The case for virtual patients/serious games

We live in an increasingly tech-savvy and connected world. Globally there are approximately 1.9 billion smartphone devices, and 1.7 billion desktop computers. In the USA, the average user spends over 5 hours per day using one of these devices [1]. A significant portion of these devices are commonly used for recreational purposes, with around 1.8 billion people playing computer games [2]. 

It is no wonder then that there is a growing trend to leverage this huge market of gamers to try and achieve outcomes beyond simple entertainment. The field of “Serious Games” has emerged, and is tipped by many to be a major “game changer” in the way we educate and train [3][4].

Simulation based learning modalities are underpinned by the theoretical premise that students learn better through experience. The skills and knowledge they absorb through practice based activities are widely thought to be both more comprehensive than those gained through traditional instructional mediums, as well as better retained. In healthcare and other high-risk professions it is seen as a necessary way to allow students to practice their skills, without putting anyone in harm’s way.

Unfortunately, traditional simulated learning experiences are very high cost. Mannequin based simulations come with a very high entry cost, as well as the ongoing costs of maintenance and skilled operators/technicians. Standardized patients require demonstrators/actors, which must be paid. The recording setups required for review and assessment/feedback after these simulations are both expensive and complex to operate, again requiring maintenance and frequent attention from audio-visual technicians. These kinds of experiences are also logistically challenging to coordinate. The students must all attend the session face to face, at the same time as the demonstrators/technicians/actors. Access to the equipment must also be booked, and students generally must share the experience in groups, as there is simply not enough resource available to let all students have their own turn.

Serious games offer a meaningful new way of providing a simulated based practical learning experience to students, which can avoid most of these issues.

• Instead of students interacting with an actor and physical equipment, they can interact with a virtual patient in a virtual computer environment, using virtual copies of equipment.
• Instead of needing to record the simulation session every action the student performs can be logged and sent to a server for the purpose of learning analytics.
• Instead of reviewing a simulation session and assessing it manually, the various actions taken in the simulated scenario can be automatically assessed, and students can be given feedback immediately.
• Instead of needing to book time with equipment and personnel, each student can simply download their own copy of the simulated scenario to their personal device, and run through it in their own time.

It is not all good news though; there are still drawbacks to providing a virtual simulated experience.

The initial cost of development is still quite high, ranging from the tens of thousands for smaller, constrained simple experiences, up to the millions of dollars for more complex and realistic simulations. The game development and artistic skills required to create these experiences are also in short supply in most academic institutions, typically necessitating some degree of external collaboration or outsourcing.

There are also some skills that a virtual environment simply cannot simulate. Despite promising developments in the area of haptics [5] , it is still not really possible for a student to physically examine the virtual patient with any meaningful sense of touch. To an extent this kind of examination can be simulated through descriptive, audio and visual feedback, but there are obviously limits. Describing what a broken bone feels like is not the same as actually feeling it for yourself.

Despite this, the pros seem to outweigh the cons. In recent years the costs of development have been massively reduced through an improvement in technology and the ready availability of cheap and powerful development tools. At the same time the potential scope and fidelity of these experiences has been vastly increased.

Historically, attempts at creating virtual patients, virtual worlds, and other computer-based simulated learning experiences have been quite underwhelming. However, times have changed. The development tools are better and cheaper, the skills are better and more readily accessible, and the market is larger and better prepared.

Figure 1 Pharmacy Simulator is one of the simulated learning experiences we've been developing at the University of Tasmania.

At the University of Tasmania we’ve been developing a range of serious games/simulated learning experiences, built upon a common framework we call our “Simulation Platform”. By building each simulation on top of this general purpose framework, we are able to substantially decrease the total costs of the development of each simulator, while at the same time improving the quality and scope of the experience.

We believe that these serious games offer a meaningful and engaging simulated learning experience for students which can replace some traditional simulated experiences more cheaply and effectively, and can augment or complement others. Importantly, by creating these experiences students will be more readily able to access simulation based training, which has previously only been available within the rigid confines of a classroom setting.

Perhaps now is the time to consider investing in the use of serious games and virtual patients as part of your curriculum?

References:

[1] http://www.smartinsights.com/mobile-marketing/mobile-marketing-analytics/mobile-marketing-statistics/
[2] http://www.statista.com/statistics/293304/number-video-gamers/
[3] http://www.uu.nl/en/news/game-companies-and-researchers-see-potential-of-serious-games
[4] http://www.forbes.com/sites/danieltack/2013/09/12/serious-games-and-the-future-of-education/
[5] http://link.springer.com/chapter/10.1007%2F978-3-319-12057-7_5