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HYBRID SIMULATION: COMBINING
MULTI-METHOD SIMULATION FOR
EDUCATIONAL INTERVENTIONS AND
RESEARCH PROTOCOLS

 Presenters/Authors: Eric B. Bauman, Parvati
 Dev, Katie White, Wm. LeRoy Heinrichs, Gerald
 Stapleton, Cindy Foronda, and Phil Bertulfo



          IMSH 2013 | Orlando, Florida
Disclosure(s)
       Eric B. Bauman, PhD, RN, Paramedic
1
         Associate Director – Center for Simulation
          Excellence, DeVry, Inc. Healthcare Group
         Division Chief, EMS – Blooming Grove Fire Dept.

         Managing Member – Clinical Playground, LLC

         Springer Publishing – Author

         Adjunct Faculty – CAE Healthcare

         Relevant Stock – CAE, Zynga, GE
Disclosure(s)
       Cindy Foronda, PhD, RN
1       Assistant Professor
           University of Miami – School of Nursing & Health Studies
           A portion of this project was supported by funds from the
            Division of Nursing (DN), Bureau of Health Professions
            (BHPr), Health Resources and Services Administration
            (HRSA), Department of Health and Human Services
            (DHHS) under grant number D11HP19238, Nurse
            Education Practice and Retention, award amount of
            $721,912. The information or content and conclusions are
            those of the authors and should not be construed as the
            official position or policy of, nor should any official
            endorsement be inferred by, the DN, BHPr, HRSA, DHHS,
            or the US Government.
Disclosure(s)
       Gerald Stapleton, MS
1       Director of Distance Education
         University of Illinois
           School   of Medicine, Department of Medical Education
                Director – Distance Education


       Katie White, MD
        Clinical Assistant Professor – Internal Medicine
         University of Iowa
           Carver College of Medicine
           University of Iowa Healthcare
Disclosure(s)
       Parvati Dev, PhD
1
         President    and CEO – Innovation in Learning, Inc.
             CliniSpaceTM

       Wm. LeRoy Heinrichs, MD, PhD
         Co-Founder      and Executive Medical Director
             CliniSpaceTM

       Phil Bertulfo
           Associate Director – Distance Education
             University of Illinois, School of Medicine, Department of
              Medical Education
Learning Objectives
    1.   Learners will be introduced to terminology found in the game-
         based learning movement
6
    2.   Learners will be introduced to pedagogy that supports learning
         occurring in game-based and virtual environments
    3.   Learners will be introduced to and immersed into virtual learning
         environment
    4.   Learners will be guided through storyboarding educational
         experiences occurring in virtual environments
    5.   Learners will experience a hybrid simulation - combining multi-
         method simulation
Overview of Main Topics

       Game-Based and Virtual Environment
7
        Terminology
       Game-Based and Virtual Environment
        Pedagogy
       Immersion into Virtual Environments
       Storyboarding the Educational Experience
       Multi-Method Simulation
Terminology
       Game-Based Learning:
8
        Learning that provides a system of rewards for
        accomplishing specific tasks and objectives. Many
        game-based learning environments also provide a
        narrative to engage learners.
         Digital Game-based platforms use virtual
          environments to stage the game.
         Not all virtual reality environments are game-based
Terminology
       Virtual World:
        an environment that hosts a synchronous digital environment,
9       persistent network of people, represented as avatars,
        facilitated by networked computers (Bell, 2008).

       Game-Based Environment:
        An environment that provides a narrative and system of
        rewards for accomplishing specific tasks and objectives.
         Game-based platforms use virtual environments to stage
          the game.
         Not all virtual reality environments are game-based
          (Bauman, 2010, p.186).
Terminology
        Avatar or Player Character:
         The term avatar is originally from Greek mythology. The gods would
10
         take the shape of mortals in the form of human avatars to walk the
         earth. In video games and virtual environments, an avatar
         transcends two planes of existence: the real world and the in-world
         or virtual world. The avatar or player-character is the embodiment of
         the person playing the game. Players live in and interact with the
         virtual or game-based environment through their avatars. (Bauman
         2010 p.183).


