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Medical-Surgical Education with

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Title: Medical-Surgical Education with


1
Medical-Surgical Education with Videogames (Youv
e gotta be kidding?)
SUMMIT Home of Translational Medical Education
Wm. LeRoy Heinrichs, M.D., PhD. Professor
(Emeritus, Active) Past Chair of Obstetrics
and Gynecology Director, Surgical
Simulation Associate Director of SUMMIT
2
S U M M I T STANFORD
Videotape Internet CDs, DVDs Simulation Vide
ogames Cell phones PDAs
E D U G A M I N G
3
Fabricatores Definition
S U M M I T STANFORD
. . . not thinking what gaming experience can be
the most motivating frame for some specific
controlled learning activities, but rather how. .
. to create a virtual environment and a gaming
experience in which the contents that we want to
teach can be naturally embedded with some
contextual relevance in terms of the game playing
... learning tasks must be contextual to the game
in the sense that they must be perceived by the
player as a true element of the game-play.
(Fabricatore 2000)
E D U G A M I N G
4
Fabricatores Definition/WLH
S U M M I T STANFORD
. . . creating a virtual environment and a
gaming experience . . . with contents that
are naturally embedded in the game playing, .
. . learning tasks are contextual and . . .
perceived by players as true elements of the
game-play. (Fabricatore 2000)
E D U G A M I N G
5
Prenskys Five Criteria
S U M M I T STANFORD
Is the game fun enough that someone who is
not in its target audience would want to play it
(and would learn from it)? Do people using it
think of themselves as players rather than
students or trainees? Is the experience
addictive? Does it produce great word of mouth
among users? ... Do users want to play again
and again until they win, and possibly after?
Are the players skills in the subject matter and
learning content of the game be it
knowledge, process, procedure, ability etc
significantly improving at a rapid rate and
getting better the longer he or she plays?
Does the game encourage reflection about what has
been learned?
E D U G A M I N G
6
Prenskys Five Criteria /WLH
S U M M I T STANFORD
Is the game fun for everyone? Do students
or traineesbecome players ? Is the
experience addictive? Do players skills and
knowledge improve rapidly? Does the game
encourage reflection about the content?
E D U G A M I N G
7
Prenskys Labels www.marcprensky.com/writing/
S U M M I T STANFORD
VS
Courtesy Jill Attewell-TELRC
Courtesy Kingsley Willis SUMMIT
Digital Native
Digital Immigrant
8
Gamers Generation vs Oldies Prensky 2001
S U M M I T STANFORD
twitch speed versus conventional
speed parallel processing
linear processing graphics first
text first random access
step by step connected
stand-alone active
passive play
work payoff now!
patience fantasy
reality technology-as-friend
technology-as-foe.
Digital Native
Digital Immigrant
9
10 Reasons Computer Games Sell
S U M M I T STANFORD
fun yields enjoyment pleasure play
intense, passionate involvement
rules structure goals
motivation interaction doing
activities
outcomes feedback yields learning
adaptive flow winning
ego gratification
conflict/competition the rush
problem solving creativity
representation a story emotion.
10
Simulations and Games (comments from
simworkshop.stanford.edu blog)
S U M M I T STANFORD
'A simulation is typically a re-creation or
creation of a plausible environment (not
necessarily a real one) in which the (usual)
activities of that environment can be conducted
by the participant. (Gaba)
'A game has rules, levels, and a winner.
Simulations don't!' (Krebs)
Serious game (definition) - a mental contest,
according to certain rules, played with a
computer, that uses entertainment to further
training, education, health, public policy, and
strategic communication.(Zyda)
'Both simulations and games allow the end users
to play the lead, decision making role in a
situation where the outcomes are important to the
user and there is a desire/quest to perform one's
best. (Pugh)
Simulations and games are learning methods that
immerse users in physical activities that prompt
ego-driven, best performances, thereby
facilitating retention.(WLH)
11
Simulations and Games Craig Brannon Legacy
Interactive
S U M M I T STANFORD
Simulations A computerized model of real life
that represents a physical or simulated process
Games Directed and competitive activity
conducted in a framework of agreed rules,
Learning Objectives in Games One wants short
term and long term goals, and in an educational
game, its good to have the game goals aligned
with the learning goals So in other words, in
order to succeed in the edugame, you need to
achieve the learning objectives!
