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The Benefits of Cross-DisciplinaryCollaboration in Construction ofA Virtual Midwifery Simulation
Colleen McCantsFay Cross Information Services Learning Technology
Jenny Bailey School of Nursing, Midwifery and Physiotherapy
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Virtual Healthcare
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Imperial College London: ‘a public engagement research project
spread over 8 islands’
‘Communication Skills Learning within Immersive Virtual Environments’, Faculty of Health, Birmingham City University,is designed to improve nursing students’ communication, team working and delegation skills
The potential benefits of immersive learning and storytelling role-play in Second Life®, Open Sim, Open Wonderland and other VEs are being explored by many healthcare educators
‘information on health and wellness issues including
diseases, surgical procedures, drug effects and interactions,
support services, and new research.’
HealthInfo Island
COMSLIVE Second Health London
Virtual Midwifery
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SLENZ
The University of Nottingham’s VMU was not the first HE virtual midwifery sim to be developed, as it was created in parallel with the Second Life Education New Zealand project, (SLENZ), which was further along the development timeline
Implementation of physical and interactive design varies according to the learning objectives and collaborator skill-sets
Timeline
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IS Learning Technology
Section
Academic Division of Midwifery
• May 2009 - placeholder shell of Maternity building on University of Nottingham's ‘web campus’ in Second Life
• May, August 2009 - Ward visits photos, local maternity hospital
• November 2009 – further construction on Virtual Maternity Unit (VMU)
• February 2010 - dev. deadline, testing
• Summer of 2010 - pilot with small group of midwifery students and educator peers
• March 2011 - use by first year midwifery students on a voluntary basis, and in lecture demonstrations
Traditional Student Experience
• In Midwifery education relies on sharing information by narrative means
• Students can find 'real life' role play situations awkward.
• Students do not always have time and opportunity to ask questions on the ward
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Immersive Storytelling
• Allows a degree of anonymity
• Students inhabit the role of a midwife, with the teacher in the role of a woman in labour
• Together they create their own narrative, with choices in care and support reflecting RL practice
• Provides ‘safe’ environment and meaningful context in which to learn from mistakes and review
Making their Own Story
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Through involvement in a narrative, student midwives … make choices in care and support.
They can make mistakes … and learn from them, ….
drawing from their 1st year training ….in a meaningful context.
Reviewing the scenario afterwards with the midwife-educator… puts knowledge into perspective.
Guiding the Narrative
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The midwife educator, as birth mother, can use the tutor HUD to control:
• Duration of labour
• Birth parameters
• Delivery
• Post-delivery readings
Tests and Observations
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Students can move and use equipment from the adjacent Store Room,… or ‘touch’ target areas on mother or baby to obtain readings.
Immediate Feedback
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The tutor can tailor results to each scenario.
Students are gently reminded if they forget…
…or attempt the impossible
Environment
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Immersion is enabled by familiar equipment and facilities, and documentation is modeled on real paperwork and sample birth plans.
Safety and Clinical Skills
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Because midwifery entails a duty of care for mother and baby, student midwives must learn to:
The VMU provides a safe environment for emulating clinical practice, so students can:
• communicate well• respond appropriately • act decisively• ensure the safety and well-being of all
• get used to thinking on their feet• have the freedom to explore• ask questions without disruption
Development of the Unit
Builder, programmer and developer worked closely together to test workability of the equipment and role-play interactions before giving students access to midwife avatars and HUDs, although the build remained open-access…
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Where to begin?
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feasibilityscoperealism
Branching possibilities
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Synthesis of skillsacademic
Making, testing animations
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excluding scenarios: optimal vs.
practical
building design: ideal, clean and
serene
programmer
builder
Research/comparison w/ other immersive
healthcare environments
assumption of simultaneous use dictated 20+metres between meeting areas
recreating the familiar: •
equipment/facilities• care options• paperwork
limiting interaction to birth mother and student midwife- no birth partner
textures from the
ward
transparent abdomen for mother and moving birth
animations ruled out
Security: birth mother avatar enabled to move
objects vs. student midwives moving objects
by clicking/code
student midwife avatars pre-
established, with clothing in their
inventories
Natural- looking babies
bespoke Avatar skins
aromatherapy garden
Additional tweaks
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Additional signs and floor directions have been added to enhance navigation and understanding
Additional tweaks
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As per the original vision, an aromatherapy garden with note cards has been created
Additional tweaks
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A self-study student and visitor area
Additional tweaks
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A full walkway around the building
View from the front
Rear view
Challenges to Development
• Lack of experience with design for healthcare
• Difficulties with shared permissions in Second Life
• Steep learning curve for making baby sculpties
• Constrained timescale for programmer
• Lack of user ability of the midwife teacher, which did improve over time
• Bandwidth affects usability.
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Lessons Learned
• Limited permissions and multiple builder/programmer avatars make the VMU difficult to package, share or migrate out to Open Sim
• Building access to the SL VMU into the curriculum would give students greater incentive to use it
• Should buildings ‘rez’ and appear only as needed?
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Testing Phase
• In order to gauge usability and impact of the prototype, two 2nd year midwifery students agreed to play the part of midwives as the midwife teacher played the birth-mother.
• Testing also undertaken with the midwife teacher and a nurse teacher.
• The students quickly and easily picked up the skills needed to interact in the role play situation
• The novelty of the environment as a means of learning was highly rated.
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Post - Pilot Phase
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Since early 2010, the project has been further developed to include more birth positions, and creation of more life-like sculptie babies.
How is it being used?
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At present, use of the Virtual Maternity Unit is being is being explored with midwife educator-led sessions taking place, and more sessions on other campuses planned.
A weekly second life club has started
Students are encouraged to visit on their own, as well, and explore the environment and learning materials available.
The simulation has proven very useful for demonstrations during
teaching.
University Open days are promoting the unit to potential students.
How many of our students will use it?
Impact:• 1st and 2nd year Midwifery students: voluntary and in-class
demos
• Potential use by Medical students to prepare for Maternity Unit experience requirement (+200/yr)
• Potential use by nursing students to prepare for Maternity Unit experience requirement (+200/yr)
• In an ideal world, new course components could entail time for learning in immersive environments.
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It is hoped that the Virtual Maternity Unit can be one of many healthcare simulations to which midwifery students may be given access and credit for learning within these environments, all within a structured curriculum.
What Determines Success?
• interest from Medical Students required to fulfill a midwifery unit requirement
• 2011 Lord Dearing Award for Jenny Bailey
• Professional interest: Royal College of MidwivesShort listed for 2 RCM national awards
excellence in midwifery educationinnovation in midwifery press release
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To date, there has been considerable interest in wider uptake of the Virtual Maternity Unit, both within the Division of Nursing, from the Medical School and from other midwifery and healthcare
educators, and we are exploring further uses.
Explore Currently, there isn’t a bespoke website for the project, but you may find updates posted here.
Feel free to visit the island in Second life, or watch short machinima of the project whilst it was in progress:
http://slurl.com/secondlife/University%20of%20Nottingham/186/219/28
Contact Us
[email protected] [email protected]
The Innovation Team Information Services Learning Technology Section
[email protected] Academic division of Midwifery
School of Nursing, Midwifery and PhysiotherapyUniversity of Nottingham
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