Our second interviewee is Dr. James Kinross who is working at the Imperial College of London (Division of Surgery, Oncology, Reproductive Biology and Anaesthetics) and is a pioneer in conducting medical simulations in the virtual world of Second Life.
Click here to see how Dr. Kinross answered these questions:
- 1) Mr. Kinross, you and your collegues have developed a virtual teaching environment for medical students. Why did you choose Second Life for such purpose?
- 2) How realistic can objects and operating rooms be in Second Life? Does your simulation focus on interactive learning or animation-based training?
- 3) Many educational meetings in SL find it difficult to interact because of the lag users have to face due to technical problems. Have you experienced something similar?
- 4) Who can access the virtual site now? Is there a teleport link we could use?
- 5) What do you think about other medical teaching opportunities such as the Ann Myers Medical Center? Are you open to co-operate with them?
- 6) Do you plan to construct other educational resources in Second Life in the near future?
1) Mr. Kinross, you and your collegues have developed a virtual teaching environment for medical students. Why did you choose Second Life for such purpose?
I should probably make it clear that i have no association with Linden lab and I have no commercial interest in Second Life (SL). My interest is purely academic, and I am trying to understand how we can utilize the tremendous power of the online metaverse to improve human health and medical education. There is now a large choice of commercial and open source virtual worlds available to researchers and picking the right one can be challenging. For us, there were basically three driving factors that lead us to second life:
1) Cost. Although it is certainly not free to develop within Second Life, the bespoke virtual worlds were prohibitively expensive and it was simply not feasible for Imperial College London (ICL) to use them as an experimental platform. We have however been able to secure funding for several islands in SL, and for this research we have been able to acquire enough ‘in house’ expertise so that we could effectively produce the quality of build we needed.
2) SL possess a scientific network: Probably Second Life’s greatest asset is its remarkable community of scientific, medical and educational users that are adapting the technology for ‘serious’ purposes that go beyond entertainment, and they are doing this in the most innovative manner. By using a social or professional platform like Second Life (providing that you are able to work with the community) it is possible to gain access to the experience of many thousands of users from all over the world.
3) Second Life is open source: This means that thousands of developers are continuously pushing the boundaries of the technology in a manner that we simply couldn’t replicate if we were working with a single in house platform or a smaller public sim. It also means that we can speak to the community to ask for help when we need it! Having said all of this, we are continually analyzing and testing other platforms, and we don’t exclusively limit ourselves to Second Life.
2) How realistic can objects and operating rooms be in Second Life? Does your simulation focus on interactive learning or animation-based training?
This is a good question! The most important thing for us was to define exactly what we needed our virtual operating theater to do. In this case we were specifically interested in teaching novice medical students how to be safe, and how to learn and act in a complex and potentially dangerous environment. We were not asking them to develop real world skills or to learn how to use objects so we focused on interactive learning with a real world teacher guiding them through the virtual surgery (although some animations were built into the model). So in that respect, we didn’t need objects to be programmed to function as they would in the real world, although this is perfectly possible. (For a different project we are creating a suite of infusion pumps for device training that will do just that). In this case, most students didn’t have expectations of interacting with high fidelity objects as they simply compared the simulation to what they already have experience of at home i.e. a computer ‘game’. As it turned out, we found that most students were positively surprised at the level of realism we were able to achieve for specific objects. However, there is little point creating objects that bear absolutely no resemblance to what students will actually use in the real world.
Therefore we spent allot of time making sure that after they visited our virtual theatre, students would recognize the specific Operating Room (OR) when they entered it for real and that they would be safe with the actual objects within it. Thus, there is an argument that this sort of specific environment should be created in a bespoke fashion (even the actual view from the St. Mary’s hospital OR is recreated in the virtual OR). We studied students in three environments: A lecture theater, a simulated operating suite or SOS ( a real world training OR) and the virtual world. Students reported no significant difference in the fidelity of the simulation between the SOS and the virtual OR. We think this is because in the virtual world, although it is clearly not ‘real’ we were able to model all aspects of the OR experience e.g. where you get changed, who you meet, the objects you see, where you go to scrub, where you have coffee! It is because of this that the students felt significantly less anxious about entering a real world theater than in the other two groups.
