Antimicrobial stewardship, as a team sport. A live, phone-based game where resident teams treat real cases on the projector — and the scoring rewards exactly the reasoning we're trying to build.
Naming drugs is easy; using them well is the hard part — and it's exactly where habits form early and stick. Formulary makes the good habits the way to win.
Reaching for the broadest agent "to be safe" — the reflex that drives resistance, cost, and C. diff.
Cultures come back and the regimen doesn't change. Narrowing on data is a learned discipline.
Price, duration, and C. diff risk rarely enter the bedside calculus — until they're made visible.
The game isn't a quiz bolted onto trivia. Its mechanics are the objectives: to win, a team has to reason the way we teach.
Teams draft a bench of agents grouped by role — antipseudomonal β-lactam, atypical coverage, MRSA, anaerobes, urinary. A live "cover the field" checklist forces the question every good empiric plan answers: what am I actually covering? They read a real local antibiogram to draft, not a memorized list.
Day 0 is an empiric bet under uncertainty. When cultures return, the board reveals the susceptibility and teams must de-escalate to the narrowest agent that still covers. The single biggest reward in the game is landing on "narrowest effective" — de-escalation is the winning move, not an afterthought.
Every regimen accrues cost per day, and broad or prolonged therapy quietly raises a C. diff roll at the end of each case. Overkill wins the moment and loses the game. Residents feel the downstream cost of "just in case" — the harm that's usually invisible at the bedside.
The shared story: the patient, the cultures, the reveal, the live standings.
Each team's console. A rotating captain submits the team's call — everyone debates it.
You. Open a case, advance the days, hit "Score & reveal." That's the whole job.
Teams draft a bench of antibiotics, then treat a case that unfolds over several days. Each day they choose a disposition (discharge / admit / ICU) and a regimen (which drugs, IV or oral). Picks auto-save on the phone; the facilitator advances and the board scores every team at once. Then the next case. Highest total after the last case wins.
8 cases span the bread-and-butter of inpatient ID — cystitis, pyelonephritis, pneumonia, cellulitis, S. aureus bacteremia, febrile neutropenia, meningitis — each grounded in IDSA / WRNMMC guidelines and a local antibiogram.
Scoring is transparent and guideline-anchored. Teams see exactly why each day earned or lost points — the feedback that makes the reasoning stick.
Final score = clinical points − cost − C. diff. A team can cover every bug and still lose to one that treated narrow, cheap, and clean.
Fits a noon conference or an academic half-day slot.
Web-based. Residents scan a QR code — nothing to install.
Split the room into teams of 2–5. Scales from 6 to 60.
You run it from one screen. Free to use.
Try a case yourself in two minutes, then I'd love to pilot it with a resident session.
Your antibiogram, your formulary, your prices — and your own cases. The ten that ship are a starting point, not the curriculum. Five steps in a browser; no spreadsheets emailed around, nothing to install, and a checker that tells you in plain English whether the right answer still wins.