Use this variation with infectious disease outcomes. When a player gets the disease (completes a pie) they transmit the virus to other players. For example, in the common cold game players might transmit the virus to players sitting in front and beside them.
Teaching points
When we play this variation of the game, players tend to assume that if the person they are sitting beside has the disease then they will get the disease immediately. We have found it helpful to pause the game at the first transmission and explain that the cold virus is transmitted, not the disease itself, and occurrence of disease will depend on the presence of other component causes. We purposely avoid talking about transmission of the disease and instead talk about transmission of the virus.
Topics such as disease latency, subclinicial infection, and symptomatic infection can also be discussed.
Note: In this version of the game there is no answer key because the transmission of the virus will be somewhat unpredictable if the game cards were distributed randomly.