Catherine Pons Lelardeux

Communication system and team situation awareness in a multiplayer real-time learning environment: application to a virtual operating room

Digital multi-player learning games are believed to represent an important step forward in risk management training, especially related to human factors, where they are trusted to improve the performance of a team of learners in reducing serious adverse events, near-misses and crashes in complex socio-technical systems. Team situation awareness is one of the critical factors that can lead the team to consider the situation with an erroneous mental representation. Then, inadequate decisions are likely to be made regarding the actual situation. This paper describes an innovative communication system designed to be used in digital learning games. The system aims at enabling the learners to share information and build a common representation of the situation to help them take appropriate actions, anticipate failures, identify, reduce or correct errors. This innovative system is neither based on voice-chat nor branching dialogues, but on the idea that pieces of information can be manipulated as tangible objects in a virtual environment. To that end, it provides a handful of graphic interactions allowing users to collect, memorize, exchange, listen and broadcast information, ask and answer questions, debate and vote. The communication system was experimented on a healthcare training context with students and their teacher. The training scenario is set in a virtual operating room and features latent critical events (wrong-patient or wrong-side surgery). Teams have to manage such a critical situation, detect anomalies hidden in the environment and share them to make the most suitable decision. Analyzing the results demonstrated the efficacy of the communication system as per the ability for the players to actually exchange information, build a common representation of the situation and make collaborative decisions accordingly. The communication system was considered user-friendly by the users and successfully exposed lifelike behaviors such as debate, conflict or irritation. More importantly, every matter or implicit disagreement was raised while playing the game and led to an argued discussion, although eventually the right decision was not always taken by the team. So, improving the gameplay should help theplayers to manage a conflict and to make them agree on the most suitable decision.

3D Real-Time Collaborative Environment to Learn Teamwork and Non-technical Skills in the Operating Room

Risk-management training in the operating room (OR) can be achieved by involving learners in a simulated risky situation. The task is particularly complex because most of the time, the causes of an accident or an adverse event imply a large variety of contributing factors that are (i) difficult to combine artificially and (ii) even harder to detect and evaluate in a dynamic training context. This paper describes a model for specifying pedagogical objectives that has been integrated and used in a 3D virtual operating room project designed to train medical staff on risk management, particularly risks linked to communication default. Training sessions organized with trainers, student-anesthetist-nurses, student-operating-nurse and student-anesthetists show how teamwork efficiency in critical situations may be evaluated in a collaborative environment.

Making Decisions in a Virtual Operating Room

Immersive Serious Games are collaborative virtual environments where learners are enabled to follow scripted educational activities by interacting in the virtual environment. The joint activity of several users requires the ability to make collective decisions, ideally preceded by an argumentation. During a decision process, opinions are given, arguments are used to back up the opinions, and a decision is made accordingly (or not). One critical feature of a serious game concerns the evaluation of the learners during, or most currently after, the game session. From an educational point of view, this evaluation considers that the argumentation preceding the decision is more important than the decision itself. Yet, the argumentation usually escapes the understanding of the game since the users argue verbally. Channeling the decision making within the boundaries of what a game or a computer system is able to comprehend is an important challenge in immersive learning games. In order to do so, we present the decision feature that we have developed and introduced in a learning game called 3D Virtual Operating Room. Users are enabled to collect information pertaining to the virtual environment. By means of a dedicated activity, users are enabled to make collaborative decisions with as much expressiveness as in real life, that is: expressing their opinion and advancing arguments supporting their opinions; or, should they be convinced by others, changing their mind and withdrawing their arguments. The decision system has been experimented by multiple teams of players and its usefulness has been highlighted by qualitative results. Future work aims to provide further evidence that the collaborative decision system is apt for assessment in a pedagogical context.

A Method to Design a Multi-player Scenario to Experiment Risk Management in a Digital Collaborative Learning Game: A Case of Study in Healthcare

In recent years, there has been an increasing interest for collaborative training in risk management. One of the critical point is to create educational and entirely controlled training environments that support industrial companies (in aviation, healthcare, nuclear...) or hospitals to train (future or not) professionals. The aim is to improve their teamwork performance making them understand the importance applying or adjusting safety recommendations. In this article, we present a method to design multi-player educational scenario for risk management in a socio-technical and dynamic context. The socio-technical situations focused in this article involve non-technical skills such as teamwork, communication, leadership, decision-making and situation awareness. The method presented here has been used to design as well regular situations as well as critical situations in which deficiencies already exist or mistakes can be freely made and fixed by the team in a controlled digital environment.

Interaction and Communication in an Immersive Learning Game: The Challenges of Modelling Real-Time Collaboration in a Virtual Operating Room

In this chapter, we describe the methodology we have engineered during the design process of the collaborative and immersive learning game 3D Virtual Operating Room. The game targets an audience of practitioners involved in the operating room and the training consists in virtually re-enacting typical perioperative activities so as to learn or improve skills related to patient safety. The challenges faced in this project include multiplayer collaboration in a shared, interactive and dynamically evolving virtual environment, and modelling educational scenarios on the basis of actual observations inside the operating room. The model we detail is grounded on a semantic definition of the environment which allowed for three innovative features. A game-mediated communication system where information pertaining to the game is exchanged in real time by the players. AI-controlled characters replacing missing players as fully equal partners. And, the ability for the game to provide feedback in real time or during a debriefing on the team’s performance against predefined pedagogical objectives.

Learning the cell cycle with a game: Virtual experiments in cell biology

Cell Cycle Learn (CCL) is a learning game designed for undergraduate students in Biology to learn common knowledge about the cell-division cycle along with practical skills related with setting up an experiment and the scientific method in general. In CCL, learners are guided through the process of formulating hypotheses, conducting virtual experiments and analysing the results in order to validate or invalidate the hypotheses. The game has been designed in the University of Toulouse and introduced last year as part of the curriculum of a cellular biology class. This paper presents early results of an evaluation of the game enabled by questionnaires filled by the participants and game data collected during the training sessions. The results demonstrate with examples that both types of data can be used to assess the games utility.