Kickoff week has a particular sound. Plenary on Monday, breakouts by franchise, a competitor session after lunch, the commercial model on Wednesday, dinner, more slides. By Friday everyone has seen everything. Nobody knows who can actually say it.
This case is about a global immunology kickoff that set out to answer that question while the week was still running. The program ran in June 2024. In six days, 1,330 participants across four franchise teams answered 301,000 questions, and 53% of the 15,238 knowledge gaps found at first attempt were verified closed before the window shut. The four teams closed between 47% and 58%, within eleven points of each other. The more useful findings, all measured inside the assessment, were about which kind of content belongs on the stage, which belongs in the game, and which belongs with a manager.
One molecule, three indications, four teams, one week
The client had a single biologic used across several type 2 inflammatory diseases. Its field team was split into four franchise teams: dermatology, asthma, nasal polyps and a cross-franchise group. Each team had its own customers, its own KOLs and its own competitive pressure, but all four needed to tell a consistent story about the same molecule.
The kickoff agenda carried a lot:
- disease mechanism and the science of type 2 inflammation, by indication;
- fresh trial data and prescribing information;
- the mode of action of a new competitor class, a JAK inhibitor, that reps would have to argue against;
- the commercial model: global priorities, the omnichannel ecosystem and the marketing approach for the year.
The audience was sales reps, MSLs and marketing, all working in English. As in any kickoff audience, some are deep specialists in one indication and some are newer to it. A kickoff has to serve all of them at once, and the traditional way to check whether it worked is a satisfaction survey and a post-event quiz with a pass mark. Both tell you something about the event. Neither tells you what a dermatology rep will say to a dermatologist the following Tuesday.
The stakes are well documented. IQVIA estimates around $200 billion of revenue at risk from loss of exclusivity by 2030, and argues that companies need an unprecedented number of launches with consistently strong performance. For a franchise built on one molecule across several indications, each kickoff is a chance to reset the field story. Wasting it on content people already know, while the hard parts go unrehearsed, is expensive.
Four games in parallel, so every team was measured on its own content
We did not run one kickoff quiz. We ran four simultaneous games, one per franchise, with 404 questions in play in total. The largest, the dermatology game, carried 171 questions and 622 players.
The reasons were practical.
First, a shared bank would have mixed signals. A cross-franchise rep struggling with nasal polyp diagnosis tells you something different from a dermatology rep struggling with the same question. Separate games kept each team's data clean.
Second, the shared material still ran through every game. Strategy, omnichannel and medical education content appeared in all four, because that was the part of the kickoff every team had to align on. Running it in parallel let us compare the teams on the same questions.
Third, the window matched the event. A six-day battle window sat on top of the kickoff week. Players met colleagues in one-minute challenges, five questions in 60 seconds, with notifications bringing them back between sessions. When someone got a question wrong, Gap Fixing sent them the explanation for their own mistake, and the question came back to check whether it had landed.
All questions came from the client's approved kickoff material. Nothing was written from outside sources, and the content was signed off before the window opened.
Half the gaps closed in six days, and the teams moved almost in step
A gap, in our method, is one person wrong on one question at first attempt. It counts as closed only when the same person answers the same question correctly later. That is a higher bar than an end-of-event test, where different people can be right on different days and the average still looks fine.
Against that bar, the program found 15,238 gaps and verified 8,087 of them closed, 53%. The other 7,151 were flagged for follow-up coaching. In our case library of 100 programs, 43% of identified gaps were verified closed across the library, and the 16 programs tied to a business moment like a kickoff closed 55% against 41% for the other 84, an observed association rather than a rule. Doing it within six days, during an event already packed with sessions, is a good result.
The four franchises closed within eleven points of each other, between 47% and 58%. That spread is fairly narrow, but it does not show the format worked equally well for every team: the teams differed in size and content, and an eleven-point gap is a real difference. What also differed was the volume of gaps each team started with.
The biggest block of gaps was not clinical
This is the finding kickoff owners least expect when we show it.
By content block, the gaps looked like this:
- Omnichannel, strategy and medical education: 7,547 gaps, 51% closed.
- Atopic dermatitis (epidemiology, diagnosis, severity scales, management): 3,914 gaps, 57% closed.
- Asthma, COPD and respiratory (type 2 inflammation, control, quality of life): 1,971 gaps, 49% closed.
- Other content blocks across the program: 975 gaps, 57% closed.
- Molecule data and mode of action (trials, mechanism, safety, prescribing): 826 gaps, 58% closed.
- Nasal polyps (diagnosis, burden, treatment pathway): 5 gaps, 40% closed.
Almost half of all gaps sat in the commercial and strategic material: priority ratings, the ecosystem, the marketing model. A caution on reading that: raw gap counts depend on how many questions each block held and how many players met them, and the shared strategy block ran in all four games. So the list shows where the volume of gaps was, not which topic was hardest. The fair comparison is errors per question asked, which our per-block summary for this program does not break out. What the volume does show is that the commercial material, which usually gets far less rehearsal than the clinical content, was not a small problem.