12
Types of Computer Games Griffiths list, WLH
emphasis
S U M M I T STANFORD
Action games Edugames Adventure,
Fighting beat em ups, Platformers
(where characters run jump along onto
platforms), Knowledge games 1st-gen.
Edugames, Simulation/modeling/role-playing,
e.g., management and strategy, 1st-gen.
Edugames, Drill-and-practice 1st-gen.
Edugames, Logical games 1st-gen. Edugames,
and Math games 1st-gen. Edugames.
1st-gen. Edugames were passive, adynamic
13
Types of Video Games Griffiths
S U M M I T STANFORD
Two unique features 1) interactive virtual
playing environments, 2) players always must
struggle against some kind of opposition
Sports simulations (e.g. golf, ice hockey,
football), Racers (e.g. Formula One racing),
Adventures (fantasy games), Puzzlers (or
brainteasers), - Edugame Platformers (see
above), Platform blasters (similar to
platformers, but require blasting
everything that comes into sight), Beat em
ups (involving physical violence such as
punching or kicking), and Shoot em ups
(involving shooting killing using various
weapons). Weird games (those not fitting
into another category), - Edugame
14
Anatomy of Videogames (after Zyda)
S U M M I T STANFORD
The Story Must be modeled computationally easy
to say! What are the learning outcomesthe
pedagogy? Create stories that embeds, achieves
learning! Whats the message? Whats to remember?
The Design Build and deploy simple tool suites
assets that express emotions decisions What
happened? What was the impact?
The Production Making the game work! Packaging
the message into the environment youve designed
and developed.
The Play-testing Checking all of the parts and
links, debug Does the game achieve the
learning outcomes? Is it challenging?
The Validation Feedback from content experts,
and users Modify.
Release for play!
15
The Language of Games (after Zyda)
S U M M I T STANFORD
Games are played for entertainment, for
amusement, for fun! They are physical or mental,
have rules, and are played for winning a stake, a
prize.
Videogames computer games with dynamic
graphics.- Edugames
Serious games videogames that use entertainment
for a purpose for training, communication,
etc.- Edugames.
Multi-user domain (MUDs) interactive
environments for advent- ure, social objectives
outcomes are influenced by users.- Edugames
Massively, multiple, online games (MMOGs)
constructs for role-playing, team-training
environments, e.g., EMCRM. - Edugames
2nd-gen. Edugames are active, dynamic
16
Can Videogames Teach?
S U M M I T STANFORD
Wrong question!! We should be asking . . .
What do videogames teach?
Why are videogames effective, engaging?
How can we harness the learning power of
videogames?
When are they useful in a curriculum?
What topics are amenable to teach with
videogames?
Can videogames enhance the pleasure of learning?
But, what is the BIG challenge??
17
Curriculum for Practice of Medicine (POM)
S U M M I T STANFORD
Patients in clinics with clinical problems
Student inquires
-Chief Complaint What brings you here?
-Present Illness Please describe how this
happened, and your experience with it-
-Past History Other contributing events?
-Family History search for a genetic basis
-Systems Review search for relevant clinical
clues
-Physical examination primary
secondary -Critical thinking leads to an ordered
Differential diagnosis, with 1, the Presumptive
diagnosis.
practicing the method teaches a discipline, and
a way of thinking!
18
Example Game Curriculum for Practice of Medicine
(POM)
S U M M I T STANFORD
Ninja Gaiden in a cavern with a waterfall
Ninja explores
Student inquires
-Central dynamic graphic
-Chief Complaint
-Present Illness
-Nearby surroundings
-Past History
-River downstream
-Floors, walls, ceiling, etc
-Systems Review
Rationale Both, exploration inquiries
yield clues to critical info
Both require attention to detail looking for the
unexpected, considering alternatives -the
Differential diagnosis
playing the game teaches a discipline, and a
way of thinking!
