A Virtual Clinic for A Virtual Clinic for Medical Student Training in Medical Student Training in Second Life Using Chat- Second Life Using Chat- Enabled Patient Simulations Enabled Patient Simulations Mary T Johnson, Ph.D. Mary T Johnson, Ph.D. SL: Magistra Clary SL: Magistra Clary Indiana University School of Medicine Indiana University School of Medicine Statewide Director for Problem Solving Statewide Director for Problem Solving Competency Competency Associate Professor of Microbiology and Associate Professor of Microbiology and Immunology Immunology Terre Haute, IN 47809 Terre Haute, IN 47809 [email protected][email protected]
Transcript
A Virtual Clinic for Medical A Virtual Clinic for Medical Student Training in Second Life Student Training in Second Life
Using Chat-Enabled Patient Using Chat-Enabled Patient SimulationsSimulations
Mary T Johnson, Ph.D.Mary T Johnson, Ph.D.SL: Magistra ClarySL: Magistra Clary
Indiana University School of MedicineIndiana University School of MedicineStatewide Director for Problem Solving Statewide Director for Problem Solving
CompetencyCompetencyAssociate Professor of Microbiology and Associate Professor of Microbiology and
ImmunologyImmunologyTerre Haute, IN 47809 Terre Haute, IN 47809
AbstractAbstract Indiana University Medical School Virtual ClinicIndiana University Medical School Virtual Clinic Developed in Second Life (SL) as a virtual setting for learning Developed in Second Life (SL) as a virtual setting for learning
medical microbiology and infectious disease medicine. medical microbiology and infectious disease medicine. Located on Eduisland 5Located on Eduisland 5 Provides training in diagnosis, laboratory medicine and problem Provides training in diagnosis, laboratory medicine and problem
solving within the SL multi-user virtual environmentsolving within the SL multi-user virtual environment Students encounter simulated patients within the Virtual Clinic Students encounter simulated patients within the Virtual Clinic
and work in teams to apply the skills of a practicing physician as and work in teams to apply the skills of a practicing physician as they organize information about infectious disease casesthey organize information about infectious disease cases
IUSM is the only medical school in Indiana & has 9 campus sitesIUSM is the only medical school in Indiana & has 9 campus sites Students are encouraged to bond within Learning Communities Students are encouraged to bond within Learning Communities
focused on areas of shared clinical interest.focused on areas of shared clinical interest. This is especially meaningful in a distributed environment, This is especially meaningful in a distributed environment,
where students might feel isolated without such interactions. where students might feel isolated without such interactions.
environment environment for first and for first and
second year second year medical students.medical students.
Patient Avatar Patient Avatar in Virtual Clinic in Virtual Clinic Waiting RoomWaiting Room
Three Learning AreasThree Learning Areas: : Rural Medicine, International Medicine, Rural Medicine, International Medicine,
and Poverty Medicineand Poverty Medicine
The Patient ExaminationThe Patient Examination
Chatbot BackgroundChatbot Background Simulated virtual patients were created Simulated virtual patients were created
based on chatbot technology; allows based on chatbot technology; allows lifelike interactions between virtual lifelike interactions between virtual patients & students, who can practice patients & students, who can practice interviewing skills. interviewing skills.
The chatbot patient answers when posed The chatbot patient answers when posed with a specific set of questions that are with a specific set of questions that are relevant to the patient case. relevant to the patient case.
As the chatbot patient answers questions, As the chatbot patient answers questions, students construct a patient history. students construct a patient history.
Students at early stages of Students at early stages of training are provided with a set of training are provided with a set of appropriate questions. appropriate questions.
After completing a minimum After completing a minimum
number of cases, students number of cases, students
Students can request specificStudents can request specific
background information aboutbackground information about
expected diseases. expected diseases.
Basic science underpinningsBasic science underpinningsfor relevant diseases are for relevant diseases are provided as mini-lectures. provided as mini-lectures.
Suitable heart, lung and bowel sounds are Suitable heart, lung and bowel sounds are available as streaming audio retrieved using a available as streaming audio retrieved using a virtual stethoscope during the physical exam virtual stethoscope during the physical exam section of the patient encounter. section of the patient encounter.
Laboratory results (hematology, chemistry, Laboratory results (hematology, chemistry, microbiology) and imaging studies (X-ray, CT, microbiology) and imaging studies (X-ray, CT, MRI, angiogram) are incorporated as MRI, angiogram) are incorporated as retrievable objects and are also retrievable objects and are also displayed on notecards that displayed on notecards that can be collected in the can be collected in the students’ inventory.students’ inventory.
Laboratory & ImagingLaboratory & Imaging
Image courtesy of the CDC Public Health Image Library
DiscussionDiscussion Cased-based clinical problems are well-established as a method for Cased-based clinical problems are well-established as a method for
teaching medical learners.teaching medical learners. However, paper-based cases are traditionally used for this purpose and However, paper-based cases are traditionally used for this purpose and
they are sometimes not as interactive a format for student learning as they are sometimes not as interactive a format for student learning as intended by the case developers.intended by the case developers.
Computer simulations are powerful learning tools because they Computer simulations are powerful learning tools because they promote active, hands-on, problem-solving by learners (NRC, 1999), promote active, hands-on, problem-solving by learners (NRC, 1999), but they are best used for individual training.but they are best used for individual training.
