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Virtual Maternity Unit in Second Life IRVW2011


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This presentation covers the creation and use of the University of Nottingham's Virtual Maternity Ward in Second Life. It was created by Colleen McCants, (artist, builder) and delivered at the Innovative Research in Virtual Worlds 2011 conference in Coventry in conjunction with Jenny Bailey (midwife) and Fay Cross (programmer). Jenny Bailey has recently been nominated for a Royal College of Midwives award for her work on the VMU.

In November 2009, the IS Learning Technology Section and the Academic Division of Midwifery at the University of Nottingham began construction on a Virtual Maternity Unit (VMU) on the University of Nottingham's web campus in Second Life. In the Summer of 2010, a small group of midwifery students and educator peers took part in the pilot, and in March 2011 it began to be used by first year midwifery students on a voluntary basis. The potential benefits of immersive learning and storytelling role-play in Second Life and other virtual environments are being explored by many healthcare educators, but the implementation of the physical and interactive design varies according to the learning objectives and collaborator skill sets. The VMU was not the first Higher Educational midwifery sim to be developed, as it was created in parallel with the Second Life Education New Zealand project, (SLENZ), which was further along on the development timeline.

Midwifery education traditionally relies on sharing information by narrative means, but students can find 'real life' role play situations awkward. The Virtual Maternity Unit enables students to immerse themselves, with a certain degree of anonymity, in the role of midwife, with the teacher in the role of a woman in labour. Through being involved in a narrative over which they have choices in care and support, the student midwives can draw on their first-year training and put it into a meaningful context, learning from mistakes and reviewing the scenario afterwards with the midwife-educator. Immersion is enabled by familiar equipment and facilities, and documentation is modeled on real paperwork and sample birth plans. The teacher is able to guide the scenario by controlling feedback such as temperature, blood pressure and stage of labour via the pregnant mother's HUD, (Heads Up Display). The timescale can also be compressed to encompass a normal series of birth events. Because midwifery entails duty of care over mother and baby, student midwives must learn to communicate well, respond appropriately and act decisively, ensuring the safety and well-being of all. The VMU provides a safe environment in which to practice doing so; one in which they can become accustomed to thinking on their feet, yet have freedom to explore and question. At present, the VMU is being used in midwife educator-led sessions, taking place several times weekly, with more sessions held on our Derby campus. Role-play in the VMU is considered a useful addition to training and experience on the real-life war

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Virtual Maternity Unit in Second Life IRVW2011

