Enhancing Tertiary Healthcare Education through 3D MUVE-Based Simulations - Teaching through Multi-User Virtual Environments - page 349

At its most basic form, a virtual world offers
three things: a) a 3D space or environment; b)
an avatar that represent the individual user; c)
interactive chat, either using text or voice or both
(Dickey, 2005). Second Life can be described as an
online computer-based entity that can simulate a
real-world environment by representing objects to
the user, providing the user with the impression, as
realistically as possible, of being in another place.
The model world may simulate rules based on the
real world or some fantasy world. Through the use
of an avatar, a digital representation of the user,
people can create, interact with and manipulate
elements of the modeled world and communi-
cate with other users (Haycock & Kemp, 2008).
Communication between users ranges from text,
graphical icons, visual gesture, sound and voice.
Although research into 3D MUVEs as learn-
ing environments is still in its infancy, a number
of studies have been conducted that document
educationally-relevant outcomes arising from
the use of such environments in relation to the
affective (e.g. sense of presence, motivation) and
collaborative aspects of learning (Bronack et al.
2005; Baker, Wentz, & Woods, 2009; Ritzema
& Harris, 2008; Haycock & Kemp, 2008). In
addition, significant extant literature is available
that documents the results of studies from similar
technologies such as immersive VR and multi-
user domains (MUDs) that support constructivist
learning, online learning communities, and digital
game-based learning (Fanderclai, 1995; Bruck-
man, 2002; Gee, 2003).
Specific to the healthcare domain, an article by
four Stanford University medical staff (Heinrichs
et al., 2008) describes a series of case studies
that compared the learning outcomes and usabil-
ity of a Human Patient Simulator (HPS) and a
developed virtual world as an instructional tool.
Thirty medical students were randomly assigned
to a HPS group and a virtual world group. Using
a pre-test/post-test the students were exposed to
four team-training cases. Results of a quantitative
study showed both groups gained a significant

difference between the pre-test/post-test scores,
with no significant differences in the gain scores
between the groups. Sixty-two percent of the
virtual world students indicated they thought
multi-player game-based training was as effective
as or more effective than traditional methods; 56%
said the game environment would be useful for
initial training; and 75% said the game environ-
ment would be useful for refresher training. These
results suggest that team training and assessment
is feasible using virtual world technologies and
that it can be as effective as the traditional method
of using human patient simulators.
A review of the literature found that in most
cases higher education students enjoyed learning
in 3D MUVEs and they could help students un-
derstand new concepts and learn new material. It
also suggested that MUVEs can also enable medi-
cal and healthcare students to make meaningful
social interactions and develop team work skills
in a safe online environment. However, Berge
(2008) cautions that activities in virtual worlds
that can be accomplished in a regular website or
by video conferencing technologies have little
value, other than novelty, and can have a negative
effect on the learning process as a result of a steep
technical learning curve and added cognitive load.
The value of MUVEs in tertiary education and
training is its ability to provide unique opportu-
nities for students to engage in online simulated
learning experiences. The unique platform of
MUVEs allows educators to create simulations
in an environment incorporating:

• Information richness: Second Life has

been described as a manifestation of the
latest instructional technology tools (Good,
2004); meeting the learning needs of dif-
ferent students learning style by allowing
a variety of content to be presented within
a simulation.

• High levels of immersion: Through will-

ing suspense of disbelief, immersion leads
to the impression that one is participating