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Reflections and Evolutions

by vj gibbins on Apr 05, 2018 at 10:16 AM}
I began using 3DGL in January 2015 ... well, that's when my first course using 3DGL started. I began learning about gaming and using 3DGL in May of 2014. I spent 8 months learning about the platform and wrapping my head around the theory and pedagogy of flipped classrooms and game-based learning. I began my PhD studies in game-based learning in Nursing (I am a Registered Nurse and a Faculty Lecturer in Nursing at my University).

3DGL spoke to me and seemed like not only a cool idea, but perhaps, the answer to the struggles I had. I was an instructor for the senior practicum course - the last course nursing students take prior to graduating with a 4 year bachelor's degree. The course comprised of a 4 week-long theory and lab intensive seminar focussing on the students' specialty practice area they were going to for the following 8 weeks of clinical practice under the supervision of an RN in practice - their preceptor.

I was the pediatrics instructor at the time. So my class of 18 included students going to pediatric: medicine, surgery, oncology, cardiology, and pediatric ICU and neonatal ICU. To make things "fun" for me, I usually also had 2 or 3 students going to adult areas as well. The challenge I had was that each of those areas has unique issues and new learning for each student. So how do I create an intensive seminar course that meets all of their needs equally and allows me to spend quality time with them during our face-to-face time in class?

3DGL allowed me to create quest streams for each specialty practice area. The learning that the students needed to do in preparation for their senior preceptorship was done online in 3DGL and during our face-to-face time I was able to focus on broader issues that pertained to all of them, concepts such as informed consent, advocacy, dealing with bullying (lateral violence) in the workplace, etc.

I KNOW that 3DGL was effective and enjoyed by the students in my classes! My evaluations and the course evaluations were always exceptional with comments like, "I learned more from those quests than I have in other semester-long courses" or, "Every course should be taught this way!"

Not everyone loved the quests or the idea of student choice in learning. Some students wanted to be told what to learn and what would be on the test so they could just study that. This differentiated the active and passive learners and helped me to see who needed more immediate support to be successful in the course and in their degree - because in nursing, as with other professions, the degree is just the first step in a career that requires a commitment to life-long learning.

My teaching has evolved since then. I teach new courses that I have created that focus on helping struggling students who have failed or been withdrawn from clinical practice courses for concerns about patient safety. While it is true that not everyone can or should be a nurse, and certainly not everyone who begins nursing school can or should or will finish successfully; there are those who just need a little more help connecting the theory to practice to enable them with the knowledge, skills, and critical thinking they need to be successful. To that end, the courses I teach now are 6 week long intensive simulations. Every class students arrive in the lab and we begin with shift report. Then the students go to their assigned manikin's bed space in our simulated hospital lab rooms. Beyond the skills and tasks that nurses perform like IV starts, catheters, and dressing changes, which for the most part can be taught to anyone, the RN needs to be able to think, interpret, and make clinical decisions. So each simulation has embedded triggers that should prompt the student to assess further, take an action, and report their concerns appropriately. They are asked to anticipate new orders and to initiate nurse-driven interventions. Each simulation has been created with real case scenarios levelled for the year of the student and the complexity of the units they are likely to be on in their next clinical learning course.

Here is why I am sharing that last part with you all in this forum. These courses have been created based upon a similar theoretical and philosophical underpinning that 3DGL and game-based learning pedagogies are built upon. That students learn through experiences that allow them to make choices and to go back and try again when they do not get it right the first time. As with the mastery learning principles inherent in 3DGL - that a quest is returned with feedback until it is acceptable, in these simulations, when students miss a key assessment finding or fail to take the appropriate priority action, the manikin (simulator) is able to cue them. For example, if the immediate care provided for the patient (manikin) with low oxygen levels was that the student raised the head of the bed, applied oxygen, and instructed the patient to do deep breathing and coughing exercises but neglected to listen to the lungs to assess for changes in air entry or quality of breaths, then the manikin can be made to cough and have audible wheezes, thereby cueing the student to go back and try again.

During debriefing, these fail and try again moments are discussed in a way that allows the student to reflect on their practice as well as their thinking and discover new ways to think about how they think IN practice.

So I see a great deal of similarity and overlap of the pedagogy of game-based learning and questing with the pedagogy of simulation. I wonder if others have used 3DGL or other game-based learning methods and / or simulations (high, medium, or low fidelity simulations)?
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