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The learning program to help bring the nursing home resident and technology together in a virtual world By Thomas W. Whiteley.

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Presentation on theme: "The learning program to help bring the nursing home resident and technology together in a virtual world By Thomas W. Whiteley."— Presentation transcript:

1 The learning program to help bring the nursing home resident and technology together in a virtual world By Thomas W. Whiteley

2 The following presentation and learning program was designed to help those in nursing homes experience a new level of freedom through social interaction and virtual physical movement. It’s Never 2 Late for a Second Life Who could benefit from this program is any nursing home individual that is able to sit in front of the computer, move a joy stick, and be cognitive of their actions.

3 The Nursing Home of the Future It is estimated that nursing home residency rates will double or triple by 2030 (Rivlin & Wiener, 1988). As of 2010, the baby-boomers began to carry out this assessment by increasing, what had been stagnant, nursing home resident rates across the country. Furthermore, as the baby-boomers tread deeper into age, the 85 years olds will rise from 1.4 percent (today) of the elderly to over 5 percent of the population by 2050. As the population ages so will the need for more nursing homes, better care, and a higher quality of life for the resident.

4 Today there are many ways, and philosophies, to carry out these goals. One non-profit group which has provided a cultural change model, and is trying to transform nursing homes, is called The Eden Alternative® ( Their vision is to eliminate loneliness, helplessness, and boredom. They offer many alternatives to the bygone era of stasis, human deterioration, and task orientation that has been prevalent in our society. Major changes include creating nursing homes where life is worth living, resident management, and stimulation though contact with animals, plants and children. It was within the Eden philosophy that I designed and devel0ped this instruction for a nursing home residents to participate in Second Life by Linden Lab ( Change is Happening

5 Second Life Second Life (SL) is a three –dimensional virtual online platform. Users, which are called residents, are not only able to socialize but also able to contribute to the world around them by creating buildings, objects, and other worlds. They are able to learn about rockets from NASA and take college courses from the University of Cincinnati. Second Life has its own economy based on a unit of currency called the Linden Dollar. There is an exchange rate and people buy this currency using U.S. dollars. People are even living off of buying and selling items and virtual real estate in this new world. In short, Second Life is the virtual image of the society in which we all physically reside in today. The thoughts behind this instruction are to allow the participant to lose their current physical limitations and reenter a world that they can navigate without the physical assistance that currently consumes their life. The major objectives include creating an avatar (identity), changing the appearance of their avatar, and traveling to the exotic lands of this world (transport).

6 Opportunity This instruction is to fill an opportunity rather than a need. Due to each resident’s condition of physical and cognitive ability, it is impossible for each individual to participate, however, each of the resident’s needs are accounted for in their daily lives, dining, laundry, housekeeping, entertainment, activities, health, and rehabilitation, and even a concierge in some homes. However, for the person who can sit in front of the computer, move a joy stick, and be cognitive of their actions, learning how to create a persona and navigate Second life offers them another level of life worth living, and an opportunity to be a contributing member of that society. “If you have knowledge, let others light their candles at it” ~Margaret Fuller

7 The Never Ending Story Because this learning instruction is individualized to one person at a time, and is constantly changing and evolving, its important for the instructor of this content to not only analyze their own participant, but also to understand how the content is modeled and arrived at in its current state. This assures the instructor that they are not going over ground that may have already been analyzed, strategized, and evaluated. In turn the instructor will input their own analysis and feedback into the material allowing for those that follow the same up-to-date instruction.

8 Presentation of Material The nursing home environment tends to be one of individualism due to each resident’s particular set of cognitive and physical abilities at use. This material should only be taught after an analysis of the individual has been completed, and then only in a one-on-one setting. Furthermore, it should be noted that the instruction may have to be repeated numerous times, and patience will need to rule the day. Each student will have to be individually analyzed for physical abilities and cognitive understanding. Although there are many other ways to eliminate loneliness, helplessness, and boredom, this instructional event would give the resident a channel to participate in a social platform, not to mention the possibilities of obtaining additional educational opportunities and the feeling of being a member of a society.

9 Goals & Objectives Each goal and objective was created to help and focus the learner to understand just the basics of opening and navigating Second Life. The objectives should also help you, instructor/designer, to make decisions as to whether future participants would benefit from this type of instruction or if the content should be adjusted to the participant’s specific cognitive or physical situation. In all cases these goals and objective should be consider fluid and adjustable; molding to the learner’s abilities and the best chance for achievement. There are a total of four goals, each represented by a phase within the program, and corresponding objectives.

10 Goals & Objectives Phase 1 Access Second Life using the Google search engine o Given the definitions, the participant will be able to verbally differentiate between a web site and search engine 90 percent of the time. o Given the steps in web site recovering, the participant will locate and open Second Life within 3 attempts. Phase II Create his or her own avatar and transform its appearance to the participant’s own desires o Given instructions, the participant will be able to acquire and name his own avatar on the first attempt. This only has to be done once.

11 Goals & Objectives Phase II (continued) o Given verbal instructions and pre-printed screen shots, the participant will be able to locate and open the “change your avatar” button within 3 attempts. o Given verbal instructions and pre-printed screen shots, the participant will be able to scroll, locate, and save a new avatar at least once in an hour session. o Given verbal instructions and pre-printed screen shots, the participant will be able to locate and open the “appearance” button within 3 attempts. o Given verbal instructions and pre-printed screen shots, the participant will be able to scroll, locate, and save new outfits at least once in an hour session.

