Before I proceed I would like to respectfully acknowledge the Ngunnawal people, the past and present traditional owners of the land. It is a privilege to be standing on Ngunnawal Land.Hi, my name is Penny Neuendorf; firstly I would like to thank the Australian Flexible Learning Framework for inviting me to speak today. The “Virtual Worlds for Health Education” project is funded by COGA through the Training Skills Needs in the Region initiative and forms the basis of this presentation today.
Today I am going to talk the pedagogical approach that CIT has taken in developing teaching and learning activities in a virtual environment. Three level approach CLICKScaffolding (constructionivism) CLICKSituated learning (Legitimate peripheral participation) CLICKDebriefing (Cognitive)
The best known virtual environment is Second Life®. People use an avatar (digital representation) to move and communication in a communal space online. Ohio University has developed a Second Life® campus for students to access course materials and the university community.CIT didn’t fall into the usual virtual world trap that is to have the technology and find something to apply it too. CIT using the “Virtual World in Health Education” project identified virtual worlds as a potential solution to two current issues within the Health and Community service areas.
The first issue is a shortage of clinical placements for the Allied Health Assistants students. 200 hours of clinical placements are an essential part of their development training them to be an effective member of a workplace. As you could image the logistical issues that this can cause and the load it puts on the professional in hospitals, aged care facilities and rehabilitation centres who are required to supervise the students.
The second issue is broad and concerns the whole health care and community service areas. Studies have indicated the one of the primary concerns of health professional is developing effective communication skills in the work place to ensure patient safety. This is not only between members of the same profession but across a range of professionals.
Keeping both these issues in mind, it was decided that a virtual environment would be the ideal solution to teach and practice communication skills and eventually take some of the load off the practicum placement dilemma.The benefits of using a virtual world environment to train and assess students range from theThe flexibility of the virtual world being remotely accessible and available 24 hours a dayIt can preserve the anonymity of the participants, this allows students to practice and make mistakes without the risk of loosing face. It is also an immersive environment; a study by the Society of Neuroscience has shown that when a person is thinking about their avatar the activity on an MRI is the same as when they are thinking about themselves. It is recordable and these recordings can be used for debriefing sessions or as resourcesThe environment is easily changed It allows simulation (scenarios) and a range of pedagogical approaches can be usedIt is also environmental friendly, as it can be accessed remotely it will save on travel costs, reduce paper CIT applied for and received a grant of $320,000 from Targeting Training Skills Needs in the Regions Initiative by COAG, to develop a virtual world environment for teaching and learning in the health area that can be accessed by students in rural and remote areas.A project reference group was formed with representative from ACT Health, CIT, Southern Area Health Services, Infection Control Society of the ACT, Charles Darwin University and GippsTAFE. It was on the advice of group that scenario role-plays were to be the focus of the project.CIT plans to embed the virtual worlds into a blended delivery of communication skills competencies. This means the teaching or learning of the skills will either take place in the classroom or online. Then the practicing and development will take place in the virtual environment and maybe even the assessment.
We took a scaffolded approach was taken to building scenarios in the virtual environment.
As with the nature of scaffolding at CIT we use a three levels approach.
The first layer is to support the learners in the virtual environment. Teaching the participants how to move and function in a virtual environment. After they have the basic moves down pat, we add a learning activity to develop their skills further. As you can see in the video in the early stages having students work in pairs allows them to help each other, using team work to problem solve. This also helps the students who are afraid of the technology to feel comfortable and safe.
In this case have picked a tunnel vision activity, where the screen goes black expect for a little hole in the centre. The participants now have to find objects in the house while in tunnel vision mode. Of course people working in health or community service areas, could both have contact with client with tunnel vision? Most participants have been able to complete this activity and do get very frustrated with only seeing in a small area. The aim of this activity is to allow the student to develop an understanding of the condition and promotes empathy.
