MAKING CLINICAL DECISIONS IN A VIRTUAL WORLD

This paper reports on a pilot study involving an international collaboration between healthcare educators at English and Canadian higher education institutions and a software development company.

Aims:
The study aimed to pilot a concept of developing a real world international decision making education experience around a significant and common health issue (dementia). The virtual world aspect allowed participants to encounter authentic real world issues and try out decision skills without any risk to patients. Ethical approval was obtained from Leeds University (UK) and Algonquin College (CA).

Design:
Learning took place as avatars in a virtual world with staff acting as patients and relatives. Patient narratives were developed from real world accounts of individuals diagnosed as having dementia and relatives of those who had dementia. A constructivist pedagogy guided the learning design and an information seeking theoretical approach was taken towards decision making. Three consecutive scenarios were played out in which the patient’s condition deteriorated and two pairs of students (UK and Canadian) were briefed by a ‘nurse’ to visit the patient and undertake a needs assessment. Following the assessment the nurse conducted a debrief about their decision making (audio recorded) and on completion of the study students were invited to complete a mixed methods online survey.

Analysis:
Audio, video and survey data was thematically analysed to generate three dimensions of findings: learning in a 3d virtual world, learning about decision making and learning about the care topic.

Findings:
Accessibility issues indicate technician support was essential for virtual world learning. Cross discipline working, in different time zones and institutions adds complexity requiring clear logistics planning. Students found it to be an engaging and informative learning experience and valued it as preparation for practice. The recruiting phase of the study encountered a ‘selling’ issue to help prospective participants understand what a virtual world and avatars. A further larger scale evaluation study is proposed to develop decision making learning with different topics.