Valerie Ness, Dr. Jacqueline McCallum, Theresa Price, Andy Whiteford School of Nursing, Midwifery & Community Health September 2009 The student nurse’s experience of using a virtual learning environment (Second Life) to receive simulation education

The Results The team and avatars

Need to teach decision-making skills in nursing Clinical simulation laboratory stretched to capacity Glasgow Caledonian University bought an island on Second Life Dedicated support team for Second Life Background

Need to teach decision-making skills in nursing

Clinical simulation laboratory stretched to capacity

Glasgow Caledonian University bought an island on Second Life

Dedicated support team for Second Life

Research Questions 1.To progress students beyond using Second Life for social networking and explore their experience of this learning environment. 2. To explore the use of Second Life to develop Non-Technical skills in nursing such as decision-making. 3. To achieve learning outcomes that are meaningful, challenging and easily replicated within the environment of Second Life. 4. To identify principles of governance that would make it feasible to use the environment of Second Life within formal educational programmes in nursing. The Study

Research Questions

1.To progress students beyond using Second Life for social networking and explore their experience of this learning environment.

2. To explore the use of Second Life to develop Non-Technical skills in nursing such as decision-making.

3. To achieve learning outcomes that are meaningful, challenging and easily replicated within the environment of Second Life.

4. To identify principles of governance that would make it feasible to use the environment of Second Life within formal educational programmes in nursing.

Caledonian University Saltire Centre created on Second Life university island

Inside the Saltire centre

The real CSL - add photo from my desktop at work The real clinical simulation laboratory

The real CSL - add photo from my desktop at work

The virtual clinical simulation laboratory on Second Life

Action Research Ethical approval gained from School ethics committee Access granted from the Dean, programme leader and module leader 350 students invited to participate 12 replied and were given information sheet 6 consented to the study and attended training 5 completed the study (1 withdrew) 3 attended the focus group Methodology

Action Research

Ethical approval gained from School ethics committee

Access granted from the Dean, programme leader and module leader

350 students invited to participate

12 replied and were given information sheet

6 consented to the study and attended training

5 completed the study (1 withdrew)

3 attended the focus group

Qualitative Data analysis exploring student’s views Focus group interviews approx 2 months after the simulation at the end of their clinical placement Transcribed by one researcher Analysed using Dieklemann finding themes Methodology

Qualitative Data analysis exploring student’s views

Focus group interviews approx 2 months after the simulation at the end of their clinical placement

Transcribed by one researcher

Analysed using Dieklemann finding themes

The patients May Colin Willie Laura Anne Precilla

May

Colin

Willie

Laura

Anne

Precilla

Themes that emerged: The importance of previous experience of gaming and/or decision-making The importance of realism and communication The use of Second Life as a tool to involve other students and qualified staff The importance of feedback The introduction of decision-making and Second Life as a concept earlier on in the programme. The Results

Themes that emerged:

The importance of previous experience of gaming and/or decision-making

The importance of realism and communication

The use of Second Life as a tool to involve other students and qualified staff

The importance of feedback

The introduction of decision-making and Second Life as a concept earlier on in the programme.

Dependent on previous experience of gaming and decision-making Accessibility (via VLE) would allow student to practice with Second Life Use other clinical areas (e.g. theatre recovery) - experience areas they haven’t been to or need practice in. Introducing it earlier in the programme Have training based on a needs assessment The Results: 1. Previous experience “ If you find out who’s actually got experience of using that kind of technology and then like say suit training to people’s needs”

Dependent on previous experience of gaming and decision-making

Accessibility (via VLE) would allow student to practice with Second Life

Use other clinical areas (e.g. theatre recovery) - experience areas they haven’t been to or need practice in.

Introducing it earlier in the programme

Have training based on a needs assessment

The Results: 2. Realism and communication “ It was actually quite like the ward I was on so it prepared me a lot.” “ You’ve got so much running through your mind at that point about what you need to do and delegate, you just don’t think “it’s just the lecturers playing with me in the other room”, so you just get on with it as if it was a real scenario.” “ I think there was an aspect of it that was so unreal that I couldn’t take it seriously… I felt there was someone else controlling you…an element of Big Brother about it”

Headsets/microphones The Results: Realism (cont) “ on a ward you’re using different senses and I felt that couldn’t be encompassed in the virtual reality of it” “ there’s all the non-verbal communication that you can’t encompass in that kind of thing….just holding someone’s hand…” “ it would cut down on the biz on screen….and I think it would definitely have benefited from using sound cause these are the senses that you use. You can be doing one thing but you are actually listening”.

Headsets/microphones

More students at the same time to allow discussion or using experienced students as patients Other staff (MDT) on screen Using qualified staff as patients/staff The Results: 3. Role of other students/qualified staff “ yeah I think there has to be scope to include it so that it’s beneficial to both sides as a teaching and a learning experience”

More students at the same time to allow discussion or using experienced students as patients

Other staff (MDT) on screen

Using qualified staff as patients/staff

Feedback – written and verbal The Results: 4. Feedback “ yeah I think it helped a lot with confidence of just knowing that I’m making the right decisions but maybe that came after when we were discussing it again”.

Feedback – written and verbal

Difficult to recount previous experience (prior to their management placement) More visible in one-to-one situations e.g. theatre recovery Would like it introduced earlier in programme The Results: 5. Decision-making “ we don’t just make decisions in third year and we don’t just make them under stress and I think maybe we need to be introduced to the idea earlier on and know that you’re actually doing it, you might not realise you’re doing it….building confidence in decision-making could maybe start earlier on….”

Difficult to recount previous experience (prior to their management placement)

More visible in one-to-one situations e.g. theatre recovery

Would like it introduced earlier in programme

Conclusions? Advantages - safe, easy to use, prepared them, practical and some found if realistic, discussion tool Disadvantages - too many words on screen/typing, unrealistic (can’t use all senses, non-verbal communication, how you say things), relying on telling other nurse what to do - can’t actually do things Questions we still have: Should we use Second Life to teach decision-making? Does it teach the appropriate skills? Is it feasible in a large programme? The Discussion

Conclusions?

Advantages - safe, easy to use, prepared them, practical and some found if realistic, discussion tool

Disadvantages - too many words on screen/typing, unrealistic (can’t use all senses, non-verbal communication, how you say things), relying on telling other nurse what to do - can’t actually do things

Questions we still have:

Should we use Second Life to teach decision-making?

Does it teach the appropriate skills?

Is it feasible in a large programme?

Possible solutions/improvements to research further: Assess student’s previous experience - training needs The importance of making it more realistic Using it as a tool to involve other students and qualified staff The importance of feedback Introducing decision-making and/or Second Life as a concept earlier on in the programme The Discussion

Possible solutions/improvements to research further:

Assess student’s previous experience - training needs

The importance of making it more realistic

Using it as a tool to involve other students and qualified staff

The importance of feedback

Introducing decision-making and/or Second Life as a concept earlier on in the programme

get a good photo from second life for here. Questions

get a good photo from second life for here.