COMSLIVE Research Results

January 21, 2011

We don’t typically republish blog articles on Wonderblog, but I know many people are interested in empirical research that documents positive learning outcomes from use of virtual worlds, so I thought there would be significant interest in this article. For background, you might first want to read Nigel Wynne’s Wonderblog article on the COMSLIVE project or watch this news story that appeared on SkyNews at the end of December.

COMSLIVE Story on SkyNews

The author, Colleen McCants from the University of Nottingham, is a multimedia graphic artist involved in e-learning since 1993. As ‘Cowlean Minotaur’ in Second Life, she builds fantastical teaching sims for the University of Nottingham’s virtual campus, described on her builder’s blog.

Notes from the 9th Virtual Worlds in Education Forum: Presentation COMSLIVE

By Colleen McCants
Multimedia Graphic Artist, IS Learning Technology Section
University of Nottingham

Originally published December 17th, 2010 at 04:12

The Wonder of Good Communication

Nigel Wynne, co-host of the Forum and Senior Academic in Learning and Teaching in the Faculty of Health at BCU, gave a synopsis of his research funded by JISC LTIG, ‘Communication Skills Learning within Immersive Virtual Environments’, which was concerned with deficits in nursing students’ communication, team working and delegation skills. According to the COMSLIVE website, poor communication is indicated in numerous unanticipated patient deaths and illnesses within the UK and US health care sectors. Basing the research around the null hypothesis that students would not benefit from learning scenarios in a virtual world, Nigel Wynne and Emma Winterman conducted exercises in the java-based, free and open source,  Open Wonderland sim, in which student volunteers could explore teamwork productivity exercises designed to support adoption of collaborative skills.

COMSLIVE sim in Open Wonderland

COMSLIVE sim in Open Wonderland

Based within a randomized control trial research design, intervention group teams engaged in Wonderland patient scenarios. Interaction with virtual world patients was followed by physical world higher fidelity computerized mannequin based simulation activities. During these activities the performance of students who had experienced virtual world learning were compared with control group students who had not. Real world behavior of these teams was observed and rated.  Given the assumption from the outset that the benefit of the scenarios would not be realized, they were surprised when intervention group students significantly outperformed control group students. Intervention group students found their virtual world learning experience both positive and indicated it was having a lasting impact on their behavior during clinical placements. Intervention group students showed improvements in such skills as practicing ‘paraphrasing’ and in showing assertiveness to change others’ behavior for a positive outcome. Using the telephony integration afforded by Open Wonderland, part of the virtual world scenarios involved using a ‘softphone’ within the sim to make a call to a tutor in the real world. During this telephone simulation students were able to practice having their requests understood and prioritized, using the Situation-Background-Assessment-Recommendation protocol.

Contacting the outside via softphone

Contacting the outside via softphone

Open Wonderland was found to be ideal for the learning and teaching scenarios from the development side, in that it could be run from behind a firewall, allowed LDAP authentication and enabled an ‘open art pathway’. Models from SketchUp, Maya and 3DS Max could be imported with relative ease, and the drag-and-drop insertion in-world of models from Google Warehouse was most useful. 3D assets created for a parallel teaching project, Virtual Case Creator, were imported, saving significant development time. Firefox worked as a browser in-world, enabling creation of monitor screens delivering real-time information via web browser windows. In practice they found the sim loaded quickly, slowed only by client specifications.

Firefox browser window delivers real-time data

Firefox browser window delivers real-time data

From 2011, use of the COMSLIVE sim will be mandatory for year one health care students. The Open Wonderland platform is scalable, allowing continued expansion of the virtual scenarios. Potential exists to support the Interprofessional Learning agenda and Objective Structured Clinical Examination testing.

Nigel introduced the talented team behind the development of COMSLIVE and VCC, Janine Dantzie and Tim Marquis. Tim chose to demonstrate his enthusiasm for the UNITY game development tool. Delivering games via web browser and allowing for an amazing level of detail, the creative pipeline he described was smooth and facile, and the support community the most helpful in his experience. In 2010, Unity won the Wall Street Journal’s Technology Innovation award in the software category. Obviously, this is one to keep in sight. Features for the tool are reviewed here.


“Games for Health” Virtual World Session

May 10, 2010

It seems like there is an increasing interest in using virtual worlds for health care applications. You may recall the recent COMSLIVE Wonderblog post describing the health care communication project at Birmingham City University.

Birmingham City University's new Open Wonderland hand washing module that assesses who has washed their hands and how often

To learn about other projects related to virtual worlds and health care, you may be interested in attending the “Virtual Worlds and Social Games for Health” day, which is part of the “Games for Health” conference. I have been invited to speak on using Open Wonderland as a platform for creating health-related virtual worlds. Here’s the agenda for the day:

Virtual Worlds and Social Games for Health (pdf)
May 25, 2010
Boston, MA

If you’re planning on attending, please let me know.


COMSLIVE – Communication Skills Learning in Immersive Virtual Environments

February 26, 2010

I have the pleasure of introducing another guest blogger today. Nigel Wynne is a Senior Academic in Learning and Teaching within the Faculty of Health at Birmingham City University in the UK. In this article, he describes some of the very exciting work he and his colleagues are doing using Wonderland in a variety of health care related projects.