19
Learning to Teach with Edugames?
S U M M I T STANFORD
The Problems Teaching as one was taught . . .
precious little time to change!
The Reality Most students play videogames. So,
. . .
The Reputation Videogames are violent! . . .
Mostly!
The Change Edugames are powerful learning tools
for teaching dynamic processes!
More Change Assessing curriculum for topics in
which practicing skills may be helpful.
Playing to Learn Edugames are the new medium.
Learning while Playing Edugaming
20
Who Will Learn to Teach with .- Edugames?
S U M M I T STANFORD
Poorest Candidates Teachers who have won
teaching awards! They have it down! . . little
incentive to change!
The Innovative Teacher Edugaming is intriguing!
Teacher-parents with Teenagers Their kids play
videogames, . . . the child shall lead them!
Problem Solvers Teachers teaching dynamic
processes, needing to change teaching practices,
need edugames!
Those Exposed Curricula in transition, in
which procedural skills must be learned. ME?
Maybe!
Become an exposure agent! Give a seminar!
21
Impact of MUDs MMOGs on Users
S U M M I T STANFORD
In chess, players doesnt identify with pawns or
the king.
In Dragons and Dungeons, players begin to
identify with the good guys vs the bad guys.
In SimCity, players become engrossed in their
manage-ment style and the outcomes.
As avatars began representing users, their
decisions and actions, the exploration of self-
vs non-self is initiated, and emotional
consequences are generated.
In MUGs MMOGs, teams and entire communities
develop in which us vs them attitudes are
expressed.
22
Impact of MUDs MMOGs on Users
S U M M I T STANFORD
23
Example of a Simple Game (courtesy, Laura
Kusumoto, Forterra, Inc.
S U M M I T STANFORD
The Lesson Teaching a game interface to new
users.
The Action to be learned In a disaster practice,
users need to push gurneys from the de-con tent
into the ED.
The Solution Divide the four users into two
teams. Demonstrate the controls to everyone
simultaneously
The Game Everyone navigates their avator to the
waiting room, gets a gurney, goes to the parking
lot, loads it, and pushes 3 back to the ED before
the other team gets 3 moved.
The Theory If challenged, learners will quickly
grasp the necessary instructions, and compete to
get their gurneys home before the other team
does. Successful edugaming!
(Photos Courtesy, Forterra, Inc.
24
Example of a Simple Game (courtesy, Laura
Kusumoto, Forterra, Inc.
S U M M I T STANFORD
(Photos Courtesy, Forterra, Inc.
25
A Game for Surgeons (after James Butch Rosser,
MD)
S U M M I T STANFORD
Fact Musicians, skaters, athletes warmup
before per-formances - what do surgeons do?
Think, scrub-up !!
Hypothesis Laparoscopic surgeons would perform
their procedures more proficiently and safely IF
they practiced a video-game immediately before
surgery.
Intervention Super Monkey Ball is a simple COTS
game that demands focused attention and rapid
actions to score a goal avoiding multiple
obstacles yields bonus points.
Theory Practicing eye-hand coordination
activities immediately before surgery enhances
proficiency.
COTS Commercialoffthe Shelf Game.
