Virtual Worlds in Healthcare Education

The following are excerpts takenA� from a paper I wrote entitled a�?The Use of Virtual Worlds in Health Educationa�? in April 2010. The paper explored the theme of virtual worlds (VWs) and their use in health education.A� In 1999, the US Institute of Medicine reported an estimated 44,000 to 98,000 deaths occurred as a result of medical error (as cited in McConnell & Pardy, 2008). These authors emphasize that the healthcare industry is one in which human and even financial (since healthcare is very expensive) costs of error are unacceptably high. And, more importantly, human factors are the number one reason these errors occur. Thus, one of the most significant challenges for healthcare educational institutions is to prepare graduates that are not only knowledgeable, but also have strong clinical (procedural), critical, and problem solving skills.

To re-iterate, gaining knowledge from textbooks alone does not prepare individuals for healthcare positions. These individuals will be required to engage in high stress decision making (McConnell & Pardy, 2008). As a result, students within programs such as medicine, nursing, dentistry and their associated allied professions must develop the capacity to make sound decisions based on the evidence or signs and symptoms that they observe and collect. Arguably then, the development of critical thinking and problem solving skills are probably as or even more important than the technical procedural skills that these students must master prior to graduation. So, the question becomes, how should instruction be guided within the healthcare setting? Driscoll (2005) states that the goal of constructivist instruction is to develop the ability to solve problems, think critically, and act and reflect on the use of knowledge. In order to achieve this end, constructivists suggest that instruction: 1) be embedded with complex, realistic, and relevant learning environments; 2) provide for social negotiation as an integral part of learning; 3) support multiple perspectives and the use of multiple modes of representation; 4) encourage ownership in learning; and, 5) nurture self-awareness of the knowledge construction process.

Healthcare education was not effective at achieving this. In fact, in many cases, student learning occurred by observing experts at work in authentic situations. However, this does not allow learners to make the learning personal.A� Therefore,role-playing, first through the use of actors and then through the use of computer-assisted instruction was utilized (Rosen, 2008). These types of learning experiences provided individuals with an opportunity to be immersed in situations and make critical decisions without causing harm. This has also been termed a�?experiential learninga��. Medicine and dentistry have been using mannequins that simulate real patients for approximately three decades within sophisticated clinical simulation laboratories (Rosen, 2008; Phillips & Berge, 2009).

In the last few years, the use of virtual worlds (VWs) in education has been gaining momentum. According to Dalgarno & Lee (2010), the advantages of
using VWs in teaching include facilitation of: experiential learning; learning that leads to increase motivation and engagement; knowledge transfer to real situations through contextual learning; and, richer, more collaborative learning than that afforded by two-dimensional learning.A�VWs are a�?three-dimensional computer-based environment[s] that simulate realitya�? (Billings, 2009, p. 489). Other authors include the terms a�?immersivea��,a�?multi-mediaa��, a�?running over the Weba��, and a�?multi-persona�� within their definitions (Wagner, 2008; Boulos, Hetherington, & Wheeler, 2007). However, some authors contend that in order to be completely immersive, VW users must use special hardware (Davis, 2009; Dalgarno & Lee, 2010). Thus, according to these authors, VWs that can be accessed using standard personal computers are less engaging because navigation is via movement of a device such as a
computer mouse.

VWs can be used by the healthcare faculty to provide lectures with a virtual lecture room, hold office hours for student counseling, provide information for review by students such as poster presentations, assign simulation exercises, and/or engage in role-play withA� students.A� The use of VWs in education, including health education, is relatively new. The costs associated are financially cumbersome and integration can be time consuming for a schoola��s administration and faculty. While the technology is still in its infancy within the healthcare educational sphere, further evaluation needs to be done in order to validate its claims of success. But there is ample evidence which shows this teaching tool can benefit the healthcare education industry, as it allows for simulation of real environments and situations without the associated risk.


Billings, D.M. (2009).
Teaching and learning in virtual worlds. [Electronic version]. Journal of Continuing Education in Nursing,November 2009 40(11), 489-490.

Boulos, M.N.K., Hetherington, L., & Wheeler, S. (2007). Second life: An overview ofA� the potential of 3-D virtual worlds in medical and health education. [Electronic version]. Health Information and Libraries Journal, 24(4), 233-245.

Delgarno,B., & Lee, M.J.W. (2009). What are the learning affordances of 3-D virtual environments? [Electronic version]. British Journal of Educational Technology, 41(1),10-32.

Driscoll, M. P. (2005). Psychology of Learning for Instruction (3rd ed.). Boston:Allyn & Bacon.

McConnell, H. & Pardy, A. (2008). Virtual patient simulation for prevention of medical error: Beyond just technical upskilling. [Electronic version]. World Hospitals and Health Services, 44(3): 36-39.

Phillips, J. & Berge, Z.L. (2009). Second Life for dental education. [Electronic version]. Journal of Dental Education, 73(11), 1260-1264.

Rosen, K.R.(2008). The history of medical simulation. [Electronic version]. Journal of CriticalA� Care, 23, 157-166.

Wagner, C.(2008) Teaching Tip: Learning experience with virtual worlds. [Electronic version]. Journal of Information Systems Education, 19(3), 263-266.

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