 Hello everyone and welcome to the 4 p.m. to 4 30 p.m. session at the 2016 open simulator community conference as a reminder to our in-world and web audience you can view the full conference schedule at conference dot open simulator dot org and tweet your questions or comments to at open sim cc with the hashtag os cc 16. At this time, we are happy to introduce a terrific session called exploring conflict resolution in virtual environments. Our speakers today are Evelyn Gossett. Shruti Patel and Rachel you more and Evelyn will be speaking first Evelyn Gossett RN MNSN is an assistant clinical professor of nursing at Indiana University Northwest School of Nursing. Her interests are in online and virtual environments for interprofessional education. Shruti Patel is a research intern in the neonatal neonatal education and simulation based training nest program at the University of Washington and a pre med student class of 2019. At the University of California Los Angeles where she is an ALD and PES honor society member. Dr Rachel you more and is an assistant professor of pediatrics at the University of Washington School of Medicine and Seattle Children's Hospital Seattle Washington and the director of immersive learning for the neonatal education and simulation based training nest program. Her research interests are in enhancing healthcare partnerships and teamwork using virtual simulations. She has published and presented internationally on using virtual environments for health professional education. Welcome all let's begin the session. Well hello everyone I'm this is Evelyn Gossett I I'm happy to be here and offer you a brief introduction to our project which was called exploring conflict resolution in the virtual environments. This team Dr. Umarin Shruti and myself and another student from Indiana University Northwest campus. We created a simulation for senior nursing management students to work through how to deal with conflict resolution in a hospital situation high stress. But very important. Venue for providing care to to sick people. Thank you. Thank you. Rachel and I will be running a little bit of a back chat here and Shruti will be available to answer or read out any questions that you have but we would really appreciate it if you. Your questions to the end. And thank you so much Ruby for the introduction. So, as you mentioned, we've been working collaboratively and creating and using virtual environments for education for quite some time. And we're very excited to present our most recent work on conflict resolution scenarios for nursing students. Or more war zones. That's great. So, first of all, keeping the war zone theme alive. What feeling do you get when you hear that you have to work on a team. Sometimes that's a great feeling and sometimes it's not, but today's workplace does rely pretty heavily on teamwork and being able to manage conflict effectively is essential for team performance. I do believe in many of you who have had any contact with the health care system know that it is particularly true for health care teams that are very complex that conflict is a major problem. Health care teams have very high skill differentiation. They have high authority differentiation. They have interdependence. Everyone really has to work together, especially when they're taking care of very complex patients and then they can also have a rotating leadership structure between positions and nurses and positions of different specialties. So because of this human factors are a leading cause of medical error in health care and that does affect everyone. So our objective of this project was to prepare senior nursing students through developing virtual scenarios on conflict resolution. So they can be the best nurses that they can be and they graduate, which this is a class that they received right before graduation. So it's essential for them as they move on to their next steps. And so we started off through a process of identifying the problem then developing learning objectives and the diagram that you see on the slide in front of you is the current six step process to curriculum development. So we use this process to really thoughtfully design and develop this curriculum and we decided that as an educational strategy, we would use virtual environments. So as we know, and I know I'm preaching to the choir here, learners can use voice text and gestures in virtual environments, and they can interact with each other, as well as with non-player characters and PCs, and they can choose to learn on their own or with others. So it's an extremely flexible option for any kind of role-playing scenarios and conflicts in particular, while I think one of the concerns we had going into this was that the potential lack of cues from body language and being able to actually see the expressions on the cases of the avatars might be an issue, we found that it was not really that much of a problem. So I'll turn it over to Professor Gossett here to talk about the design. This slide tells you about our design for the conflict resolution learning activity, which what we work to keep in a very simple format. And it just involved a nursing management office and the use of several off-site locations that we have been working with in OpenSim previously. We wanted to keep the environment to focused and targeted for very naive OpenSim users. Next. So this slide shows you how simple the environment was. The left side of the slide is showing you an example of nursing students in the learning activity, and the right side is showing you the simplicity of the environment. On this slide, you see the students on the left side as they come into the learning environment in OpenSim, and they're reading their instructions here. On the right side is a simulated Africa traveler type hospital and the scenario for the learning activity continues there. Next. And finally, to create this learning activity, we broke it up into like five phases. The first phase was we call the pre-semester phase, and this part was focused on strictly the development of the curriculum and identification of the learning objectives. We wrote the scenarios, discussed them in terms of what did we want the students to, what did we want the students to know, which role did we want to give information to about the scenario. And the next part was when the course actually began as the semester began, you'll see on the left side of this screen it says in class introduction to the OpenSim. I meet with the students in the classroom and teach them technical setup of imprudence. We use imprudence in the classroom and introduction, basic introduction to the virtual worlds and simple orientation to be in an avatar and walking, talking, using sound, and just a general acclimation to the OpenSim environment. And as the semester goes on, we turn it into what we call a flipped classroom. And in the flipped classroom phase, we're using our universities learning management