Sunday, October 17, 2010

Training Nurses Using Second Life

In my wanderings this weekend, I explored a Second Life sim operated by Glasgow Caledonian University (Glasgow Caledonian 103, 108, 23) after reading an academic article late last week about nursing simulation training conducted there. The study was a great example of the potential for virtual worlds to extend teaching beyond the boundaries of the real world, even involving complex medical training.

Exploring Glasgow Caledonian University's Sim in Second Life

This particular study was undertaken due to the lack of opportunities for nurses in training to experience decision-making exercises about patient care in real-life settings, due mainly to a lack of supervisory nurses to oversee students and keep patients safe.

The Caledonian study included 5 nurses who were exposed to a nursing simulation environment involving 6 virtual patients with a variety of ills.

The simulated patients ranged from May, an 88 year old woman with a urinary infection and senile dementia, to Colin, a 22 year old athlete who was in recovery after having just undergone knee surgery. Other virtual patients were suffering from acute pain, awaiting medical procedures, or awaiting the results of tests.

Once in-world, each nursing student was provided with a scenario before completing the simulation independently. Each was asked to assess the patients, prioritize their care, and discuss the basis for care decisions. To keep things interesting--and as realistic as possible--the simulated patients engaged in a variety of behaviors intended to test the student's skills, including May, the dementia patient, wandering away from the ward at one point without being detected.

Some students reported that the scenarios tested their knowledge and skills the same as if they were in a real-world environment. One student said that "even though it's a computer programme...the decisions I made are still the decisions I would have made if I was out on the ward." The students also made some critical errors during the simulation and were later able to reflect on their mistakes and what they would have done differently.

Not all of the participants agreed that the scenario was realistic enough to test their skills, though. Some said that the lack of audio cues and other information they would have had in a real setting would have lead them to make different decisions. Communication was also a barrier, in that students had to type to communicate, an obvious difference from real-world communication.

Nevertheless, this study pointed up a couple of important points. First, was that Second Life can offer institutions cost-effective ways to carry out virtual learning, even about a very complex practice such as nursing. The costs and complexities of carrying out this type of simulation training in real life (hiring actors, directing them, managing the logistics, etc.) was eliminated by using a virtual platform to conduct the training.

More importantly, the students' thinking was tested, which lead to some reflection and discussion about how they might have acted differently. Whether or not the simulation was a perfect recreation of a real world nursing ward seems to be less important than whether it's "good enough" to stimulate students to connect theory to practice, and then learn from any mistakes that result.

Another important point is that universities are still willing to experiment with Second Life as both a platform for virtual training and as an academic research environment. Second Life has taken some PR hits over the years, as I've noted in previous posts, and SL's reputation among the academic community is far from stellar, especially after the problems with Woodbury U. Studies like the one reviewed here, however, can go a long way toward correcting the negative impressions of virtual worlds as simply playgrounds for overgrown adolescents.

In reality, virtual worlds are a new frontier with almost limitless potential, but that also require patient, careful, and thorough exploration to realize the true benefits.


McCallum, J., Ness, V., & Price, T. (In press) Exploring nursing students' decision-making skills whilst in a Second Life clinical simulation laboratory. Nurse Education Today.

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