Midwifery, Birthing and Second Life

birthing-unit-aug2009 For the past couple of years I’ve been aware of the work going on in New Zealand with midwifery training and Second Life, mostly thanks to the updates over at SLENZ.

Machinima maker Pooky Amsterdam dropped me a line about a film she’s helped produce that explains the role of Te Wāhi Whānau – The Birth Place in Second Life. The lead educator on the project is Sarah Stewart (SL: Petal Stransky), with SLENZ Project co-leader, Terry Neal (SL: Tere Tinkel) and Scotland based Russell (Rosco) Boyd also heavily involved.

After walking through the actual build and after watching the machinima, the main impression I’m left with is how midwife-driven this project is. What I mean by that, is the birthing unit is so much better than most in existence in the real world. As a Registered Nurse (but not a midwife), I’ve witnessed half a dozen births and even from that limited perspective I can totally appreciate how much better a birthing environment Te Wāhi Whānau is compared to even the better hospital-based birthing units. As a clinical simulation for midwives, I can see its power as a key adjunct to lab-based learning and practicums. The gamut from initial assessment of labour to initiating breastfeeding and perineal care is covered in a comprehensive way.

Take some time to watch the 6-minute machinima:

The SLENZ team deserve major kudos for their work over the past couple of years – they’re some of the true pioneers in virtual worlds and health.

You can of course view the birthing unit for yourself here.

The physical health impacts of virtual environments

(Originally published earlier this week over at The Metaverse Journal)

razer-naga Over the past few days a product announcement and some interesting research have come together for me in illustrating some of the downsides of heavy regular use of virtual environments. I’m talking specifically about the physical impacts here: we’ve covered the psychological positives and negatives repeatedly (e.g. here and here). In regard to the psychological side, I’ve always believed the benefits and opportunities well outweigh the downsides, which is being recognised by professionals working in the area.

The research that caught my eye comes from the American Journal of Preventative Medicine, as reported by MSNBC. The researchers tested the hypothesis that gamers tended to be more overweight and had poorer mental health than non-players. The results, after surveying 552 people in the Seattle area of the US, showed that the hypothesis was essentially correct. Looking at the overweight issue, most people may say “well gee there’s no surprise there”. The gamer stereotype is certainly one of the overweight male staying up at all hours whilst eating endless bags of potato chips. Like any stereotype there can be distorted echoes of reality and this research is doing just that. I doubt there’s anyone claiming that heavy gaming or virtual environment use is good for one’s physical health in respect to exercise and nutrition. Sure, consoles like the Wii are increasing the level of physical activity but the jury is well and truly out on whether it equates to other forms of desirable physical activity. This research was conducted in 2006 but only published now, with an admission it’s just a taste for further research needing to be done – its findings however do point to the challenges for gaming, and by association, virtual environments.

The product announcement that I saw not long after the research above was for an MMO-gaming mouse produced by Razer, called the Naga. Here’s Razer’s PR pitch for it:

It’s not unique in that there’s no shortage of multi-button gaming mouses. What struck me though was the twelve buttons on the left-hand side that are designed purely for thumb use. Knowing the pace of MMO gaming at times, it seems astounding to me that you’d put one thumb through the trauma of operating twelve buttons continuously. In the five minutes-plus of sales pitch above, you’ll hear the word ‘comfort’ a few times, but that’s it. You’ll also hear a couple of mentions of statements like “playing all day” as qualifications for the level of effort that went into producing the design.

Am I alone in thinking that no matter how good the device’s ergonomics are, relying on one digit to control twelve buttons is a recipe for disaster? Sure, the heavy use of a keyboard for the same activity isn’t ideal either, but usually the repetition is spread around a few more digits if keyboard shortcuts are being used. Of course, gaming is different to broader virtual world use, but in proportion the same issues remain.

My point overall? Virtual environments are really no different to the real world in respects of the need to engage in physical activity. The ever improving development of new interface options may assist, but the reality in the short to medium term is that plenty of real world concentration on nutrition and exercise is needed. The three people I know best who are involved in virtual environments 8-16 hours a day all own pets and tend to have an exercise schedule. Do you?

