Metaverse Health

Archive for December, 2008

The ever-growing number of health-related projects occurring in virtual worlds continues to seep through to the academic literature. On the 18th December, the International Journal of Environmental Research and Public Health published an article titled Web 3D for Public, Environmental and Occupational Health: Early Examples from Second Life.

The abstract:

Over the past three years (2006-2008), the medical/health and public health communities have shown a growing interest in using online 3D virtual worlds like Second Life® (http://secondlife.com/) for health education, community outreach, training and simulations purposes. 3D virtual worlds are seen as the precursors of ‘Web 3D’, the next major iteration of the Internet that will follow in the coming years. This paper provides a tour of several flagship Web 3D experiences in Second Life®, including Play2Train Islands (emergency preparedness training), the US Centers for Disease Control and Prevention—CDC Island (public health), Karuna Island (AIDS support and information), Tox Town at Virtual NLM Island (US National Library of Medicine – environmental health), and Jefferson’s Occupational Therapy Center. We also discuss the potential and future of Web 3D. These are still early days of 3D virtual worlds, and there are still many more untapped potentials and affordances of 3D virtual worlds that are yet to be explored, as the technology matures further and improves over the coming months and years.

You can download the full article here.

The December Student BMJ has an excellent overview of the growing use of Second Life for medical simulation.

The collaborative and immersive meetings aspects are also covered and although the article is pitched at non-virtual world users, it provides a balanced summary of goings-on to date.

A big thanks to Mal Burns for the heads-up.

Australian Second Life resident, Seshat Czeret, provides a guest post, which appeared on The Metaverse Journal in the past week. Thanks Seshat!

There is always a lot of talk about ‘accessibility’, so-called ‘making things usable for the disabled’. You also hear a lot about phrases like ‘discrimination’, ‘equal opportunity’ and ‘political correctness’. It can be difficult to work out what is actually needed to help a disabled person live a fulfilling and useful life, and what is excessive ‘correctness’. Hearing what life is like for a disabled person can help.

I’m disabled. I use Second Life extensively. This is my story.

In the atomic world, the fleshworld, I’m almost totally housebound. I can only do chores – or SL work – for a short time before I have to rest. I only have a few hours a day in which I’m functional, and even for those I’m not fully functional. I haven’t been since I was a teenager. Some days – even some weeks or months – I have even less, or am not functional at all.

When I do go out, I have to use a mobility scooter or a wheelchair. I can walk, but walking the length of a mall would tire me out to the point where I’d need several hours of sleep to recover. For various reasons – which would probably be boring – even with the assistance of the scooter or the wheelchair, going out is very stressful and leaves me tired. I have to plan outings carefully.

So I can’t do atomic world work. By the time I got to work, I’d be too weak to achieve anything. I’ve tried, over and over again, many times in the last two decades. I’ve done it, but only at the cost of aggravating my problems.

Fortunately for me, I live in the 21st Century. I can do work from home! I’ve done voluntary work for the Open Source community. I’ve done other sorts of online voluntary work. I’ve written articles, and twice written a book. Unfortunately, the pace of work expected of an author of books exceeds what I can do – the first time I wrote a book, I was more than a year recovering.

But in Second Life, I can be useful.

In Second Life, I teach. I only have to be focussed for an hour and a half or so at a time, which is a stretch of time I can manage. And I don’t have to leave my house, exhausting myself, to do so. I can teach in text, with student questions also in text, so my hearing problems don’t matter. Much of the typing is done in advance, so I don’t overstrain my arms and hands, and only have to type the personalisation of the class for the individual students I’m teaching that day.

In Second Life, I am an NCI helper. I sit and listen in on the NCI chat/questions group channel. When there’s a problem I can help with, I can choose to respond – or not! If I’m having a high pain day, I let others catch that question. If I’ve responded to too many questions and need a break, I let others catch that question. If I can answer, however, I will.

In Second Life, I run a business. I don’t have to be there all the time, I can set things up and then go collapse into my bed. I can create things that other people like, in the times when I am functional, and rest when I’m not. I can do the business management stuff when I’m capable of it, not to someone else’s timeframe.

Best of all, in Second Life, my body works. I can run, and dance, and fly, and ‘talk’, and ‘hear’. I can attend art shows, or watch people creating art in sandboxes.

