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Transcript of 2009 Inacsl Bauman
Teaching Cultural Competencein Web-Based Communities
Eric Bauman, PhD, RN Alex Games , PhD
© Copyright by Eric B. Bauman 2009All Rights Reserved
Author Information and COI Statement
Alex Games, PhDAssistant Professor
Michigan State UniversityDepartment of Telecommunications, Information
Studies &Media
COI: None
Eric Bauman, PhD, RNFaculty Associate
University of Wisconsin School of Medicine &Public Health
Department of Anesthesiology
COI: Consultant -Vernon Memorial Healthcare and TMFDInvestments: Pfizer, SHSAX
Identity and Consequence
• Virtual communities encourageparticipants to “try on” differentidentities and reflect on theconsequences of their decisions while“wearing” these identities.
(Gee, 2003; Turkle, 1995)
Why is Identity and ConsequenceImportant in Clinical Education?
• Acculturation and Indoctrination of aprofessional
• Cultural Competence• Learning as Behavioral Change
Popkewitz, 2007
Acculturation - Indoctrination
• Part of the educational experience focuses on learning how tobecome part of a cohort
• Beyond the required professional knowledge base, noviceclinicians must come to understand the conduct andexpectations of the rank and profession they hope to join
How to: Look - Act - ReactGee, 2003; Popkewitz, 2007
From Novice to Expert: Transition fromthe virtual world to the real world
• Avatars and virtual worlds can be designedto evoke students preconceived notions ofculture and identity– In terms of cohort social norms and cues– In terms of professional expectations and cues
Benner, 1984
Chris Holden, PhDAsst. ProfessorUniversity of New MexicoUniversity College
Ulrike (Rica) DieterleLibrarianEbling Health Sciences LibraryUniversity of Wisconsin - Madison
IDENTITY
Gerald StapletonUniversity of Illinois at ChicagoCollege of Medicine
Allan BarclayLibrarian and Information ArchitectEbling Health Sciences LibraryUniversity of Wisconsin - Madison
IDENTITY
Moses Wolfenstein, MSDoctoral Student
Department of Curriculum & InstructionUniversity of Wisconsin-Madison
School of Education
So what about Identity?
Identity is fluid and malleable - How can we use this fluidity to enhance learning experiences?
As instructors should we or do we need to impose restrictions on in-world identity
Cultural Competence• Published literature readily discusses the importance of integrating
cultural competence into health sciences curricula• There is little literature to indicate that simulation and standardized
patient education has readily integrated culture and diversity intohealth sciences curricula.
• Both obvious and subtle cues related to culture, gender, and race canoften have profound social-cultural implications and biologicalconsequences related to diagnosis and treatment
• Cues derived during observational and behavioral encounters maydrive important decisions related to diagnosis and patient care.
(Culhane-Pera, Reif, Egli, Baker, and Kassekert, 1997; Tervalon and Murray Garcia, 1998;Smedley, Stith, and Nelson, 2003; Steele and Aronson, 1995)
Learning as Behavioral Change• Through in-world interaction and during post experience
debriefing instructors can facilitate behavioral responses fromstudents that represent either cultural competence or culturalcliché and stereotypes
• Educators bear the responsibility for providing environmentsthat provide a safe medium to facilitate the transfer ofknowledge and facilitate behavioral change
• Web-based and virtual worlds can provide a translationalplatform for behavioral change related to culture and diversity
Thiagarajan, 1992; Games and Bauman 2009
The Ecology of Culturally CompetentEducational Design
• Context(s)• Character(s)• Narrative• Activity
Context• Virtual simulated spaces can be designed in ways that
authentically capture environmental fidelity– Replicate in virtual form aspects of the real world that
students occupy in actual practice• Safer environments where students could afford to learn from
mistakes with no risk to patients– virtual worlds provide opportunities for learning and
professional development without the consequencesassociated with actual therapeutic misadventure
• Virtual simulation overcomes some of the barriers associatedwith fixed or physically created environments– Money, Location, Space allocation
Games and Bauman, 2008; Squire 2006; Bauman, 2007
Character• The fluidity and malleability of virtual environments applies not
only to the look and feel of virtual teaching spaces, but alsolearners identities
• The ability to try on multiple identities may be of great value forthe construction of learning experiences involving culture anddiversity
• Players shape and design their avatars (characters), whichbecome their in-world identities
• Identity expectation related to ones future professional affinitygroup is an important tenet of learning
(Gee, 2003; Squire, 2006)
Narrative• Narratives provide peoples memories with a collection of
patterns that help them recognize and make sense of the world
• Narratives assist players in the negotiation of their identities,particularly projective identities. Projective identities placelearners in the shoes of the virtual identities they are playing
• Narratives also provide spaces for reflection on theconsequences of student action or inaction. Learners can beencouraged to see the consequences of their decisions frommultiple perspectives and deliberate practice
(Bruner, 1991; Gee, 1991, 2003)
Activity• Interactivity is one of the most important defining characteristics of
successful learning in games and virtual worlds.
