Measuring Impact

As I sit down to answer this week’s question- “How will you know if the users or participants in your project will be impacted in the way you hope?” I am rather depressed about the preliminary results of a SurveyMonkey survey that I just reviewed. This survey assessed student satisfaction with a Second Life patient interviewing experience that we just finished beta testing. Granted, the sample size is very small (only 2/5 students have responded so far) but these students did not appear to enjoy or appreciate the experience. This is an important survey as it will likely determine whether or not we proceed with Second Life at our institution at this time. To answer this question about impact you will first need to determine what type of impact you want to measure. Do you want to look at satisfaction as we did in our Second Life survey? Or, is it more appropriate to look at access or performance? This will help you to decide what tools to use to measure these parameters.

A survey delivered through a vehicle such as SurveyMonkey is just one of many tools that can be used to determine the impact of your project. It was fascinating to read the chapter by Loh in Games and Simulations in Online Learning that talked about designing online games assessment as “information trails”. I had just had a discussion with the director of our continuing education program regarding a push to track the time that doctors spent completing online programs. The accreditation agencies are concerned that doctors are not engaging with the continuing education materials and want to monitor time spent on task. Continuing education departments may be required to implement timing mechanisms in their online courses. Anyone who has shopped online has likely been the subject of a tracking technology. Have you noticed that Amazon.com has an amazing knowledge of your likes and dislikes? I also use tracking technology in my Moodle course in the form of participant logs to review the content accessed by students. We recently completed a study comparing access of online content as documented in the Moodle logs to performance on a related test question and found that access had a significant dependent association with scores. A bit of a no-brainer perhaps, but we found that students need to access the online content we provided in order for learning to occur.

Measuring performance is important if games are to be integrated into education due to the focus on measurable outcomes. This can make it challenging to build a game if one does not have access to a skilled team of designers. Commercial products are available that can integrate scores into a learning management system. For example, SoftChalk allows the novice to integrate activities such as crossword puzzles and drag/drop exercises into the LMS and SCORM technology allows for tracking of scores. A number of tracking technologies can be used to track activity in games and simulations involving avatars. Very useful reports can be generated but often this involves significant knowledge of coding and algorithms.

Gibson, D., Aldrich, C., and Prensky, M. (2007). Games and simulations in online learning: research and development frameworks. Hershey, PA: Information Science Publishing.

Beginning to Put the Game Together...

My current interest in gaming revolves around supporting chiropractic and health care education. The game/simulation I hope to develop will be based on the process of obtaining information from a history and exam to come to a correct diagnosis for a patient presentation. The proposed game described below supports my personal learning theory as it is based in cognitivism. Students need an underlying basis of facts in order to succeed. If they fail, they will be sent back to T1 in chiropractic school (i.e. a tutorial)- wonderful motivation! Far transfer will be supported as the elements will be derived from real-life situations and scenarios as much as possible using the typical forms used in an office and video clips of real a real patient. Hopefully the gaming elements will serve as motivating and reinforcing factors stimulating the students to want to complete the exercise. I am motivated to make an extremely important part of a student learning experience as fun and interesting as possible.

My primary concern still revolves around actually creating a game that I can use in my teaching. I do not currently have the resources or team players to create the ideal type of game that I visualize. Since I don’t want to simply present a game idea for my final project I will need to scale down my vision. I will try to create a simulation with embedded gaming elements and concepts rather than a full-fledged game. The student will start out by clicking to enter a chiropractic clinic. They would then a patient file folder to view information regarding their patient. Students will eventually have to progress through a series of cases to successfully complete the game. These cases will support the concepts emphasized in the Methods 3 technique course. The consequences of incorrectly diagnosing and treating a patient might range from the patient leaving your office, screaming in pain, demanding their money back, to the most serious- death or disability related to failure to identify a stroke in progress. Success results in an increase in patient files and money in the bank. I could eventually expand the game to include insurance coding elements and could have some fun with this- video clips of insurance adjustors, money entering and leaving the bank account, etc. Some of these elements may be theoretical at this point due to my limited skill set and lack of a game design team. However, the underlying simulation will still support the learning in my classroom. A simple game can be just as engaging as a multimedia, sound-blasting game with realistic bloodshed so that is what I am going to focus on. I think that using a branching concept might work. I could perhaps do this with the lesson function in Moodle or with a series of linked web pages created in Dreamweaver. I also have access to an interactive scenario builder software that could possibly be integrated into this process. The gaming elements would need to be embedded into these pages which could be challenging or impossible at this time. I will still describe the vision for these elements. Perhaps if the student answers a question correctly the branch takes them to a page with a flash animation adding money to their bank account and directing them forward in the process. If they answer incorrectly, they are sent back to chiropractic school via a tutorial and must answer the questions in this tutorial before they can see the patient again.

