This document outlines a project using virtual worlds to provide flexible, interprofessional education (IPE) to students. It describes two training programs focused on serving homeless populations (ESHP) and those with Alzheimer's disease (AVIT). The training occurred in a virtual simulation environment built in Second Life. Students learned through roleplaying scenarios using a triad model with roles as provider, client, and observer. Evaluations found the training significantly improved students' self-efficacy in working with these populations. Lessons learned include customizing schedules, using external voice programs, and exploring new platforms to enhance non-verbal responses.

1. Re-visioning Interprofessional
Education in Virtual Worlds
Susan Toth-Cohen, Ph.D., OTR/L
Jefferson Center for Interprofessional Practice and Education (JCIPE)
Thomas Jefferson University, Philadelphia, USA
Anne C. Smith, M Ed.
Five Sparrows Counseling and Educational Services

2. Introduction: Interprofessional Education in
Virtual Worlds
• From their inception, virtual worlds have attracted
educators from many disciplines
• Benefits for networking and immersive experience have been
well documented
• While virtual world education has engaged multiple
disciplines to learn with, from, and about each other*
• Potential for innovation in interprofessional education (IPE)
has not been fully realized.
• We outline ways to re-vision IPE using a flexible learning
framework to develop, implement, and enhance virtual
world training programs.
BUT
*WHO definition of IPE

3. Introduction: Interprofessional Education in
Virtual Worlds
Presentation Outline
1. Introduction
2. Theoretical Model
3. Description of Project
4. Format of Training
5. Implementation
6. Lessons Learned
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4. Introduction: Interprofessional Education (IPE) in
Virtual Worlds
Key Affordances Relevant to IPE
• Participate with members of the interprofessional team, while
in geographically dispersed areas (Warbuton, 2009)
• Practice skills in a safe environment less hampered by fear of
making mistakes (Hansen, 2008)
• Enact simulations that would otherwise be physically or
ethically impossible to simulate in real life or too costly to
create (Walker & Rockinson-Szapkiw, 2009)
• The ability to create transformative experiences by enacting
simulations through an avatar within a social environment
(Edwards, 2012)

5. The Flexible Learning Model
The flexible learning model described by Casey and Wilson
(2005) stems from a movement in education toward greater
learner centeredness, control, and independence (Wanner &
Palmer, 2015)
The model is multi-dimensional and encompasses teaching and
learning at a distance; it also uses technology to enable new
ways that learning can take place (Gordon, 2014).
The main tenet of this model is learner control, by providing
options for learners (and developers) to customize learning
experiences to meet their needs.

6. Theoretical Model
Flexible Learning
1.Institution
Implementation
Pedagogy
Technology
fixed Time flexible
fixed Content flexible
fixed Entry Requirements flexible
fixed Instructional Approach & Resources flexible
fixed Delivery and Logistics flexible
(who can participate)
Derived from:
Collis & Moonen, 2012

7. Description of Project
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In this section we will describe the:
• Populations of focus
• Creation of the sim
• Flexible learning model application
• Triad model

8. Description of Project:
Populations of Focus
Enhancing Services for Homeless Populations
(ESHP)
Alzheimer’s Virtual Interprofessional Training
(AVIT)

9. Description of Project: Creation of the Sim
Orientation Area

10. Description of Project: Creation of the Sim
Creating Key Town Areas

11. Description of Project: Creation of the Sim
Homeless Person’s Tent

12. Description of Project: Creation of the Sim
The ESHP Community Center

13. Description of Project: Creation of the Sim
Transitional housing center for women and children

14. Description of Project: The Triad Model
The Triad Model has been used for decades for training across a
range of human services professions. As early as 1971, Ivey
used this model for counseling.
Students (as avatars) work in teams
(trios) to take turns enacting the
three roles of:
1. Helper/provider
2. Client/homeless individual or person
with Alzheimer’s disease
3. Observer
Additional role of caregiver (in
Alzheimer’s disease)

15. Description of Project: The Triad Model
Simulation 1 for Mrs. Jenkins:
Provider’s office
Simulation 2 for Mrs. Jenkins:
Home evaluation with PT and
caregiver

16. Format of Training
Overview: Dimensions of flexibility

17. Format of Training - Instructional approaches and resources
• A brief biography of each
client that provides
background information
• Links to videos that show
persons similar to those who
will be enacted in the
simulations
• Peer reviewed journal
articles with details about
the specific population and
effective intervention
approaches
Blackboard Learn site with
preparatory resources...
Second Life Sim Center

18. Format of Training - Instructional approaches and resources
Simulation followed by debriefing

19. Outcomes
ESHP
Outcomes
2016-2018
Self-Efficacy in
Working with
Homeless
Populations
Pre-Post
Change
2017,
N=18
p Value Pre-Post
Change
2018, N=15
p Value
Increase p ≤ .0001 Increase p ≤ .005
Table 1. Confidence/Self-Efficacy Outcomes of the ESHP:
First Two Years.

20. Outcomes
Table 2. Confidence/Self-Efficacy Outcomes of AVIT (Simulation 1)

21. Some Lessons Learned
- Programs can be easily customized to scheduling needs
- ESHP took place over a 2-4 month period, while AVIT was
completed in a 2 week time frame
- We found both time formats worked well with the 2 training
programs and are confident the formats can work with
other populations of focus
- Use of Second Life voice was an area of challenge,
especially for the shorter AVIT program
- We found that using voice external to Second Life (Zoom
web conferencing) works well

22. Final Comments and Directions from Here
Benefits of short-duration, intensive time
frame
• Learner efficiency and initiative
• Time restrictions motivate students to
maximize experience
• No time for procrastination!
Elicit and consider suggestions from students
• Pre-create avatars vs. using existing SL
avatars and having the students modify
them
Explore further debriefing questions related to
empathy
Explore other virtual platforms that will better
enable non-verbal emotional responses

23. For more information,
contact:
Susan Toth-Cohen, PhD, OTR/L
Second Life: Zsuzsa Tomsen
Professor and Director, Post-professional Doctoral Program
Department of Occupational Therapy
Jefferson (Philadelphia University + Thomas Jefferson
University)
Email: susan.toth-cohen@jefferson.edu

24. Acknowledgements
This work was funded in part by the Jefferson Center for
Interprofessional Practice and Education at Thomas Jefferson
University, by a 2017-18 Dean’s Grant from the Jefferson
College of Health Professions (Philadelphia, USA), and with
funding from the Women’s Board of Thomas Jefferson
University Hospital
The authors wish to thank Eileen Young, OTS, for her valuable
contributions to the literature review for this paper.