        Non-Player Character:
         In-world agents of and from the game or virtual environment. NPCs
         are a function of programming and do not exist outside of the game
         or virtual environment. NPCs are in-world characters that the
         players’ (learners’) avatars interact with. This term originated from
         paper-based role- playing games like Dungeons and Dragons. It is a
         narrower definition than bot; however, there is often a blurring
         between the definitions of bot and NPC (Bauman, 2010 p. 186)
Terminology
        VOIP (Voice Over Internet Protocol)
         Voice Over Internet Protocol. VOIP is most commonly known for
         applications like Skype or Magic Jack, where it is used in place of a
11
         traditional telephone line. VOIP is also used in a number of other
         applications including web-based game or virtual world environments.

        Text-Based Communication Platform (i.e. in Second Life, Unity, Others)
         Text-Based Communication Platforms allow for written communication
         to occur via the internet and other communication tools. Short Message
         Service (SMS) is the most widely used data application used in the
         world (3.6B users). While most commonly used in the mobile phone
         industry, texting is an often found and used tool in web-based virtual
         worlds and game environments
Hybrid Simulation

        Virtual Sim               Real World Sim         Virtual Sim
12




  Successful Hybrid Simulation uses multiple modalities of simulation in a
complimentary way to meet facilitate a learning experience or facet research




      Real World Sim            Virtual Sim            Real World Sim
Pedagogy
        Experiential Learning (Kolb)
            Novice to Expert – Thinking-in-Action (Benner)
              The quality of the clinician’s decision making is influenced and
13
               improves over time based on previous experience within the
               profession

            Thinking-on-Action& Thinking-in-Action (Schön)
              Novices first learn to think on action, reflecting on their past
               decision-making process or experience.
              Later as students move toward proficiency and expertise they
               are able to think-in-action because they have a stable of
               experiences to draw on. The practitioner engages in a form of
               internal talk-back as an experience unfolds.
Pedagogy
    Situated Cognition
      Socially Situated Cognition (Gee)
                Learning and eventually practice takes place in an inherently social context. The how,
    14
                 why, perception of the learning space and eventual clinical space matters in terms of
                 outcome

            Designed Experience (Squire)
                Learning and evaluation take place as a function of performance

            Created Space/Environment (Bauman)
                An environment that has been specifically engineered to replicate an actual existing
                 environment, producing sufficient authenticity and environmental fidelity to allow for the
                 suspension of disbelief

            Ecology of Culturally Competent Design (Games and Bauman)
                Addresses the rigors and challenges of accurately situating culture within virtual
                 environments using a four-element model that emphasizes the importance of activities,
                 contexts, narratives, and characters
Introduction to CliniSpace

 15




http://youtu.be/9ki8FATgJzU
Introduction to OpenSim

16

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Hybrid Simulation (Part A)

