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in realistic experiences (Dede, 2005). By
simulating an experience in a virtual world
such as Second Life trainees can concen-
trate on the clinical problem as it would
be presented in reality, without relying on
their imaginative senses, improving the
student cognitive development of a skill or
understanding (Alinier, 2007).
MUVEs provide healthcare educators with
unique teaching and learning strategies that can
assist in meeting the needs of today's healthcare
students. A review of the literature suggests that
students can learn and understand new concepts
and material, make meaningful social interactions
and develop teamwork skills in virtual worlds
such as Second Life (Haycock & Kemp, 2008;
Ritzema & Harris, 2008; Baker et al., 2009).
Overall, Second Life is an ideal setting for proac-
tively engaging healthcare students in constructing
knowledge which relates to realistic problems as
well as assisting in the development of problem
solving skills in a collaborative environment
without inflicting harm to patients (Heinrichs et
al., 2008). A virtual simulation has the ability to
create an artificial social structure where problem-
based scenarios can be created, allowing students
to actively co-construct mental models of techni-
cal and interpersonal skills through experiencing
human interaction in problematic environments.
Unlike traditional technologies immersive virtual
worlds such as Second Life can incorporate essen-
tial learning materials with effective educational
gaming strategies (Gee, 2003).
The use of 3D MUVEs for simulation-based
teaching and learning in higher education draws
on a broad range of extant research conducted
over the past three decades and can be synthesized
with newer developments and examples that have
come about since the advent and proliferation
of the “3D Web.” Currently, perhaps due to the
media hype and attention surrounding the area,
much of the recently-published literature on the
use of 3D games and virtual worlds is “show-
and-tell,” highly rhetorical in nature and bereft of
sound theoretical underpinnings. Building on the
constructivist approaches investigated above, the
authors will explore a variety of current health-
care simulations operating within the MUVE of
Second Life to illustrate the impact and viability
of simulation education using MUVEs.
Multi-user interactivity: As discussed
earlier, problem-based learning is more ef-
fective in teams trying to solve problems.
Second Life enables problem centered
role-play activities involving peer interac-
tion and critical thinking where students
can link up with others who have knowl-
edge they need; lurk, watching others who
know how to do what they want to do;
and lunge, jumping in to try new things
(Sontag, 2009).
Gaming elements: While many try to de-
fine and differentiate games from simula-
tions, it is arguable that they are more alike
than they are different. Aldrich (2004)
weakens the distinction between the two
by recommending that educational simula-
tions should incorporate “applied pressure
situations that tap users' emotions and force
them to act” (p. 9). He advocates viewing
educational simulations as being a result of
the convergence of simulation elements,
game elements, and pedagogical elements
(Aldrich, 2005). Simulations in virtual
worlds can incorporate multi-user gam-
ing elements similar to that of Massively-
Multiplayer Online Role-playing Games
(MMORPGs). By incorporating gaming
aspects into a virtual simulated environ-
ment, students can become motivated to
learn and obtain a meaningful experience
by playing an active role in the learning
process (Gee, 2003).
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