• Participation in virtual worlds is only meaningful when players areactively engaged in their environment rather than passively observing it
• The game and its environment define identity and developing affinitygroups
• In the health sciences, virtual spaces include familiar settings wherelearners can practice many of the activities germane to the professionsthey hope to join
(Gee, 2003; Taekman, Segall, Hobbs and Wright 2007)
Conclusion• Virtual or web- based communities that authentically replicate real-
world clinical experiences can provide translational educational andresearch experiences for both students and educators
• virtual platforms facilitate access to learning experiences that wouldotherwise be difficult or impossible to recreate in traditional educationalenvironments
• Virtual or web-based experiences may provide consistent exposure todiverse cultural content across curricula that are NOT available inactual clinical or traditional mannikin-based simulation environments
• Virtual and web-based educational platforms should take advantagethe malleable nature of their environment to further develop studentexperiences related to culture and diversity
• Evaluation of virtual worlds in the context of health scienceseducation is important because the potential for understandingthe role of cultural sensitivity in virtual and designedenvironments may provide a useful lens for assessment ofcultural competence
References
Bauman, E. (2007). High fidelity simulation in healthcare. Ph.D. dissertation, The University of Wisconsin-Madison, United States. Dissertations & Thesis @ CIC Institutions database. (Publication no. AAT3294196)
Benner, P. (1984). From novice to expert: Excellence and power in clinical nursing practice. Menlo Park, CA:Addison-Wesley.
Bruner, J. (1991). The narrative construction of reality. Critical Inquiry 18 (Autumn), 1-20.Culhane-Pera, K.A., Reif, C., Egli, E., Baker, N.J., and Kassekert (1997). A curriculum for multicultural
education in family medicine. Family Medicine, 29(10), 719-723.Games, I. and Bauman, E. (In Press). Virtual worlds: An environment for cultural sensitivity education in the
health sciences. International Journal of Web Based Communities.Gee, J. P. (1991). Memory and myth: A perspective on narrative. In A. McCabe & C. Peterson (Eds.), Developing
narrative structure (pp. 1 - 26). Mahwah, NJ: Erlbaum.Gee, J.P. (2003) What Videogames Have to Teach Us About Learning and Literacy. New York, NY: Palgrave-
McMillan.Popkewitz, T. (2007). Cosmopolitianism and the age of school reform: science, education and making a
society by making the child. Routledge.Smedley, B. D, Stith, A. Y, and Nelson, A. R. (Eds.). (2003) Unequal treatment: Confronting racial and ethnic
disparities in health care. Washington, D.C.: National Academies Press.Steele, C.M. & Aronson, J. (1995) Stereotype Threat and the Intellectual Test Performance of African
Americans. Journal of Personality and Social Psychology. 69(5), 797-811.Squire, K. (2006). From content to context: Videogames as designed experience. Educational Researcher.
35(8), 19-29.Taekman J.M., Segall N., Hobbs G., and Wright, M.C. (2007). 3DiTeams: Healthcare team training in a virtual
environment. Anesthesiology. 2007: 107: A2145.Tervalon, M. and Murray-Garcia, J. (1998). Cultural humility versus cultural competence: A critical distinction in
defining physician training outcomes in multicultural education. Journal of Health Care for the Poor andUnderserved, 9(2), 117-125.
Turkle, S. (1995) Life on the screen. Identity in the age of the Internet. New York: Touchstone.
Special Thanks
• Eric Graves: American Research Institute• Gerald Stapleton: University of Illinois at Chicago
College of Medicine• Jerry Heneghan: Virtual Heroes• Jeff Taekman: Duke University - Human Simulation
and Patient Safety Center• Bob Waddington: SimQuest• Allan Barklay: University of Wisconsin - Madison,
Ebling Library
Contact Information
Eric Bauman, PhD, RNB6/319 CSCDepartment of Anesthesiology600 Highland AvenueMadison, WI 53792-3272
Email: [email protected]: 608-263-5911Linkedin: http://www.linkedin.com/in/ericbbauman