An online shared environment like SL is especially practical for An online shared environment like SL is especially practical for cooperative learning using medical simulations (Piturro, 2008).cooperative learning using medical simulations (Piturro, 2008).
Although only in its beginning stages, there is great potential for the Although only in its beginning stages, there is great potential for the Medical School Virtual Clinic to evolve into a dynamic and meaningful Medical School Virtual Clinic to evolve into a dynamic and meaningful platform for the exchange of ideas. platform for the exchange of ideas.
Lessons learned apply to medical training at multiple levels, from high Lessons learned apply to medical training at multiple levels, from high school vocational education to university pre-med programs through to school vocational education to university pre-med programs through to medical school & post-graduate settings for learning. medical school & post-graduate settings for learning.
Within SL, a safe environment is provided where the language, Within SL, a safe environment is provided where the language, actions, informal culture, and norms of medical practice can fuse actions, informal culture, and norms of medical practice can fuse into a routine process through repetition and group interaction into a routine process through repetition and group interaction (Piturro, 2008; Yu and Young, 2008).(Piturro, 2008; Yu and Young, 2008).
This type of learning atmosphere has been heralded in the This type of learning atmosphere has been heralded in the educational literature and popular media for its potential to “enrich educational literature and popular media for its potential to “enrich existing curricula and supplement traditional classroom learning” existing curricula and supplement traditional classroom learning” (Lok et al, 2006).(Lok et al, 2006).
It also brings to bear on the learning process the power of social It also brings to bear on the learning process the power of social networking theory with its emphasis on a user-controlled networking theory with its emphasis on a user-controlled environment (Ondrejka, 2004).environment (Ondrejka, 2004).
Networking with peers, experts, and with additional information Networking with peers, experts, and with additional information sources makes learning more interesting and more immediate.sources makes learning more interesting and more immediate.
The relevant and applied context allows students to be more active The relevant and applied context allows students to be more active and creative in their engagement with the learning process and creative in their engagement with the learning process (Scardamelia, 2002). (Scardamelia, 2002).
ReferencesReferences Lok, B, Ferdig, RE, Raij, A, Johnsen, K, Dickerson, R, Coutts, J, Stevens, A, & Lok, B, Ferdig, RE, Raij, A, Johnsen, K, Dickerson, R, Coutts, J, Stevens, A, &
Lind, DS (2006) “Applying Virtual Reality in Medical Communication Lind, DS (2006) “Applying Virtual Reality in Medical Communication Education: Current Findings & Potential Teaching & Learning Benefits of Education: Current Findings & Potential Teaching & Learning Benefits of Immersive Virtual Patients”. Virtual Reality 10(3-4): 185-195. Immersive Virtual Patients”. Virtual Reality 10(3-4): 185-195.
Ondrejka, C. (2004) “A Piece of Place: Modeling the Digital on the Real in Ondrejka, C. (2004) “A Piece of Place: Modeling the Digital on the Real in Second Life” Social Science Research Network, Accessed on 5-20-08 and Second Life” Social Science Research Network, Accessed on 5-20-08 and available at SSRN: http://ssrn.com/abstract=555883 available at SSRN: http://ssrn.com/abstract=555883
National Research Council (1999) How people learn: Brain, mind, experience, National Research Council (1999) How people learn: Brain, mind, experience, and school. Washington, DC: National Academy Press.and school. Washington, DC: National Academy Press.
Piturro, M. (2008) “Virtual Medical Simulation”. MD Net Guide New Media. Piturro, M. (2008) “Virtual Medical Simulation”. MD Net Guide New Media. Accessed on 5/22/08 www.mdnglive.com/articles/Accessed on 5/22/08 www.mdnglive.com/articles/
Scardamelia, M. (2002). “Collective cognitive responsibility for the Scardamelia, M. (2002). “Collective cognitive responsibility for the advancement of knowledge”. In B. Smith (Ed.) Liberal Education in a advancement of knowledge”. In B. Smith (Ed.) Liberal Education in a Knowledge Society. Chicago, Open CourtKnowledge Society. Chicago, Open Court
Yu, C.-P. and Young, M.-L. (2008) “The Virtual Group Identification Process: A Yu, C.-P. and Young, M.-L. (2008) “The Virtual Group Identification Process: A Virtual Educational Community Case” Cyberpsychology & Behavior, 11(1):87-Virtual Educational Community Case” Cyberpsychology & Behavior, 11(1):87-9090
THIS PROJECT IS PART OF A MULTI-INSITUTIONAL COLLABORATIONTHIS PROJECT IS PART OF A MULTI-INSITUTIONAL COLLABORATIONUSING AIM-L LANGUAGE AND THE SECOND LIFE ENVIRONMENTUSING AIM-L LANGUAGE AND THE SECOND LIFE ENVIRONMENT
Mary T Johnson (SL: Magistra Clary) Mary T Johnson (SL: Magistra Clary) Indiana University School of MedicineIndiana University School of Medicine
Douglas Danforth (SL: DrDoug Pennell)Douglas Danforth (SL: DrDoug Pennell)Ohio State University College of MedicineOhio State University College of Medicine
Bob Heller (SL: Duyu Voom) Bob Heller (SL: Duyu Voom) Athabasca University Athabasca University Centre for PsychologyCentre for Psychology
Mike Procter (SL: Snik Philbin)Mike Procter (SL: Snik Philbin)Athabasca UniversityAthabasca University
