

Earlier this year, I had the wonderful opportunity to conduct research on Bubble Beats Trainer with middle school students. I was scared that middle schoolers might not show as much interest toward BBT, but I was pleasantly proven wrong.
A 7th grader exclaimed something while playing: “I didn’t even know I had to wash my thumbs!”
I was completely appalled by his statement. For a 13-year-old, I assumed proper handwashing technique was common knowledge. But when we first asked students to play Bubble Beats Trainer (BBT), my preconceptions were quickly shattered. Every student was unaware of at least one step in handwashing.
To address these gaps in knowledge and performance of accurate handwashing technique, BBT came in: an interactive video game teaching students not just how to wash their hands, but when. It was the perfect way to investigate whether handwashing knowledge was teachable to these students–and to what extent?
Initially, I was not sure of how students might respond to the game. Teenagers are notorious for feeling “too cool” for certain things, and my worry was BBT would fall under this category. Especially for the 8th graders.
Yet, each class I worked with was a pleasant surprise. The students loved the game. Engagement levels blew me away. No corner of the classroom was short of laughing, screaming playfully at the tablets, and exclamations of “ohhhs” and “whoas.”
Unknowingly, students were learning as much as they were having fun! Each of BBT’s three game modes (Practice Mode, Challenge Mode, and Contagion Mode) taught varying skills to the students.
In Practice Mode, players were introduced to the essential steps of handwashing. Covering all areas of the hand with water, soap, and diligent scrubbing was pivotal. It served as a warm-up for the next game mode, Challenge Mode, where students were tasked with applying the same techniques in a timed environment. Failing to clean certain areas of the hand led to a decrease in health points. I witnessed this time crunch bring out students’ competitive sides, as they would compare the amount of health left over with their friends. Students rushed to see who amongst their friends survived the most rounds.
For their last round, students played Contagion Mode. The goal was to prevent the spread of viruses in a school setting by sending infected individuals to wash their hands. Many students told me that tapping furiously on infected children was their favorite part.
I had a blast conducting the research at BBT because I really saw how children not just learned from it, but thoroughly enjoyed it.
The techniques learned from BBT worked like magic. Immediately after playing, students took the time to thoroughly scrub and inspect each area of their hand. They applauded each other as investigators shone a UV light on their hands after using Glo Germ (a lotion that simulates germs), revealing the squeaky clean palms, fingers, and nails of their friends.
I was more than thrilled! It seemed this game accomplished a perfect transfer of knowledge; in just 2 classroom sessions, these students learned new handwashing techniques and effortlessly applied it to real life at the sink. Still, the ultimate question loomed at large: would this knowledge stay with them in the long run? Would they keep practicing and implementing this new, critical handwashing health habit for the rest of their lives? We were eager to find these answers.
An Interesting Encounter
While we had no time to continue the habit formation part of our research, an interesting encounter happened months later.
I was invited to come back to the same middle school to attend their spring musical. Handing out the playbills was a group of 8th graders who played BBT months earlier. Before I could acknowledge them, they walked across the room from the other side. To my amazement, they approached me saying, “We still wash our hands like how BBT taught us.” They even demonstrated the very same and correct handwashing steps on the spot! All of them! I couldn’t help but smile. After all this time, their enthusiasm for BBT and proper handwashing technique remained.
I was even informed by the middle school’s science teacher that students asked her if, after completing classwork, they could play BBT as a may-do activity.
BBT is a game that beautifully blends education with interaction and fun. There is some secret formula at play! With the right approach, even something as routine as handwashing can be transformed into engaging habits that last a lifetime.
Bianca Cardona is a high school senior and intern at Indelible Learning.
Mentor and Advisor: Dr Jasminka M. Vukanovic-Criley
Dr. Jasminka Vukanovic-Criley MD, FACP, FHM is a multiple award-winning physician, internist, hospitalist, healthcare & education innovator & Associate Clinical Professor of Medicine at UCLA. She is a career mentor & advisor to numerous undergraduate, graduate & postgraduate students & faculty. As a researcher, Dr. Criley received awards from the National Institutes of Health & the U.S. Department of Education Her work focuses on creating research-driven #edtech games & digital media to improve health, civics, science education & promote healthy habits. Dr Criley is also a sought-after speaker & a founding Board member of Physician’s Weekly. She can be reached on X at @criley_md and at www.linkedin.com/in/jasminka-criley-md