system, which is Canvas, and we also use Zoom video conferencing and of course the OpenSim virtual world environment. So it's quite a challenge for the students to incorporate all these different things, switching between the learning management system, the video conferencing, and the virtual world. But we've become sort of expert at managing to get the students situated with all of that. The virtual activities are scheduled on regular class times, and so that flipped classroom portion is during their regular classroom scheduled time. But these students also have a clinical experience at a local hospital. And so we incorporate their learning activities there to what we're doing in the virtual world. And finally, in the flipped classroom, we also use, in the virtual world, we use debriefings following our simulations. And the orange section here is in-class discussions, which we have regarding their total experience as an avatar and in the virtual world learning environment, and we use Zoom to do that. And the final portion of our phase is the post-semester phase where we get the students' comments and concerns about their entire experience through the semester. And we do believe, again, we've learned a number of lessons as Professor Gossett alluded to around working with students, go through the development phase into implementation. And we believe that the pilot of this curriculum was successful because from the standpoint of the virtual space, we kept it very simple. We did simple scenarios about common staffing issues, and that was all that was needed to achieve the objective of generating discussion and problem-solving. The other thing that we did was we tried to link it to existing work. So we found ways of applying existing builds to the new curriculum. We didn't want to reinvent the wheel each time we did this course. And lastly, we were able to get the learner's perspective and should be delighted that Shruti was here to be part of this presentation because she helped greatly during that initial phase of development and we were glad to have her in. Now during implementation, we again, as Professor Gossett alluded to, had a student who was actually experienced in simulation and able to assist the class as a teaching assistant. And he was able to organize them, to get them in world between classes, and he actually stepped in as one of the roles when we needed to, if one student wasn't able to make it out of a group of three or so. David Lettson says his name and I want to call him out for the great work that he did. Unfortunately, he can't be here today. We also found that skilled facilitator debriefing, especially since we're dealing with conflicts, which is a topic that's charged and potentially have a lot of impact on both the individual's perceptions as well as the behaviors, was very important right after the scenario as well as in class. And we also use the learning management system for questions and group discussion between classes. So our next steps really quickly are to assess conflict management skills at the individual team and organizational level. And in conclusion, I'd like to say that a structured approach, as we've been very briefly trying to describe here with which embedded virtual simulations on conflict resolution as a senior nursing class practicum into a nursing curriculum is a potential way in which we can teach very sensitive subjects, but very important subjects using virtual environments. I'd like to invite you all to learn more at our booth, which is both 20 on OSCC next go three, and I'd like to open this forum for questions. Thank you. Thank you, Evelyn Shruti and Rachel for a terrific presentation. As a reminder to our audience, you can see what's coming up on the conference schedule at conference dot open simulator dot org. Following this session, we will resume at 430pm in the same keynote region with a panel presentation entitled Oculus and music technology. Also, we encourage you to visit the OSC OSCC 16 poster Expo in the OSCC Expo three region to find accompanying information on presentations and explore the hyper grid tour resources and OSCC Expo two region along with sponsor and crowd funder booths located throughout all of the OSCC Expo regions. Thank you again to our speakers and the audience and if you have any questions we have a couple of minutes for that. Okay, thank you. We have one question. Do you find that NPCs are as good as humans in role play. So we've used both NPCs and humans in role play and for this particular topic we decided to go with humans and had the students in their own roles as either the nurse manager, or the charge nurse, or staff nurse, and we found that to be successful. I think as we learn more about the subject and more about how the dialogue flows we could certainly trial an NPC in that role and I think it would be a reasonable option but since we're very early in this process we decided to go with human roles. I would like to make another comment about that. My students in the face to face environment following this activity express to me how they really enjoyed going in more than once so at some time they were they were all required to be the nurse manager. But if they went in another time with their classmates they would take the charge nurse role and then they would go in as the staff nurse and so they were able to act out whatever they wanted to to make the situation and at the end they really verbalize to me greatly how they really enjoyed going back in doing it and being in a different roles. But I would like to try the NPC but the role play is much more exciting. Even would you also speak to one of the questions here about whether the learning curve using opens them took a lot of time away from the actual training. I feel that some students are fine on day one but that's probably about maybe a quarter of the class and then a few will have issues that are technical related to their devices and maybe another quarter of the class tend to take a little longer. Do you feel like that's about right. That's exactly right. We've Dr. Oomer and I have been doing this for five years and each semester. I have the maximum amount of nursing students I can have in one of these groups is 10. That's by state regulation for nurse training. And when I have 10 I maybe have two who are able to become avatars and deal with all the technology within one or two weeks. I always seem to have one or two who by week six or seven still don't get it. But I have them come to my office on campus and I will work with them individually and show them how to do things in outside of the classroom and that. So I have to hold I have to hold their hands a lot and not allow them to become frustrated. I encourage them and tell them it's OK. It's not easy to be an avatar. OK, I think we need to round this up but thank you all very much for presenting and maybe we could if anyone has any questions can contact the ladies personally. Thank you so much.