  1. 1. The Benefits of Cross-DisciplinaryCollaboration in Construction ofA Virtual Midwifery Simulation Colleen McCants Fay Cross Information Services Learning Technology Jenny Bailey School of Nursing, Midwifery and Physiotherapy 1
  2. 2. Virtual HealthcareThe potential benefits of immersive learning andstorytelling role-play in Second Life®, Open Sim,Open Wonderland and other VEs are beingexplored by many healthcare educators ‘Communication Skills Learning within Immersive Virtual Environments’, Faculty of Health, Birmingham City University, is designed to improve nursing students’ communication, team working and delegation skills ‘information on health and wellness issues including diseases, surgical procedures, drug effects and interactions, support services, and new research.’ Imperial College London:‘a public engagement research project spread over 8 islands’ 2
  3. 3. Virtual MidwiferyThe University of Nottingham’s VMU wasnot the first HE virtual midwifery sim tobe developed, as it was created in parallelwith the Second Life Education NewZealand project, (SLENZ), which wasfurther along the development timeline Implementation of physical and interactive design varies according to the learning objectives and collaborator skill-sets 3
  4. 4. Timeline• May 2009 - placeholder shell of Maternity building on University of Nottinghams ‘web campus’ in Second Academic Life Division of Midwifery• May, August 2009 - Ward visits photos, local maternity hospital• November 2009 – further construction on Virtual Maternity Unit (VMU)• February 2010 - dev. deadline, testing• Summer of 2010 - pilot with small group of midwifery students and educator peers IS Learning• March 2011 - use by first year Technology midwifery students on a voluntary Section basis, and in lecture demonstrations 4
  5. 5. Traditional Student Experience• In Midwifery education relies on sharing information by narrative means• Students can find real life role play situations awkward.• Students do not always have time and opportunity to ask questions on the ward 5
  6. 6. Immersive Storytelling • Allows a degree of anonymity • Students inhabit the role of a midwife, with the teacher in the role of a woman in labour • Together they create their own narrative, with choices in care and support reflecting RL practice• Provides ‘safe’ environment and meaningful context in which to learn from mistakes and review
  7. 7. Making their Own StoryThrough involvement in a narrative,student midwives … make choices incare and support.They can make mistakes … and learnfrom them, ….drawing from their 1st year training….in a meaningful context.Reviewing the scenario afterwardswith the midwife-educator… putsknowledge into perspective. 7
  8. 8. Guiding the NarrativeThe midwife educator, as birth mother, can use the tutor HUD to control: • Duration of labour • Birth parameters • Delivery • Post-delivery readings 8
  9. 9. Tests and ObservationsStudents can move anduse equipment from theadjacent Store Room,… or ‘touch’ target areason mother or baby toobtain readings. 9
  10. 10. Immediate FeedbackThe tutor can tailorresults to each scenario. Students are gently reminded if they forget… …or attempt the impossible 10
  11. 11. EnvironmentImmersion is enabled by familiarequipment and facilities, anddocumentation is modeled on realpaperwork and sample birth plans. 11
  12. 12. Safety and Clinical SkillsBecause midwifery entails a duty of care for motherand baby, student midwives must learn to:• communicate well• respond appropriately• act decisively• ensure the safety and well-being of all The VMU provides a safe environment for emulating clinical practice, so students can: • get used to thinking on their feet • have the freedom to explore • ask questions without disruption 12
  13. 13. Development of the Unit Builder, programmer and developer worked closely together to test workability of the equipment and role- play interactions before giving students access to midwife avatars and HUDs, although the build remained open-access… 13
  14. 14. Where to begin? 14
  15. 15. Branching possibilities 15
  16. 16. Synthesis of skills Research/comparison assumption of simultaneous Security: birth mother w/ other immersive avatar enabled to move healthcare use dictated 20+ metres between objects vs. student environments midwives moving objects meeting areas by clicking/codelimiting interaction excluding student midwifeto birth mother scenarios: avatars pre-and student recreating the familiar: optimal vs. established, withmidwife- no birthpartner • equipment/facilities practical clothing in their • care options inventories • paperwork textures transparent abdomen for from the mother and moving birth aromatherapy ward animations ruled out garden bespoke building design: Natural- Avatar ideal, clean and skins Making, testing looking serene babies animations builder 16
  17. 17. Additional tweaks Additional signs and floor directions have been added to enhance navigation and understanding 17
  18. 18. Additional tweaksAs per the original vision, anaromatherapy garden withnote cards has been created 18
  19. 19. Additional tweaksA self-study studentand visitor area 19
  20. 20. Additional tweaks A full walkway around the buildingView from the front Rear view 20
  21. 21. Challenges to Development• Lack of experience with design for healthcare• Difficulties with shared permissions in Second Life• Steep learning curve for making baby sculpties• Constrained timescale for programmer• Lack of user ability of the midwife teacher, which did improve over time• Bandwidth affects usability. 21
  22. 22. Lessons Learned • Limited permissions and multiple builder/programmer avatars make the VMU difficult to package, share or migrate out to Open Sim • Building access to the SL VMU into the curriculum would give students greater incentive to use it • Should buildings ‘rez’ and appear only as needed? 22
  23. 23. Testing Phase• In order to gauge usability and impact of the prototype, two 2nd year midwifery students agreed to play the part of midwives as the midwife teacher played the birth-mother.• Testing also undertaken with the midwife teacher and a nurse teacher.• The students quickly and easily picked up the skills needed to interact in the role play situation• The novelty of the environment as a means of learning was highly rated. 23
  24. 24. Post - Pilot PhaseSince early 2010, the project has been further developed to includemore birth positions, and creation of more life-like sculptie babies. 24
  25. 25. How is it being used? At present, use of the Virtual Maternity Unit is being is being explored with midwife educator-led sessions taking place, and more sessions on other campuses planned. A weekly second life club has started Students are encouraged to visit on their own, as well, and explore the environment and learning materials available.University Open daysare promoting the unitto potential students. The simulation has proven very useful for demonstrations during teaching. 25
  26. 26. How many of our students will use it?Impact:• 1st and 2nd year Midwifery students: voluntary and in-class demos• Potential use by Medical students to prepare for Maternity Unit experience requirement (+200/yr)• Potential use by nursing students to prepare for Maternity Unit experience requirement (+200/yr)• In an ideal world, new course components could entail time for learning in immersive environments. It is hoped that the Virtual Maternity Unit can be one of many healthcare simulations to which midwifery students may be given access and credit for learning within these environments, all within a structured curriculum. 26
  27. 27. What Determines Success? To date, there has been considerable interest in wider uptake of the Virtual Maternity Unit, both within the Division of Nursing, from the Medical School and from other midwifery and healthcare educators, and we are exploring further uses. • interest from Medical Students required to fulfill a midwifery unit requirement • 2011 Lord Dearing Award for Jenny Bailey • Professional interest: Royal College of Midwives Short listed for 2 RCM national awards excellence in midwifery education innovation in midwifery press release 27
  28. 28. Explore Currently, there isn’t a bespoke website for the project, but you may find updates posted here. Feel free to visit the island in Second life, or watch short machinima of the project whilst it was in progress:
  29. 29. Contact Us The Innovation TeamInformation Services Learning Technology Section Academic division of MidwiferySchool of Nursing, Midwifery and Physiotherapy University of Nottingham 29