In Second Life, I am a person and not a disability.

On the Linden Lab blog, Pathfinder Linden has written on the successful World AIDS Day initiative in Second Life, run by the Karuna organisation. He’s coined the phrase ‘Ecosystems of Support’ and it’s very fitting for initatives like this.

Over the past six months, there’s been a significant momentum build in regards to health and virtual worlds, and certainly support networks are pivotal within that development. The challenge is convincing the wider circle of health professionals, individuals seeking help or support and their families / friends that virtual worlds offer another option that can make a real difference.

Rather than assessing their students through a paper-based examination, or even by having real, live people come in to pretend to be patients, it is starting to become more common to hear of healthcare educators asking their students instead to use computer applications and tools featuring digitally-created patients.

There are a myriad decisions that need to be made surrounding patient care. Students need to be able to wield a large amount of technical data, be able to think well on the fly, and be able to make quick yet considered decisions as healthcare professionals. These digitally-created, or virtual, patients can assist in building these skills.

Though virtual patients look just like the avatars that represent actual people in virtual worlds, the virtual patients usually have either an artificial intelligence (AI) or a scripted backend behind them. As opposed to an AI, the scripted backend cannot make decisions itself – instead , it follows a decision tree that has already been set before the student engages with it.

Medicine

Source 1, Source 2

MyCaseSpace is a Web-based application which presents virtual patients to students at irregular intervals throughout the span of their course. Virtual patients may contact the student at any time of the day or night, through their computer, and request a clinical consult. The virtual patients use avatars to communicate visually with students; the speech of the virtual patients can be accessed in 13 different languages. These patients use a scripted backend for their interactions, the design of which was based on video-game decision trees.

The application can easily be updated and altered to include virtual family members of the virtual patient to make demands upon the students.

Critical thinking skills used to be tested by setting examination papers; some people believe that the current set of students, being more digitally aware, will respond better to a digital presentation. Others are of the opinion that modern students have an expectation that they will continue to receive paper exams, and may have trouble with digital resources.

Though it has not been proven that this method of assessment results in either better or poorer results for the students, the professors and tutors find the system to be most beneficial for them. The application collects, stores, and processes data generated by the students’ assessments, cutting down on time and tedium, and increasing accuracy, for the marking individual.

Nurses

Source

“Nurse Island” has been set up inside Second Life by the Glasgow Caledonian University. Apart from the virtual representation of the university, built so that prospective students can learn to find their way around campus, the Nursing Skills Laboratory has been recreated and populated with virtual patients. These patients can be controlled either by an AI or by a tutor, and use text to speech synthesis rather than recorded voices.

The conversations held between patients and students are recorded, so that students can be debriefed later by a tutor. This facility will open early next year.

Paramedics

Source 1, Source 2

This Second Life project represents a partnership between St George’s, University of London and Kingston University.

Paramedic students will work in teams of three or four, and will encounter emergency scenarios in Second Life in which they will need to treat a virtual patients or patients. They will need to perform such tasks as checking the patient’s pulse, dressing wounds and administering drugs. They may also need to be able to use equipment that would typically be found in an ambulance, such as oxygen masks and electrocardiograms (ECG). After assessing and treating the patient, they must load the patient into the ambulance and set a GPS device to take them to the hospital.

On reaching the hospital, students then handover a set of patient notes to their tutor via email.

Emily Conradi, e-Projects Manager, says: “Paramedic students spend a lot of time in work placements, which can be based anywhere in the country, so it can be hard for the students to meet face-to-face with each other and with their tutors.”

CPR and emergency first aid

Source

The Italian Resuscitation Council (IRC) headquarters in Second Life (to teleport there, click here) has been set up as a place that people can be trained and re-trained, whether they be instructors, medical professionals or laypeople.

The IRC training simulations for instructors and medical people would include simulations to improve and test teamwork, leadership and technical skills. The simulations would also impart knowledge concerning CPR and other emergency training procedures.

Some of the information directed at laypeople includes cardiac arrest prevention knowledge and basic life support information.

In conclusion

Effectiveness of learning is not the only reason to use a virtual world or virtual patients. If learning is not less effective than by using other methods, and there are other benefits to the virtual alternatives, they may still be well worthwhile.