For many healthcare educators, finding new and innovative ways to relay information to their students has become an essential way to stay current in the classroom. In many of these scenarios, technology is the key that links the teacher with their student and bridges the gap of understanding.

But some nursing universities and colleges are taking technology in the classroom to a whole other level. The development of virtual reality training using virtual worlds such as the current market leader, Second Life, is attracting interest from the healthcare education community.

According to a paper from Imperial College London that focuses on addressing changes and demands facing healthcare academics, "game-based learning has been considered as the new generation of 'digital natives' - 'native speakers' of the digital language of computers, video games, mobile phones and the internet".

Maria Toro-Troconis, senior learning technologist for Imperial College's faculty of medicine, has worked to offer medical students the opportunity to push the boundaries of traditional education. "We wanted to develop a game-based experience, basically concentrating on the diagnosis process," she said. The game-based learning system utilises Online Multi-User Virtual Environments (MUVE), a "rich interactive 3D collaborative spaces where users can meet and interact."

The goal of London's virtual hospital is to provide students with a unique learning experience that allows them to role-play with virtual patients, to develop diagnostic and treatment activities. Created in 2007, the virtual hospital was an experiment that allows visitors to envision the future of healthcare delivery.

The online version of the respiratory ward is a dynamic but orderly place. Five digital representations of patients or avatars are set up in their own rooms, complete with charts of their diagnosis, sinks for hygienic purposes and a series of machines and tubes attached. The rooms are designed to be easy for computer users to navigate around while giving students a look at what is to be expected in a real hospital.

"Compared to the class room, it could be more engaging," Toro-Troconis says. "[The students] are immersed in the virtual hospital and we wanted to have different triggers to make them realise how things work in a real hospital."

One trigger forces students to wash their hands before they are able to speak with patients. It is tactics like these that help develop important habits for nursing students.

The pilot project was conducted with a group of 42 third-year nursing students, 23 were selected based on their varying aptitude for videos games, from basic to experience, to complete compulsorily activities in Second Life.

The remaining 19 completed a basic e-module that modelled the course curriculum. The point of splitting the group in two was to find what worked best for a 21st century student. The results were unexpected.

"The only significant difference we found was the Second Life group found the experience more useful," said Toro-Troconis.

"It was funny because the [preference for Second Life] were in the female group, which means the females found the experience more useful than males; that is really interesting because we are working on a game-based approach and we tend to think that games are for boys and not for girls."

Another pioneer in virtual education, John Miller, a nursing instructor at the Tacoma Community College in Washington state in the US also runs a nursing training simulation on Second Life for his students. He stressed experiencing a medical emergency or illness in a virtual world can help bridge the wide gap between classroom and book-based learning and practising on a real life patient.

His simulations show, for instance, a patient experiencing a grand mal epileptic seizure. He also encourages his more computer literate students to innovate. "I tell them to build me a virtual brain, showing the various lobes," Miller said.

"We have overcome the Second Life learning curve with a focused orientation for students. They learn only the highest priority avatar skills at first. When students create accounts, they first step into Second Life only on our island and are not with the rest of the virtual world. We even facilitate setting up the accounts so there are no glitches."

To demonstrate a typical training scenario, University World News visited Miller's Second Life simulation. His avatar, named JS Vavoom, treated a digital patient, who was suffering from severe leg burns. Vavoom began the routine visit by asking the patient how he was feeling that morning.

The patient groaned and complained about pain in his leg. After checking the patient's blood pressure on a simulation monitor, Vavoom set up an IV and administered 2mg in morphine. The routine was technically accurate and modelled a possible scenario that real-life nurses are often faced with.

With the aim of illustrating the spontaneity of this method of teaching, Vavoom was forced to administer CPR and use a digital defibrillator on the digital patient when his condition suddenly worsened. The patient was stabilised and sent to the intensive care unit for further monitoring.

Speaking via Second Life chat, Vavoom said, "All objects can become interactive - a medical dispenser has drawers of medication that may be selected, applied to the patient, and affect the vitals and condition of the patient. This can be done with very minimal [computing] skills".

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