The second layer is a simple one to one scenario; it involves two roles, a youth worker and an angry client. As you can imagine most people don’t have any problems playing the angry client. Students / participants are given their roles prior to the session, so they have time to go away and research the characteristics of that role and the communication skills that are needed. In this case the person playing the angry client might want to find out what sort of issues a family will have when their income is suddenly cut off The person playing the youth worker might want to explore what options they can offer the angry client (food vouchers, maybe cash from a charity) and how to deal with difficult people and conflict resolution skills. I think the best comment I heard after some participants completed the scenario was from a teacher who stated, this is just like being in the workplace, and it goes to show angry clients are everywhere!!!Participants can be support by the teacher in a few ways.The teacher can play one of the rolesThe teacher can be invisible an assist as requiredThe teacher can run the scenario in a computer lab, with all the students together, for the first time to hand hold participants as required Debriefing sessions at the end of the sessions to iron out any problemsOur aim was to make the scenarios and the learning environment as authentic as possible and to encourage “ownership” by the learner. Our aim was to make the scenarios and the learning environment as authentic as possible to encourage “ownership” by the learner. By keeping the role information brief it has allowed students to improvise and develop their roles, this gives them more ownership and connection with the roles they play. We found with heavily scripted roles that the students were more likely to read off the sheet what their problems were rather than act them out.Being in a virtual environment we are also using learner aided scaffolding with “just in time” information or teacher/ student moments. This means that if a teacher sees that a student is faltering or needs assistance, the scenario role play can pause while relevant information is given and then restarted. Of course, this can also work the other way when the student calls a pause to the scenario for assistance.
The third level of scaffolding is where the support starts to be removed, the participant gets the opportunity to “show off” their skills and knowledge, in a more complex multiplayer scenario. For these, we have been using two different scenarios. The first one is for Allied Health Assistant Students.Student works with a physiotherapist or occupational therapist to help a client suffering with MS to find some energy saving techniques when working in the kitchen.Now this doesn’t sound very complicated but as is the nature of MS she is feeling very well on the day and just wants them to hurry up, this of course tests not only their communication skills but also their patients. With the different roles in the scenario, students will have to research communication skills, MS, energy saving techniques and typical behaviours of all of the roles.
The second multiplayer scenario we have been using is for Community Services students and it is around an Anger management workshop. One of the students has to facilitate the session while the other have to play the different people attending the workshop. The roles cover a range of people with wide and varied conditions from drug addicts, ADH, domestic violence, angry in the workplace to homeless alcoholics; hopefully the students have to research into typical behaviour of these roles and the communication skills they will need to run a smooth session. The feedback from the multiplayer scenario is varied but most comment that they get more immersed with the larger number of participants. They also find with a larger number of avatars that they can’t keep track of who is who which increased how immersed the participants felt.Next we move on to situated learning and a “community of practice”.
Core ideas of the scenario came out of Instructional Design Workshops, a variety of people from relevant areas were invited to brainstorm ideas.Teachers from the relevant qualification have helped to design the virtual environment and the objects that they contain. This was to make the environment as similar to their potential working environments as possible (an authentic workplace). We also sort input from Indigenous Advisors about the look and feel of the environment.
A lot of the objects in the rehabilitation centre have been designed from photographs taken at CIT Rehab and Fitness centre
and from Therapy ACT
To make an effective community of practice, all participants need to have a shared goal, to develop knowledge and skills for a set outcome. All participants come to the virtual environment with their own sets of skills and knowledge (ranging from novices to professionals) and as a collective they use the range of skills and knowledge to achieve an outcome. The multiplayer scenario that we have been using with the Allied Health Assistant students allows for a range of health professionals to be involved. Having the students take on the role of the health professional shows that many of them are able to take on the persona of the professional. The aim is to have professionals from all over the country be able to participant and work in the virtual environment with the students to eventually reduce the amount of practicum hours that the students need to do. Another joint activity that has been designed to capture inter professional communication between a case management team, involving Doctors, senior nursing staff, registered nurses and enrolled nurses, and community practice nurses. This meeting has been developed around an ethical issue and patient confidentiality. This is a very complex scenario and will need to broken down into chunks over the semester building up to playing the whole scenario. In this case the practice (part of the communities of practice) is the bringing together a group of practitioners (who are at different stages in their development, skills and knowledge), who are able to share ideas and resources. The practice is evident in the experiences, stories and tools that are used to help achieve an outcome ergo a shared practice.This situated learning also encourages serendipitous learning, meaning that while the students are in a world playing in a scenario they will learn and develop skills without knowing it.This is where the debriefing stage is important to highlight these skills and bring them to the students attention.