  • 1. HYBRID SIMULATION: COMBINING MULTI-METHOD SIMULATION FOR EDUCATIONAL INTERVENTIONS AND RESEARCH PROTOCOLS Presenters/Authors: Eric B. Bauman, Parvati Dev, Katie White, Wm. LeRoy Heinrichs, Gerald Stapleton, Cindy Foronda, and Phil Bertulfo IMSH 2013 | Orlando, Florida
  • 2. Disclosure(s)  Eric B. Bauman, PhD, RN, Paramedic 1  Associate Director – Center for Simulation Excellence, DeVry, Inc. Healthcare Group  Division Chief, EMS – Blooming Grove Fire Dept.  Managing Member – Clinical Playground, LLC  Springer Publishing – Author  Adjunct Faculty – CAE Healthcare  Relevant Stock – CAE, Zynga, GE
  • 3. Disclosure(s)  Cindy Foronda, PhD, RN 1 Assistant Professor  University of Miami – School of Nursing & Health Studies  A portion of this project was supported by funds from the Division of Nursing (DN), Bureau of Health Professions (BHPr), Health Resources and Services Administration (HRSA), Department of Health and Human Services (DHHS) under grant number D11HP19238, Nurse Education Practice and Retention, award amount of $721,912. The information or content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any official endorsement be inferred by, the DN, BHPr, HRSA, DHHS, or the US Government.
  • 4. Disclosure(s)  Gerald Stapleton, MS 1 Director of Distance Education  University of Illinois  School of Medicine, Department of Medical Education  Director – Distance Education  Katie White, MD Clinical Assistant Professor – Internal Medicine  University of Iowa  Carver College of Medicine  University of Iowa Healthcare
  • 5. Disclosure(s)  Parvati Dev, PhD 1  President and CEO – Innovation in Learning, Inc.  CliniSpaceTM  Wm. LeRoy Heinrichs, MD, PhD  Co-Founder and Executive Medical Director  CliniSpaceTM  Phil Bertulfo  Associate Director – Distance Education  University of Illinois, School of Medicine, Department of Medical Education
  • 6. Learning Objectives 1. Learners will be introduced to terminology found in the game- based learning movement 6 2. Learners will be introduced to pedagogy that supports learning occurring in game-based and virtual environments 3. Learners will be introduced to and immersed into virtual learning environment 4. Learners will be guided through storyboarding educational experiences occurring in virtual environments 5. Learners will experience a hybrid simulation - combining multi- method simulation
  • 7. Overview of Main Topics  Game-Based and Virtual Environment 7 Terminology  Game-Based and Virtual Environment Pedagogy  Immersion into Virtual Environments  Storyboarding the Educational Experience  Multi-Method Simulation
  • 8. Terminology  Game-Based Learning: 8 Learning that provides a system of rewards for accomplishing specific tasks and objectives. Many game-based learning environments also provide a narrative to engage learners.  Digital Game-based platforms use virtual environments to stage the game.  Not all virtual reality environments are game-based
  • 9. Terminology  Virtual World: an environment that hosts a synchronous digital environment, 9 persistent network of people, represented as avatars, facilitated by networked computers (Bell, 2008).  Game-Based Environment: An environment that provides a narrative and system of rewards for accomplishing specific tasks and objectives.  Game-based platforms use virtual environments to stage the game.  Not all virtual reality environments are game-based (Bauman, 2010, p.186).
  • 10. Terminology  Avatar or Player Character: The term avatar is originally from Greek mythology. The gods would 10 take the shape of mortals in the form of human avatars to walk the earth. In video games and virtual environments, an avatar transcends two planes of existence: the real world and the in-world or virtual world. The avatar or player-character is the embodiment of the person playing the game. Players live in and interact with the virtual or game-based environment through their avatars. (Bauman 2010 p.183).  Non-Player Character: In-world agents of and from the game or virtual environment. NPCs are a function of programming and do not exist outside of the game or virtual environment. NPCs are in-world characters that the players’ (learners’) avatars interact with. This term originated from paper-based role- playing games like Dungeons and Dragons. It is a narrower definition than bot; however, there is often a blurring between the definitions of bot and NPC (Bauman, 2010 p. 186)
  • 11. Terminology  VOIP (Voice Over Internet Protocol) Voice Over Internet Protocol. VOIP is most commonly known for applications like Skype or Magic Jack, where it is used in place of a 11 traditional telephone line. VOIP is also used in a number of other applications including web-based game or virtual world environments.  Text-Based Communication Platform (i.e. in Second Life, Unity, Others) Text-Based Communication Platforms allow for written communication to occur via the internet and other communication tools. Short Message Service (SMS) is the most widely used data application used in the world (3.6B users). While most commonly used in the mobile phone industry, texting is an often found and used tool in web-based virtual worlds and game environments
  • 12. Hybrid Simulation Virtual Sim Real World Sim Virtual Sim 12 Successful Hybrid Simulation uses multiple modalities of simulation in a complimentary way to meet facilitate a learning experience or facet research Real World Sim Virtual Sim Real World Sim
  • 13. Pedagogy  Experiential Learning (Kolb)  Novice to Expert – Thinking-in-Action (Benner)  The quality of the clinician’s decision making is influenced and 13 improves over time based on previous experience within the profession  Thinking-on-Action& Thinking-in-Action (Schön)  Novices first learn to think on action, reflecting on their past decision-making process or experience.  Later as students move toward proficiency and expertise they are able to think-in-action because they have a stable of experiences to draw on. The practitioner engages in a form of internal talk-back as an experience unfolds.
  • 14. Pedagogy  Situated Cognition  Socially Situated Cognition (Gee)  Learning and eventually practice takes place in an inherently social context. The how, 14 why, perception of the learning space and eventual clinical space matters in terms of outcome  Designed Experience (Squire)  Learning and evaluation take place as a function of performance  Created Space/Environment (Bauman)  An environment that has been specifically engineered to replicate an actual existing environment, producing sufficient authenticity and environmental fidelity to allow for the suspension of disbelief  Ecology of Culturally Competent Design (Games and Bauman)  Addresses the rigors and challenges of accurately situating culture within virtual environments using a four-element model that emphasizes the importance of activities, contexts, narratives, and characters
  • 15. Introduction to CliniSpace 15 http://youtu.be/9ki8FATgJzU