Birmingham City University Logo

It’s always struck me as slightly odd that many virtual world platforms divorce the user from the tools they use every day as they communicate, collaborate and work with colleagues. One of the strengths of Wonderland is its capacity to integrate real world tools within a virtual world setting. Staff within the Online Simulation and Immersive Education Research Group, Centre for Health and Social Care Research, at Birmingham City University, UK, are applying Wonderland in order to enhance Communication Skills Learning amongst learners preparing for work within the National Health Service. Following a nine month scoping exercise during which a range of virtual world platforms where explored in terms of their potential application to communication skills development, we decided that Wonderland could have a significant transformative impact in this area of our provision.

Birmingham City University Wonderland Simulation Center

Most of the unintended mortality and morbidity within the health sectors in the UK and USA have communication deficits as a contributing if not root cause. How then can Wonderland help to provide a more creative solution to what is a very real social imperative? Well, when we break down communication we get three rough subsets: verbal, non-verbal, and written components.

Verbal communication within Wonderland is enhanced by its support of 3D immersive audio. Here, for example, learners are aware of the direction from which verbal communications and sounds emanate and may be more strongly prompted to respond to verbal communications by facing the direction from which they came and by facing the person they are communicating with.  We think that this will add significantly to the fidelity associated with the learning activities we are planning.

Birmingham City University - example of interactive animated objects

Non verbal communication can be facilitated by the gesture controls that learners can activate when communicating with other learners. How do they acknowledge understanding and receipt of a request, do they use non-verbal communications to emphasise their own verbal communications? By encouraging deliberate use of non-verbal communication in Wonderland, can we help support more effective communication within real world settings?

Within the health care sector, practitioners are required to record every aspect of the care they are associated with, to follow protocols, and use proformas. Written communication skills are therefore essential. Using the Open Office word application within Wonderland, we can encourage learners to collaboratively complete care plans, patient assessment forms, and observations charts as well as access policy documents, just as they would in the real world. If we can enable access to Wonderland from within a Trust either by deploying behind their own firewall or by providing access to a world hosted elsewhere, then hospitals could have a very powerful tool with which to train their staff to use the systems that they are legally required to use and are judged against in the real world.

Birmingham City University collaborative care planning via shared application

In addition to the above, Wonderland allows teachers to open up a fully functioning Firefox browser. Whatever one student views in the browser is viewed by all other students co-located in the same space. We believe that this application on its own adds incredible value to our virtual world learning scenarios. If we look at virtual world technology as a simulation technology, then it is impossible to simulate the real world without enabling learners to access the web in their virtual world. From a pedagogic perspective, we can use the browser to transfer any web-based content into a trigger for collaborative learning, all within a 3D immersive space!

For example, as an adjunct to our virtual worlds work we have developed a wide range of online patient simulations using software known as Virtual Case Creator (VCC). With VCC simulations, learners find problems, solve problems, and make decisions. One aim of our project is to explore how effective VCC learning is if students collaborate in-world as they access the VCC simulations using the web browser.

Birmingham City University Flash-enabled web pages

One more feature of Wonderland that attracted us to this platform is its telephony integration. So many referrals within the health care sector take place over the phone. Nurses have to communicate patient information via telephone in order to persuade doctors to see their patients, for example. So important is effective telephone communication that in health care we have communication protocols to help ensure that staff can bundle and convey information as effectively and efficiently as possible. Within Wonderland, our students will assess a patient and then make a phone referral in-world to a phone in the real world. If their  referral is effective they will persuade a doctor in the real world to attend in-world. How cool is that!!

Birmingham City University - interaction between real world and virtual world

One of Wonderland’s unique selling points is the utility it affords teachers. By this I mean the ease with which scenarios can be created. Using the drag and drop feature, images, 3D models, and PDF’s can be dragged from a desktop into the world. A great example of this is the Wound Care learning activity we set up in 20 minutes. We simply dragged and dropped some wound images into world, dragged in a PDF document with information about wound care practice, (which automatically opened in its own viewer), added some care plans and an assessment chart for students to complete collaboratively and then added a poster with guidance for the learners.  For a little extra context, we dragged and dropped in some models from the Google 3D Warehouse or from our own Wonderland inventory. Hey Presto!!! With no scripting or modeling required, we created a rich, student-led, activity-focused learning scenario.

Birmingham City University - drag and drop images for collaborative learning

There are lots of other reasons why Wonderland seems such an attractive choice for teachers and trainers including, authentication, 100% Java, being free (yes that’s right, free!). I already stand the risk of being accused of blog hogging, so I need to quickly move to a close!

Our COMSLIVE Project aim is to design a communication skills Wonderland environment and assess the extent to which this fosters real world change within our students as they engage within our high fidelity simulation centre learning activities. We are also exploring how scalable Wonderland set up is in terms of the number of worlds we can run concurrently, the number of scenarios in a world, and the number of avatars in a scenario. This is all looking good at the moment as we conduct a series of stress tests. In common with most Faculties of Health, we have high student numbers. There are 3000 student nurses in one course alone.

The project is funded by the Joint Information Services Committee with a significant additional contribution by the University. We  have also partnered with Sandwell and West Birmingham NHS Trust and Middlesex University.

More information on COMSLIVE can be found at the JISC project website and at the Birmingham City University project website (very nascent). For more information please feel free to drop me a line.

Nigel Wynne

National Teaching Fellow
Senior Academic L&T
Head- Online Simulation and Immersive Education Research Group
Faculty of Health
Birmingham City University
nigel.wynne @ bcu.ac.uk


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