The final cog in our pedagogical gear is debriefing
The briefing part, prior to in world activities, is the building of the underpinning knowledge; this can happen in a classroom situation, online or by a distance model. The preparation brief is where the students are given their role in the scenarios; the student is then required to research into the communication skill and the characteristics of their role so they will be able to act appropriately in the role play, as I mentioned earlier with the MS and angry management scenarios.The post scenario debrief is the most important part of the learning. This is where either the teacher or the students via peer review critically reflected on the activity and the knowledge and skills that were displayed.This debriefing process will allow the teacher to guide the students through the experiences by focusing on their actions, thoughts, values and beliefs and moving to how this experience and the skills they have developed will change their behaviour and beliefs when dealing with similar situations in the future. An example of the Angry Client conflict resolution scenario would be: John it was great how you de-escalated the situation with the angry client when you paraphrased and acknowledged his feelings. Did you notice that when you got distracted and didn’t look like you were listening that his angry escalated and it took you a while to be able to calm him down? John what a great idea to offer him a cup of tea while he waits it was great that you didn’t add the gin like he suggested……John what do you think you would do differently if you played the same scenario again?
Currently we are in the trialling and testing phase of the project. We are running the three activities with a range of student groups and with teaching staff. The information we receive from this trial will help form a framework form developing scenario role-plays to be performed in a virtual environment in the futureOur plans for the future include more experiences for the students like the tunnel vision activity.
The developers are working on a left sided stroke avatar, that will move to the right when you try and walk forward, the vision will also be out of focus on the one side, the audio will also come out slight garbled, making it hard for other people to understand the speech.
For the community service sector we are also working on an avatar that is on ecstasy. The avatar will move in a dance like way when ever it is moved, it will have trouble speaking until after they find and suck a lollypop. The screen will be brighter and the sound louder. These two experiences will be solo experience that the students can play in to develop their virtual environment skills.
The developers are also working on scripting and angry client “bot”.This will be an computer driven avatar that will offer different programmed responses to key words that the students use. This will also add another layer to the scaffolded approach by giving the students to opportunity to pop into the world and practice dealing with an angry client prior to playing it wills another live person.
This shows one of the great advantages of virtual worlds, it gives students time to practice and develop their skills in a safe, non-treating, anonymous environment.
In conclusion, while this approach to virtual environments is not totally new, Gipps TAFE Verbl project (2008) focused on the risky situations virtual world, we have added to this project/research by using scaffolding to engage and develop the students. We consciously chose not to use an existing commercial virtual environment like Second Life® because we wanted to isolate the students and keep the purity of the scenarios by eliminating the incidental interactions with other external avatars. By using a three cogged layered design (Scaffolding, situated learning and debriefing) we are able to create an immersive workplace were students, professionals and teachers can interact in a structured scenario with a specific outcomes from multiple locations.
One that allows all participants to exit the process with more skills and knowledge than when they entered. ANY QUESTIONS
ACT Elearning Showcase Penny Neuendorf
Virtual Worlds in Health applying pedagogy virtually<br />8th December 2009<br />Presentation by Penny Neuendorf<br />
4.1 Errors due to communication failure<br />3.7 most errors related to human error<br />3.5 Team members commuicate well <br />Patient Safety Survey Report(mean score on a scale of 1 (strongly disagree) to 5 (strongly agree) across 4,826 nurses/respondents)<br />Source: Nursing2006, May 2006; H&HN research, 2005<br />
Dr. Zachary Smith (Jonathan Harris ) and Will Robinson (Billy Mumy) and the Robot from Lost in Space<br />http://images.google.com/imgres?imgurl=http://www.clevelandseniors.com/images/remember/robot/lost-space-robot-will.jpg&imgrefurl=http://www.clevelandseniors.com/forever/remember-robot.htm&usg=__0wpg34FDNhtNf_EbLgTjgzElXic=&h=449&w=400&sz=35&hl=en&start=5&um=1&tbnid=OIVM62zZ-6_iGM:&tbnh=127&tbnw=113&prev=/images%3Fq%3Drobot%2Bfrom%2Blost%2Bin%2Bspace%26hl%3Den%26rls%3Dcom.microsoft:*%26um%3D1<br />