Granted, simulations are not new—they have long been a part of medical training. Hospitals often build operating rooms just for training purposes, and they use sophisticated patient dummies to teach students how to perform exams, measure vital signs, and other tasks. Computer models like CD-ROM simulations have also been in use for years at medical schools and other healthcare training programs.
Still, pro-SL educators argue that the era of CD-ROMs and dummies is over. “No kid wants to put in a CD-ROM and do a set sim—they want interactivity and social networking,” Miller says. “SL takes what’s great about simulations and gives them that social aspect. It’s more like real life.”
“The real innovation in SL clinical simulations is that they bring people together in a clinical space—you are standing next to an avatar who is a real patient, and the doctor avatar to your right is a resident at Massachusetts General Hospital and the nurse to your left is at the University of Pennsylvania hospital,” says John Lester, the Education and Healthcare Market Developer at Linden Labs, the company that created Second Life. SL can also give students greater access to experts in a field. “If there’s an expert in Brussels who is a specialist in a procedure that I want to teach my students, I can bring him or her into the virtual space to train them,” Lester says.
Students can also discuss their work, network, and compare notes in a way that isn’t always possible in real life. “When the staff left [the sim], the students often stuck around and continued to talk about the scenario and their experience,” Diener says. “A lot of our students travel from very remote locations, so this is a unique chance for them to socialize.”
Of course, arguably the most significant benefit of SL training is the cost. Real-life training facilities require thousands, and sometimes millions of dollars to build and maintain, not to mention travel expenses for students and faculty. For example, Dartmouth Hitchcock Medical Center in Hanover, N.H., built a state-of-the-art training facility with rooms, dummies, equipment, and software. The price tag? Over $2.5 million. The sophisticated mannequins used by medical schools cost hundreds of thousands of dollars each. But SL simulation rooms can be created for minimal costs, and accessed from anywhere in the world for the price of an Internet connection.
“[Officials at Dartmouth Hitchcock] say, ‘the biggest challenge is getting people here’” to use the real-life facility, Lester says. “You have to travel to New Hampshire to use it. Moving around in the physical world is expensive and the biggest obstacle in medical training.”
Critics have pointed out that there are plenty of unanswered questions about health-care education in SL, and that little empirical research has been done to see if it really works. For their part, schools with SL programs are slowly but surely gathering data on the virtual world’s effectiveness. At Imperial College London, David Taylor, director of virtual worlds and medical media in the Department of Biosurgery and Surgical Technology, has been doing his own research: “We tested [the virtual O.R.] in a controlled experiment on 40 first-year medical students prior to their first visit to a real O.R. We wanted to determine if [the SL program] gives them more confidence before their first exposure to the real thing. We’ve found it is just as effective as the training O.R. in the physical world.” Diener says that his surveys of medical students show that their emotional reactions to medical crises in SL are very similar to the ones they have to real-life simulations.
Diener also emphasizes that SL can expose students to situations that a standard academic program can’t duplicate: “[SL] is not about creating an automated teaching environment. It’s about giving students experiences we can’t give them otherwise, because it’s impossible or unsafe. For instance, if I’m going to examine a Muslim woman, her husband will be in the room, maybe even standing next to me. How do I teach students to deal with that scenario in a classroom?”
