This document summarizes the implementation of a virtual patient system using Second Life at the University of East London. It discusses using Second Life to provide realistic clinical experiences for healthcare students in physiotherapy and herbal medicine programs. The challenges of manageability and sustainability are addressed through a web-based editor to add and modify patient case data and reusable components. Initial feedback from students was positive, but more case development is needed. Expanding the system to other programs like podiatry is also discussed.

1. Rose Heaney Learning Technology Advisor Jo Dawes Senior Lecturer, Physiotherapy Implementing a Manageable Second Life ® Virtual Patient system B School of Health and Bioscience University of East London

2. Overview of presentation UEL Context Why Second Life? The Virtual Patient Manageability Evaluation Future Conclusions R

3. Context Healthcare programmes at UEL Podiatry Physiotherapy Herbal Medicine Acupuncture R

4. Herbal Medicine Plant and medical sciences Historically the right to primary diagnosis Blended delivery on campus for seminars & clinical training (500 hours) in Herbal Medicine clinic home learning with on-line support for academic component Students mostly p/t, mature, female, geographically dispersed Staff mixture of p/t practitioners and UEL bioscience staff R

5. Physiotherapy Professional programme entitling graduates to become HPC registered Chartered Physiotherapists. Combination of campus based and practice based learning. Case based learning part of curriculum Cases presented as paper exercises. J

6. Common Issues Difficult to recreate real life clinical experiences for students to learn from in the class room setting Limited access to: Real patients Diverse range of conditions Shortage of respiratory based clinical placements for the undergraduates Safety – adequate preparation for meeting critically ill patients J

7. Possible Solutions lifelike simulations PBL scenarios interactive J

8. Second Life ® 3D virtual world created by its residents who interact through avatars Virtual World (VW) definition: A computer-generated display that allows or compels the user (or users) to have a sense of being present in an environment other than the one they are actually in, and to interact with that environment (Schroeder 1996, 2008) R

9. low confidence resistant take it enthusiastic high confidence leave it Technology spectrum Manageability – a key challenge R VLE SL Students

10. Inspiration for Project J UEL Virtual Lab Imperial Respiratory Ward St. George’s paramedic scenarios Heart Murmur Sim

11. SL Polyclinic UEL HABitat island Virtual Lab Crime Scene House Social space Cash injection to develop along with other facilities (external developer) Now maintained in-house R

12. J http://vfc.uelconnect.org.uk/users/choong/output/5ae3a0a12.flv

13. Manageability (& Sustainability) Same virtual patient model for physiotherapy and herbal medicine (and any other area e.g. podiatry) Web based editor (connected to a database) where staff can add & modify textual case data Reusable generic components – equipment and ward layouts, patient types, images, multimedia resources R

14. Phase 1 Manageability Using simple web editor academic can: add patient dialogue (trigger words & responses) textual info for all items: Chart Notes Test results Xray notes etc. add / maintain quizzes (including images) http://www.uelconnect.org.uk/2ndlife/ R

15. Phase 2 Manageability Academics could learn to do SL side work: Connecting media to hotspots on patient Manipulating patient appearance and bay layout using predefined patient sets in inventory Building & scripting will remain the preserve of specialist but once infrastructure and library of reusable resources in place the need for this is minimised R

16. Student / staff experience - Herbal 11 in pilot (all levels), but others have also used it Enthusiastic in the main Surveys during orientation + online discussion forum, reflective journals, focus groups Need more cases ‘ Conversation’ with patient problematic Technical barriers on home PCs Staff – case development is not trivial R

17. Where next – Herbal? More cases …differentiation Case building by experienced students A more holistic learning environment (distance learners): Dispensary Herb garden Tutorials Staff ‘office hours’ Social spaces R

18. Student / Staff experience - Physio Early phase of a qualitative study: to consider usability and acceptability 19 students volunteered to try SL out. Anecdote post orientation - enthusiasm and eagerness Data collection: semi-structured interviews with external researcher and “contextual analysis” of usability J

19. Where next - Physio? This depends on outcome of study, but… SL could become part of module teaching Use for preparation for clinical placement Use for revision Case building could be used as a learning tool for more senior students J

20. However we need to ..... Build a library of cases Develop patient dialogue “ Admit” different patients to our clinic depending on cohort

21. Where next – more disciplines? Podiatry in pipeline Visits by students of other institutions Collaborative ventures with other institutions Inter disciplinary activities e.g. sputum sample going to lab Prospective students J

22. Conclusions Qualified success Manageability and sustainability key to future developments Challenges cannot be ignored Collaborative potential Internally – shared experience of staff and students from different disciplines Externally with other institutions R & J

23. Thanks Contact details [email_address] SL: Justina Dotterkelch [email_address] SL: Maisy Carter