3) Many educational meetings in SL find it difficult to interact because of the lag users have to face due to technical problems. Have you experienced something similar?
Yes, this is a problem and it can make running a meeting stressful! It is a particular problem for first time users as the interface and the speed of interaction between experienced users can also be a little overwhelming. Naturally, I am biased as I have been to so many excellent educational meetings in Second Life and I am convinced of the power of this sort of technology. I have literally met researchers I would never have had the opportunity to work with in the real world. Once you get used to the technology lag it is possible to work around it or accommodate it in a way that is not intrusive. The danger is that these things can create a bad first impression or discourage further engagement. The lag experienced due to platform instability or broad band speed has significantly improved and this will continue to do so. However, I think the emphasis is now on the educational / Linden community to develop solutions to some of the more significant technical barriers facing us right now…like how to minimise the learning curve for first time users, how to ensure that users can clearly and unambiguously identify each other, intuitive HUD’s, how to protect data etc…
Some of the escapism aspects of Second Life are very useful e.g. in some meetings it gives some people more confidence to voice their opinion. However, if Second Life is to be embraced by the wider educational/scientific community it needs to be able to take on a more formal tone when necessary. We have run several meetings in SL for medical professional education and patient engagement as part of NHS London health reform. Nearly all first time users describe positive experiences and that they can communicate in an organic method that is currently not possible using a telephone or other online conferencing systems. Furthermore, they are able to meet and talk to people in a way that is not often possible in real life. Communication brings the health metaverse to life, and the reason why the technology lag is worth over comming. The future of medical research is dependent on multidisciplinary collaboration, and the online metaverse facilitates this like no other media.
4) Who can access the virtual site now? Is there a teleport link we could use?
The first piece of work we produced was Second Health (www.secondhealth.org.uk). The aim here was to create a vision of healthcare reform within London’s National Health Service (NHS) which all users could come and experience. This island is always open and can be found here.
We are in a period of rapid development right now, as we are also currently creating a training environment for nurses which will enable us to tackle the issue of device training in the virtual world. The Imperial College London training centre for the department of Biosurgery and Surgical Technology can be found here.
Once we have completed the next round of testing we will open it up so that you can all come and have a look or indeed use it for educational purposes!
5) What do you think about other medical teaching opportunities such as the Ann Myers Medical Center? Are you open to co-operate with them?
The really exciting thing for me, is watching the growing number of innovative medical education projects that are able to engage with students, patients, professionals and the pubic in entirely novel ways. The Ann Myers Medical Center provides an extremely important teaching resource in Second Life, and it was one of the first institutions to recognize the importance of engaging with the virtual world community with respect to health care education. We would ofcourse be delighted to collaborate with the Ann Myers Center, and this would be in the spirit of the health metaverse. The ‘open source’ revolution has really challenged the way that more traditional scientists work, and I see an open spirit of collaboration as being essential to the success of this medium.
6 ) Do you plan to construct other educational resources in Second Life in the near future?
Definitely. The Department of Biosurgery and Surgical Technology (BSST) at Imperial College London sees the online health metaverse as an extremely valuable educational resource and it has therefore recently created a Medical Media and Design Laboratory (MMDL) to ensure that it is able to harness virtual worlds in the most effective way possible for the improvement of human health and education. Dave Taylor (Davee Commerce) is currently leading the virtual worlds program and we are very lucky to have clinicians who can work with builders (such as Robin Winter) and computer scientists in house. I mentioned previously that we are currently creating a training simulation to teach nurses how to use medical devices, and we are looking to open the current OR simulation for multi disciplinary team education within Second Life. This will therefore undergo continued development and refinement. We are also continuing to develop technologies which we hope will facilitate communication at future educational meetings. As soon as we have something new to show you, you will be the first to know!