Healthcare Support Groups in Virtual Worlds

As promised, I wanted to spend some time going over the recent handful of peer-reviewed papers submitted for the health-focused recent issue of the Journal of Virtual Worlds Research.

First cab off the rank is the paper titled The Growth and Direction of Healthcare Support Groups in Virtual Worlds by John Norris. Its focus is a review of four virtual worlds (Second Life, Kaneva, There and IMVU) and the breadth and popularity of support groups in existence around health issues.

For the regular virtual worlds follower, there’s nothing too surprising in the findings, but they’re noteworthy all the same:

- Second Life support groups revolved predominantly around disabilities and mental health issues in regards to numbers of members.

- IMVU groups also featured mental health issues heavily,mainly due to a very popular ‘Suicide, Depression, and Relationships’ group.

- There.com skewed toward general health topics with a significant cohort of interest in the disabilities area.

- Kaneva had a slightly different focus on Gay, Lesbian and Transgender issues, as well as autism.

There is a caveat openly referred to by John Norris in his work: the numbers of participants in these groups are relatively small, particularly when compared to the burgeoning 2D health support space with its myriad discussion forums and other community mechanisms. That said, he makes some good assertions:

1. That the advent of virtual worlds provides another means for people to seek highly customised healthcare support, meaning the potential for finding the exact niche being sought is higher as adoption grows.

2. That, like any emerging area of healthcare, there needs to be more research done on the efficacy of the approach.

3. That the lack of access to good quantitative and qualitative data poses a challenge for those who see the need for more research.

Journal of Virtual Worlds Research: 3D Virtual Worlds for Health and Healthcare

The Journal of Virtual Worlds Research continues to go from strength to strength, and the current edition is devoted to health and virtual worlds. I’ll be writing about some of the specific pieces in coming weeks, but you’ll see the full table of contents below:

Table of Contents

Editor’s Corner

Musings on the State of ’3-D Virtual Worlds for Health and Healthcare’ in 2009

Maria Toro-Troconis, Maged N. Kamel Boulos

Abstract | PDF

Invited Articles

Virtual Worlds in Health Care Higher Education

Constance M Johnson, Allison A Vorderstrasse, Ryan Shaw

Abstract | PDF

Peer Reviewed Research Papers

The Growth and Direction of Healthcare Support Groups in Virtual Worlds

John Robert Norris

Abstract | PDF

Development of a Virtual Reality Coping Skills Game to Prevent Post-Hospitalization Smoking Relapse in Tobacco Dependent Cancer Patients

Paul Krebs, Jack Burkhalter, Shireen Lewis, Tinesha Hendrickson, Ophelia Chiu, Paul Fearn, Wendy Perchick, Jamie Ostroff

Abstract | PDF

Does this Avatar Make Me Look Fat? Obesity and Interviewing in Second Life

Elizabeth Dean, Sarah Cook, Michael Keating, Joe Murphy

Abstract | PDF

Research Papers

Development and Evaluation of Health and Wellness Exhibits at the Jefferson Occupational Therapy Education Center in Second Life

Susan Toth-Cohen, Therese Gallagher

Abstract | PDF

Research-in-Brief Papers

Development of Virtual Patient Simulations for Medical Education

Douglas R Danforth, Mike Procter, Richard Chen, Mary Johnson, Robert Heller

Abstract | PDF

“Think Pieces”

Virtual Worlds, Collective Responses and Responsibilities in Health

Rashid M Kashani, Anne Roberts, Ray Jones, Maged N. Kamel Boulos

Abstract | PDF

Pitfalls in 3-D Virtual Worlds Health Project Evaluations: The Trap of Drug-trial-style Media Comparative Studies

Maged N. Kamel Boulos, Inocencio Maramba

Abstract | PDF

Towards a virtual doctor-patient relationship: Understanding virtual patients.

Vanessa Gamboa González

Abstract | PDF

Editor-in-Chief’s Corner

Cultural Identity in Virtual Reality (VR): A Case Study of a Muslim Woman with hijab in Second Life(SL)

Methal Mohammed

Abstract | PDF

Shaping the ‘Public Sphere’ in Second Life: Architectures of the 2008 U.S. Presidential Election

Annabel Jane Wharton

Abstract | PDF