Evolution of Initial Thoughts on Game-Based Learning

As I proceed through the course, read, and review the work of my classmates I am getting a much deeper sense of how game-based learning can related to education. I’m still not much of a gamer myself but I have determined that the reason for this is primarily lack of time. It’s not that I don’t like to game, I simply don’t have the time to devote to become good at a game and it is much less enjoyable to play a game that you are not good at. This is a concept that I really need to address in the games that I create because my students are likely to be time-strapped adult learners as well. Previously I stated that I would like to develop the skills needed to integrate games into my current online teaching. I had suspected and now it has been confirmed that creating games is not an easy process and often requires a skilled team including programmers. Since I don’t have this team, I will need to focus on keeping any games quite simple at least in terms of technology. Realistically I will probably be adding gaming elements to my courses rather than developing full-fledged games. That said, I would really like to somehow develop a game similar Life or Death to use in chiropractic education.

Game Based Learning AnalysisApplied to: Emergency Room- Life or Death

Integrating Gaming Elements into Simulations

I took this course (Educational Games and Simulations) primarily for the “simulation” component. I had a great deal of interest in developing and creating medical simulations but little (or no?) interest in true gaming. I have played sports for much of my life but have never been much of a gamer. The one game I do currently play is Wii Fit which brings gaming into my workout so I don’t have to feel guilty about the time spent. Chapter 8 in Digital Game-Based Learning talks about the relationship of games and simulations. Simulations are not games because they do not have all of the required elements of rules, goals and objectives, outcomes and feedback, conflict/competition/challenge/opposition, interaction, and a story (p. 119). The problem with simulations is that they can quickly become boring once the novelty has worn off. If I am going to create engaging simulations I will need to integrate aspects of gaming into these simulations.

I was chatting yesterday with one of my older colleagues about what I was doing in class. He mentioned a game he used to play called Life and Death and talked about how much he enjoyed this game and wished that he still had the equipment to play it on. As I was reading today I found the same game mentioned in Prensky (p. 215). Prensky mentions that Life and Death is the game that got him into the field of gaming. The game takes place in a hospital and you are the doctor. You start the game by conducting history and examinations on patients with various symptoms. You have to perform the correct procedures and ask the right questions to arrive at a diagnosis. When you finally get a diagnosis of appendicitis you get to go to the operating room. If you miss a step such as scrubbing up you kill your patient and get sent to medical school (a tutorial) to learn what went wrong. I think that this is the type of activity that I need to bring into any simulations that I create. I could set up a similar learning activity related to chiropractic rather than an operating room. Students would have to follow the same history and examination steps mentioned above and if they got the diagnosis correct, they are then allowed to adjust the patient (rather than operate). If they then perform the adjustment correctly, they get the positive reinforcement of the cracking sound of joint cavitation, a smile and sigh of relief from the patient, and money ($$$chingchingching) builds up in their bank account. If they do it wrong, the patient walks out the door and they are sent back to chiropractic school. This would add most or all of the required elements of gaming to what could have been a boring simulation. My only concern is actually being able to create such a game by myself. Much of Prensky’s book talks about the teams of people required creating a new video game and I do not have the luxury of working in such a team.

Learn more about Life and Death at this link: http://www.classic-pc-games.com/pc/simulations/life_and_death.html

Game/Simulation/Pedagogy

Based on chapters 6, 7, and 8 in the Aldrich textbook there is a rather overwhelming number of details to keep in mind when developing a new game or simulation. You really need to understand what the end goal of the project is. Using linear content that moves along a specific path from start to finish is probably the best choice for a new designer as it is less costly, faster to develop, and is less frustrating to students. Instructor-supported dynamic learning would likely be the most effective means of teaching clinical skills to future doctors but this can be complex and costly. I am currently conducting a beta test of a patient interview experience for chiropractic students in Second Life. I believe that this would be categorized as a dynamic instructor-supported learning experience but there is also a significant stand-alone component. It is definitely resource intensive to create and offer. The basic structure of this experience involves a linear path that closely simulates real life. The student is presented with patient intake forms via the Moodle course management system prior to meeting with the patient in Second Life. They conduct the interview and then enter Second Life again to complete follow-up documentation and paperwork. However, the patient interview portion of the project is quite dynamic and unpredictable.