26
A Game for Surgeons (www.psychology.iastate.edu/fa
culty/ dgentile/MMVRC_Jan_20_MediaVersion.pdf )
S U M M I T STANFORD
27
A Game for Surgeons (www.psychology.iastate.edu/fa
culty/ dgentile/MMVRC_Jan_20_MediaVersion.pdf )
S U M M I T STANFORD
28
A Game for Surgeons (www.psychology.iastate.edu/fa
culty/ dgentile/MMVRC_Jan_20_MediaVersion.pdf )
S U M M I T STANFORD
29
A Game for Surgeons (www.psychology.iastate.edu/fa
culty/ dgentile/MMVRC_Jan_20_MediaVersion.pdf )
S U M M I T STANFORD
30
A Game for Surgeons (www.psychology.iastate.edu/fa
culty/ dgentile/MMVRC_Jan_20_MediaVersion.pdf )
S U M M I T STANFORD
31
A Game for Surgeons (www.psychology.iastate.edu/fa
culty/ dgentile/MMVRC_Jan_20_MediaVersion.pdf )
S U M M I T STANFORD
32
A Game for Surgeons (www.psychology.iastate.edu/fa
culty/ dgentile/MMVRC_Jan_20_MediaVersion.pdf )
S U M M I T STANFORD
33
A Game for Surgeons (www.psychology.iastate.edu/fa
culty/ dgentile/MMVRC_Jan_20_MediaVersion.pdf )
S U M M I T STANFORD
34
A Game for Surgeons (www.psychology.iastate.edu/fa
culty/ dgentile/MMVRC_Jan_20_MediaVersion.pdf )
S U M M I T STANFORD
35
A Game for Surgeons (www.psychology.iastate.edu/fa
culty/ dgentile/MMVRC_Jan_20_MediaVersion.pdf )
S U M M I T STANFORD
36
A Game for Surgeons (www.psychology.iastate.edu/fa
culty/ dgentile/MMVRC_Jan_20_MediaVersion.pdf )
S U M M I T STANFORD
37
A Game for Surgeons (www.psychology.iastate.edu/fa
culty/ dgentile/MMVRC_Jan_20_MediaVersion.pdf )
S U M M I T STANFORD
38
Which Games for Laparoscopic Surgeons?
S U M M I T STANFORD
Super Monkey Ball, Solid Scope, Star Wars
Racers best of 100 evaluated by Rosser, et
al.! What do VG teach? gt strategic thinking gt
focused attention on targets gt eye-hand
coordination gt direct navigation routes gt
variable speeds of actions gt error
prevention gt satisfaction from successful gt
humility -) - completion, - bonus points
Which VG for Interventional radiologists,
Cardiologists, Gastroenterologists,
Oto-laryngologists, . . . etc.?????? ANY n
ALL endoscopists and interventionalists?!
39
Games for Health (www.seriousgames.org)
S U M M I T STANFORD
Dance Dance Revolution exercise
Iceworld and Splash coping with pain burns,
cancer
Yourself! Fitness dynamic personal workout
sessions
Code Orange hospitals and mass-casualty events
Cardiac Arrest diagnosis and treatment
procedures
VR Phobia fear of flying, spiders, heights,
and driving.
Obeez City game for bariatric surgery
Hazmat Hotzone a first responder simulation
ER Chicagos County Hospital 911
Paramedic . . . from over 500 serious
games titles!! (Prensky 2004)
40
Games for Health (www.seriousgames.org)
S U M M I T STANFORD
Dance Dance Revolution exercise
Iceworld and Splash coping with pain burns,
cancer
Yourself! Fitness dynamic personal workout
sessions
Code Orange hospitals and mass-casualty events
Cardiac Arrest diagnosis and treatment
procedures
VR Phobia fear of flying, spiders, heights,
and driving.
Obeez City game for bariatric surgery
Hazmat Hotzone a first responder simulation
ER Chicagos County Hospital 911
Paramedic . . . from over 500 serious
games titles!! (Prensky 2004)
41
Preparing to Teach with .- Edugames?
S U M M I T STANFORD
Began to study A book! Get online! Investigate!
Play!
Go to a conference with a friend! Youve begun!
Continue!
Discuss with your students who are gamers
theyll guide and help you with ideas, and
know-how!
Discuss with peers brain-storm ideas join
forces! Attend, present at TATRC-West/SUMMIT
Workshops!
Make a connection with a laboratory or a company
that shares your vision!
Just do it!
http//www.gamesforhealth.org/healthgames.html,
http//simworkshops.stanford.edu/
42
Medical and Surgery Training with Videogames
S U M M I T STANFORD
The SUMMIT Team Parvati Dev LeRoy Heinrichs
Pat Youngblood Madhu Khanna http//simworkshop
.stanford.edu/
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