That makes sense once you say it out loud. Reps have heard the mechanism story for years. The commercial model is new every kickoff, it is presented once in a plenary, and nobody practises it afterwards. Then it is expected to shape how territories are planned and how omnichannel activity is run for twelve months.
The commercial model is new every kickoff, it is presented once in a plenary, and nobody practises it afterwards.
Three questions, three different fixes
We tracked individual questions in the dermatology game from first to last attempt. Three of them show why "more repetition" is not the answer to every gap.
A strategy target: split three ways, then mostly fixed
One question asked what each country was expected to implement under the global priority framework. At first attempt the answers split three ways: most people chose the correct target, but a sizeable minority picked one of two lower thresholds. That pattern is typical of material that was presented but never rehearsed. People remember that there was a number. They do not remember which.
Repetition worked well here. Of the 172 people wrong at first attempt, 138 were verified as corrected on a later attempt, about 80%.
Severity scales: pure recall, steady progress
Another question asked which disease severity scales an international consensus recommends for atopic dermatitis. This is recall, plain and simple. Of the 158 people wrong at first attempt, 72 were verified as corrected through the game alone.
That is not a perfect score, but it is the right channel. Nobody needs a plenary session on scale acronyms. Another round of challenges, and a reminder before the next cycle meeting, will move it further.
Barrier dysfunction: a misconception that barely moved
The third question asked what makes the epidermal barrier dysfunctional in atopic dermatitis. The right answer lies in changes to the composition and organisation of barrier lipids. At first attempt, most of the wrong answers went to a genetic explanation built on gain-of-function mutations, which runs the wrong way round.
Repetition barely touched it. Of 181 people wrong at first attempt, only 54 were verified as corrected, leaving 127 who were not. At their last attempt, 125 of them were still choosing the gain-of-function mechanism. Carried into a call, that would be a rep telling a dermatologist the opposite of the real story, confidently, because it sounds scientific.
This matches a pattern across our library. In one in five of the example questions we tracked, fewer than 20% of the people who were wrong corrected it; some of those were never retested, so not all are proven misconceptions. Where the wrong answer keeps coming back, as it did here, it is not a memory gap. It is a misconception, and they need someone to sit with the rep, explain why the intuitive answer is wrong and check the new explanation in their own words.
Four lessons for anyone building a kickoff agenda
- Measure the commercial material, not just the clinical. Most kickoff testing focuses on the science. Here, the strategy and omnichannel block produced the most gaps. If it goes unmeasured, it goes unfixed.
- Sort content by how it responds to repetition. Recall (scales, thresholds, targets) moves with the game. Some mechanism questions had lower closure rates and warranted follow-up assessment and coaching. Knowing which is which lets you allocate plenary time, breakouts and coaching on data.
- Run franchises in parallel, with shared content across all of them. Separate games kept each team's signal clean, and the shared strategy questions let leadership compare alignment across teams on the same material.
- Use the event window, not the week after. The game ran while the content was fresh and everyone was already in kickoff mode, and half the gaps closed inside six days. We cannot separate the timing from everything else in this program, but it is the pattern we see. A follow-up quiz two weeks later would meet a field already back in territory.
A fair objection: isn't this just gamified revision?
Some kickoff owners worry that a game during the event distracts from the sessions, or that it rewards speed over understanding.
We see it the other way round. The sessions deliver the content once. The game shows, within hours, who absorbed what, and hands that back to the people running the breakouts. On speed, the one-minute format is short, but the metric that matters is not the score in any single challenge. It is whether the same person gets the same question right later. That is a verified correction within the assessment, gathered in fast, light sessions. One later right answer does not rule out a lucky guess, which is why we look at patterns across people and questions rather than single corrections.
There is also an honest limit. A kickoff game tells you what people know, not whether they will use it in the call. Knowledge is necessary, not sufficient. But a rep who holds the wrong mechanism will not fix it by practising objection handling on top of it.
What we would do differently next time
We would run a short diagnostic before the kickoff. Even two days of challenges on last year's commercial model and the core mechanism story would have shown the size of the strategy gap and the barrier misconception before the agenda was locked. The plenary could then spend ten minutes on the mechanism, with a clear before and after, instead of discovering the problem on day three.
We would hand the misconception list to franchise managers during the week, not at the end. 125 names with one specific wrong belief is a very workable coaching brief. It fits into a ride-along or the first cycle meeting after the kickoff.
And we would plan reinforcement. Murre and Dros's 2015 replication of Ebbinghaus, a single-participant relearning experiment with nonsense syllables, shows that unrehearsed material fades fast and that spacing helps; after 31 days the savings were about 4%. It is not a measure of what reps forget about a molecule, but the direction is clear enough. A kickoff that closes half its gaps in six days still needs spaced follow-ups across the first quarter to keep them closed.
Where Atrivity fits
This kickoff ran on Atrivity: four simultaneous games, battles in a shared window, Gap Fixing for each person's own mistakes and readiness by team and topic. The platform did the measuring. The decisions, what to put on stage, what to leave to the game and what to hand to managers, were made by the client using the data. The question to take to your next kickoff planning meeting: which part of your agenda do you expect the field to get wrong, and how would you know by Wednesday?