Contemporary Theory Bauman Imsh 2010

Examining Contemporary Theory forVirtual and Game-Based Learning

Eric Bauman, PhD, RN, Paramedic© Copyright by Eric B. Bauman 2010

All Rights Reserved

Author Information and COI Statement

Eric Bauman, PhD, RNFaculty Associate

University of Wisconsin School of Medicine &Public Health

Department of Anesthesiology

COI: Consultant -Vernon Memorial Healthcare and TMFDInvestments: Pfizer, SHSAX

What’s Wrong with Traditional TheoryNothing & Everything

• Traditional theory provides historical prospective andin some cases a starting point for contemporarytheories.

• Traditional learning theories predate moderntechnology including virtual and game-basedimmersive environments.

• The learner can no longer be seen as an emptyvessel waiting around for a fill-up of expertise

• Traditional learning theories often does notadequately address behavioral aspects ofprofessional practice such as Culture & Diversity

Students are Students, Right?What worked for me is good enough for today’s students

• Most of today’s students grew up in the age of the Internet - theyembrace digital culture. They are likely to have a high degree of medialiteracy and adaptability

• Students are well positioned to take advantage of virtual and game-based learning environments and opportunities

• Digital media is no longer seen as a facet of culture limited toentertainment and communication.

• The modern learner is accustomed to multi-media environments and iscomfortable using these environments for academic, personal, andprofessional gain. Students today don’t expect good engagingtechnology - they DEMAND IT!

• Institutions that do not embrace a sense of media literacy find itincreasingly difficult to compete for today’s best and brightest students

Historical PerspectiveExperiential Learning Theories

• Schön (1983): Reflection-on-Action.Reflection through internal dialog ortalk-back– Contextually Emergent

• Benner (1984): Thinking-in-Action.Reflection of previous experienceeffects current practice– Contextually Emergent

• Kolb (1984): Experiential Processesas Cyclical and reflective

Contemporary Theories• Created Environment1• Designed Experience2

• Socially Situated Cognition3

• Ecology of Culturally Competent Design4

(Bauman 20071;Games & Bauman4; Squire, 20062 Gee, 1991,19933

Created Environment

• An environment that has been specificallyengineered to accurately replicate an actualexisting space, producing sufficient authenticityand fidelity to allow for the suspension ofdisbelief. Simulated environments, whether fixedin the case of mannikin-based simulationlaboratories resembling elaborate theatrical sets,or existing in virtual reality, are createdenvironments.

Bauman, 2007

Designed Experiences• A Designed Experience is engineered to

include structured activities targeted tofacilitate interactions that drive anticipatedexperiences. These activities are created toembody participant experience asperformance. Many theme parks are basedin part on the theory of designed experience.

Squire 2006

Socially Situated Cognition• Refers to learning theory that is

situated within a material, social, andcultural world. Learning that is situatedtakes place in contextually specific andauthentic environment with a host ofvalues and expectations.

Gee,1991,1993

Ecology of CulturallyCompetent Design

• Addresses the rigors and challenges ofaccurately situating culture withinvirtual environments using a four-element model that emphasizes theimportance of activities, contexts,narratives, and characters.

Bauman, In Press; Games and Bauman, In Press

Activity• Interactivity is one of the most important defining characteristics of

successful learning in games and virtual worlds.

• Participation in virtual worlds is only meaningful when players areactively engaged in their environment rather than passively observing it

• The game and its environment define identity and develop affinitygroups

• In the health sciences, virtual spaces include familiar settings wherelearners can practice many of the activities germane to the professionsthey hope to join

(Gee, 2003; Taekman, Segall, Hobbs and Wright 2007)

Context• Virtual simulated spaces can be designed in ways that

authentically capture environmental fidelity– Replicate in virtual form aspects of the real world that

students occupy in actual practice• Safer environments where students could afford to learn from

mistakes with no risk to patients– virtual worlds provide opportunities for learning and

professional development without the consequencesassociated with actual therapeutic misadventure

• Virtual simulation overcomes some of the barriers associatedwith fixed or physically created environments– Money, Location, Space allocation

Games and Bauman, In Press; Squire 2006; Bauman, 2007

Narrative• Narratives provide peoples’ memories with a collection of

patterns that help them recognize and make sense of the world

• Narratives assist players in the negotiation of their identities,particularly projective identities. Projective identities placelearners in the shoes of the virtual identities they are playing

• Narratives also provide spaces for reflection on theconsequences of student action or inaction. Learners can beencouraged to see the consequences of their decisions frommultiple perspectives and deliberate practice

(Bruner, 1991; Gee, 1991, 2003)

Character• The fluidity and malleability of virtual environments applies not

only to the look and feel of virtual teaching spaces, but alsolearners identities

• The ability to try on multiple identities may be of great value forthe construction of learning experiences involving culture anddiversity

• Players shape and design their avatars (characters), whichbecome their in-world identities

• Identity expectation related to one’s future professional affinitygroup is an important tenet of learning

(Gee, 2003; Squire, 2006)

So why should weturn to these newfangled theories?

Why turn to theoriesthat stem from themodern videogamemovement and the

entertainmentindustry?

Cracked.com & capt_weasle

Cracked.com & darrenjames140

Because we are interested inteaching our students to

become something other thangood technicians!

What we are reallyinterested in…

• Identity and Consequence• Acculturation and Indoctrination of a

professional into practice• Cultural Competence• Learning as Behavioral Change

Popkewitz, 2007

Cracked.com

Identity and Consequence• Virtual communities encourage participants to “try

on” different identities and reflect on theconsequences of their decisions while “wearing”these identities.