One important concept that I learned in chapter 8 was that the appropriate blend of the three elements of simulations, games, and pedagogy will result in the best educational experience. It is important that the simulation be accurate and the performance situation has to be similar to the learning situation. The virtual chiropractic clinic I created for a Second Life virtual interviewing experience has been designed to recreate a real-life clinic and the patient avatar is operated by a real-life geriatric patient with real-life aches and pains and has been built to look as geriatric as SL allows. Game elements bring fun into an experience but need to be used judiciously as they typically increase the time on task. I might be able to introduce a gaming element into my SL experience by having the students play a “who wants to be a millionaire chiropractor” with questions taken from the patient history. If they missed something during their interview with the patient, they will not be able to answer a question. Another gaming element in this experience involves the students (and the instructors!) creating their doctor avatars and names. This may be time consuming and really not necessary but I have found that there is a tendency to take a great deal of time creating this avatar. There is a definite pedagogical base to this SL educational experience and many of these pedagogical elements are the same as they would be in the real world. The students view background material on the patient in the form of intake paperwork and they are able to discuss their experience with other students via a Moodle discussion forum.

I am finding that there is a reason that games and simulations are often lumped together in discussion due to the many potentially overlapping elements involved.

Initial thoughts and concerns regarding game based learning

I am actually quite excited to learn more about game
based learning. I think it is an important area to explore in terms of increasing student engagement and is a way to make learning more interesting. I have not been much of a “gamer” to date so I have a lot to learn in this area. My current gaming experience involves using the Wii and Second Life (if that is considered a game). I would LOVE to figure out a way to use the Wii technology to teach proper body positioning and thrust technique for chiropractic students. Past gaming experience is limited to PacMan- I’m quite challenged using keyboard commands for the online version. I don’t want to date myself but I also remember Pong!

I hope that through this course I can develop the skills to allow me to integrate games into my current online teaching. Our chiropractic students could benefit from simulating patient encounters and situations whether through a virtual world experience or through a game. The Aldrich textbook provided great examples of gaming in education and got me quite interested to explore further. It also gave me some ideas for potential projects. One of my major concerns that I have is the time that it is likely to take to create these games. I’m also concerned about my limited technical skills.

"About Me"

Welcome to my blog. As you can see, it is a continuation of a blog I started during my first term at Boise. This term it will serve two purposes- I will be posting as part of the requirements for the educational Games and Simulations course and I will also use it to model blogging for my students in the Nutrition Master's program at Northwestern Health Sciences University in Bloomington, MN.

My background is diverse with previous degrees and careers in food service, dietetics, exercise physiology and chiropractic. I am a doctor of chiropractic and currently teach classroom, hybrid, and online courses at NWHSU. I live in a condo in downtown Minneapolis with my dachshund Sachey (short for Salchicha- Spanish for sausage). Several years ago I had never used email or PowerPoint. To learn more about teaching and technology I started with a certificate in Instructional Tchnology from the College of St. Scholastica and transferred to BSU for a more technology oriented program. Apparently I cannot get enough of this topic as I am planning on pursuing doctoral degree once I finish the MET next fall. I am currently a GA for Dr. Dawley and helped her to teach Online Course Design last term.

In a previous life (before school!) I was very active in the sport of rugby, first as a player and then as a team physician. This allowed me to travel extensively across the US and internationally to Canada, England, Wales, Scotland, France, and Australia. Now my travel is limited to professional conferences. Last year I was lucky enough to present in Beijing and Melbourne and supervised a clinical work experience for students in Costa Rica. As a side note, the Great Wall is truly one of the 7 Wonders of the World!

















Educational simulations for the medical and chiropractic professions are a special interest of mine. We are offering a clinical education experience in Second Life at NWHSU for the first time this term. Our students will use their avatars to conduct a patient interview with the avatar of a geriatric patient in Second Life. Below is screen shot of the virtual chiropractic clinic in Second Life.

To learn more about Second Life in Medical education check out this video created as a course project: http://www.youtube.comwatch?v=6RdwqK2di7M