• Identity is fluid and malleable - How can we use thisfluidity to enhance learning experiences?

• As instructors should we or do we need to imposerestrictions on in-world identity

(Gee, 2003; Turkle, 1995)

Acculturation - Indoctrination

• Part of the educational experience focuses on learning how tobecome part of a cohort

• Beyond the required professional knowledge base, noviceclinicians must come to understand the conduct andexpectations of the rank and profession they hope to join

How to: Look - Act - ReactGee, 2003; Popkewitz, 2007

Cultural Competence• Published literature readily discusses the importance of integrating

cultural competence into health sciences curricula• There is little literature to indicate that simulation and standardized

patient education has readily integrated culture and diversity intohealth sciences curricula.

• Both obvious and subtle cues related to culture, gender, and race canoften have profound social-cultural implications and biologicalconsequences related to diagnosis and treatment

• Cues derived during observational and behavioral encounters maydrive important decisions related to diagnosis and patient care.

(Culhane-Pera, Reif, Egli, Baker, and Kassekert, 1997; Tervalon and Murray Garcia, 1998;Smedley, Stith, and Nelson, 2003; Steele and Aronson, 1995)

Learning as Behavioral Change• Through in-world interaction and during post experience

debriefing instructors can facilitate behavioral responses fromstudents that represent either cultural competence or culturalcliché and stereotypes

• Educators bear the responsibility for providing environmentsthat provide a safe medium to facilitate the transfer ofknowledge and facilitate behavioral change

• Web-based and virtual worlds can provide a translationalplatform for behavioral change related to culture and diversity

Thiagarajan, 1992; Games and Bauman 2009

Transition from the virtual world to the real world• Avatars and virtual worlds can be designed to evoke students

preconceived notions of culture and identity– In terms of cohort social norms and cues– In terms of professional expectations and cues

• Virtual or web- based communities that authentically replicatereal-world clinical experiences can provide translationaleducational and research experiences for both students andeducators

• Virtual or web-based experiences may provide consistentexposure to diverse cultural content across curricula that areNOT available in actual clinical or traditional mannikin-basedsimulation environments

References

Bauman, E. (2007). High fidelity simulation in healthcare. Ph.D. dissertation, The University of Wisconsin-Madison, United States. Dissertations & Thesis @ CIC Institutions database. (Publication no. AAT3294196)

Bauman, E, (In Press). Virtual reality and game-based clinical education. In Gaberson, K.B., & Oermann, M.H.(Eds) Clinical teaching strategies in nursing education (3rd ed).New York, Springer Publishing Company.

Benner, P. (1984). From novice to expert: Excellence and power in clinical nursing practice. Menlo Park, CA:Addison-Wesley.

Bruner, J. (1991). The narrative construction of reality. Critical Inquiry 18 (Autumn), 1-20.Culhane-Pera, K.A., Reif, C., Egli, E., Baker, N.J., and Kassekert (1997). A curriculum for multicultural education

in family medicine. Family Medicine, 29(10), 719-723.Games, I. and Bauman, E. (In Press). Virtual worlds: An environment for cultural sensitivity education in the

health sciences. International Journal of Web Based Communities.Gee, J. P. (1991). Memory and myth: A perspective on narrative. In A. McCabe & C. Peterson (Eds.), Developing

narrative structure (pp. 1 - 26). Mahwah, NJ: Erlbaum.Gee, J.P. (2003) What Videogames Have to Teach Us About Learning and Literacy. New York, NY: Palgrave-

McMillan.Popkewitz, T. (2007). Cosmopolitianism and the age of school reform: science, education and making a society

by making the child. Routledge.Smedley, B. D, Stith, A. Y, and Nelson, A. R. (Eds.). (2003) Unequal treatment: Confronting racial and ethnic

disparities in health care. Washington, D.C.: National Academies Press.Steele, C.M. & Aronson, J. (1995) Stereotype Threat and the Intellectual Test Performance of African Americans.

Journal of Personality and Social Psychology. 69(5), 797-811.Squire, K. (2006). From content to context: Videogames as designed experience. Educational Researcher.

35(8), 19-29.Taekman J.M., Segall N., Hobbs G., and Wright, M.C. (2007). 3DiTeams: Healthcare team training in a virtual

environment. Anesthesiology. 2007: 107: A2145.Tervalon, M. and Murray-Garcia, J. (1998). Cultural humility versus cultural competence: A critical distinction in

defining physician training outcomes in multicultural education. Journal of Health Care for the Poor andUnderserved, 9(2), 117-125.

Turkle, S. (1995) Life on the screen. Identity in the age of the Internet. New York: Touchstone.

Special Thanks• Eric Graves: American Research Institute• Gerald Stapleton: University of Illinois at Chicago

College of Medicine• Jerry Heneghan: Virtual Heroes• Melanie Lazarus: ARCHIMAGE• Jeff Taekman: Duke University - Human Simulation

and Patient Safety Center• Bob Waddington: SimQuest• Allan Barclay: University of Wisconsin - Madison,

Ebling Library

Contact Information

Eric Bauman, PhD, RNB6/319 CSCDepartment of Anesthesiology600 Highland AvenueMadison, WI 53792-3272

Email: [email protected]: 608-263-5911Linkedin: http://www.linkedin.com/in/ericbbauman