12 Goals & Objectives Phase III Navigate the avatar within the confines of Second Life o Given verbal instructions and pre-printed screen shots, the participant will be able locate and open the “walk/run/fly” button within 3 attempts. o Given verbal instructions and pre-printed screen shots, the participant will be able to complete an assigned course by walking once, running once, and flying once, within a one hour session. Phase IV Identify at least three areas of interest and demonstrate how to circumnavigate to those sites o Given a list of themes in second Life participant will rank the order of his interest between 1 and 10, one being the least interested and 10 the most, immediately upon receiving the list.

13 Goals & Objectives Phase IV (continued) o Given verbal instructions and pre-printed screen shots, the participant will be able to locate and open the “Destination” button within 3 attempts. o Given verbal instructions and pre-printed screen shots, the participant will be able to input and transport his avatar to three different areas within one hour long session. “It is never too late to be who you might have been” ~George Eliot

14 Sections of Instructional Design.  History, Environment and Model  Audience Analysis  Learning Assessment  Content Outline and Program  Evaluation  Summary

15 History, Environment & Model This learning program was originally designed as a project to partially fill the requirements of my Masters of Education (M.Ed.) though Colorado State University. The idea came to me one day as I walked into work, when one of the residents stopped me, and had to tell me all about how special her day had been. She explained to me that during her session of rehabilitation earlier that day, she used the parallel bars and was able to walk; this was the first time since her stroke a few years ago. I was thrilled to hear her talking about every detail and walked away with a warm feeling in my heart and a smile on my face. Later that night I was thinking back at how animated and energized her voice had expressed the exhilaration and elation she was feeling. I then began to wonder if it would be possible to give all of our residents some level of this gratification when it hit me, Second Life.

16 History, Environment & Model The first instructional event took place at Amberwood Court Rehabilitation and Care Center in Denver Colorado. Amberwood has 75 beds and specializes in rehabilitation from surgery, stroke, illness or injury. It also serves Denver’s Korean community by providing: Korean speaking staff Korean style entrées and dining Korean television and newspapers Participates and partners with Denver Korean community celebrations Amberwood focuses on the “whole person” needs and uses The Eden Alternative model in carrying out its mission.

17 History, Environment, & Model At Amberwood activities are planned for each day of the week, morning and afternoons. Past activities include fishing, shopping, movies, crafts, bingo, cooking, and live music. The staff is encouraged to bring their pets to work and on many days it is not usual for two or three dogs to be wandering around the halls. Amberwood also encourages residents to become animal owners, too. The environment tends to be in a constant state of movement and noise. Many of the residents will wander the halls all day. Others may be going to appointments, entertaining family and friends, or just wanting to talk. This instruction fits into this medley of sights and sounds that constitutes this establishment and many others.

18 History, Environment, & Model Seels and Glasgow’s ISD Model 2: For Practitioners (1998) was used for the design of this project. I have chosen this one mainly for its utilization of feedback from the participant during the design and instruction event.

19 History, Environment, & Model A better visual representation of Seels and Glasgow’s ISD Model 2: For Practitioners is this one from Design Applause. Please notice how the design and implementation are melded though out the later stages. They each complement the other and work in tandem to complete the learning event.

20 Audience Analysis The resident I asked to collaborate with me is a large part of the current Amberwood environment. He has resided as president for the resident council board and manages the resident’s store. He is always offering his concern and help to other tenants within the building. He is currently wheelchair confined but is able to move from his chair to his bed on his own. He is a permanent fixture in the halls and many times he can be found in the rehabilitation room working out with weights. He uses the computer at least once a day for socializing, shopping, and listing to music. An audience analysis was conducted to further my knowledge in designing and developing a curriculum to educate this person in how to create an avatar and navigate Second Life.

21 Audience Analysis Because of the participant’s decrease in cognitive ability, many of the questions were created to try and understand how this person interacted with the computer and how much social activity he currently engages in. I conducted a one-on-one interview on October 14, 2013 in the guest greeting area of Amberwood Court. I have posted the full analysis here: Please click “Audience analysis”

22 Audience Analysis To answer the question about his education, it was fabricated. I learned later that he always had a set answer for normally asked questions, such as education level, profession, etc. However, this does not devalue all of his answers. My major concern was his usage of the computer and how well he gets around on it; If he likes to fantasize a little, so much the better. This exemplifies the flexibility within the content of instruction to mold its self to the participant’s cognitive resources.

23 Learning Assessment Each learning assessment at the end of each phase in the program was created for immediate feedback (Seels & Glasgow, 1998) and for the participant’s health and safety. The major markers are accomplishment and time. Accomplishment offers the facilitator a visual identification, such as an open box, of the likely outcome of certain procedural steps. Time, on the other hand, acts as an indicator of possible problems. If the participant’s time slows down, the evaluator then must decipher its cause as either cognitive or physical. Additional steps should be enacted, such as stopping or offering a rest to the participant. In all cases the participant should be fully aware that he is able to stop the process at any time, for any reason. Each assessment will be conducted upon completion of the lesson plan, and performed exclusively by the instructor.

24 Syllabus & Instruction Program Please click “Instruction Program”

25 Formative Evaluation The formative evaluation of this instruction is as personalized as the participant. It should be used before and during the instruction delivery phase. Prior to the instruction event those with knowledge of the participant’s cognitive and physical capacity, such as social services, activities personnel, nursing, family, and doctor, should review the material suitability and provide an “expert” opinion. Some of the questions that should be asked of these stake holders include: o Is the instruction appropriate for the participant? Explain. o Is the delivery method appropriate for the participant? Explain. o Is the vocabulary, examples, and illustrations appropriate ? Explain. o Are the goals and objectives within reason for the participant? Explain. o What would you add or subtract from the content to aid in successful completion of goals and objectives?

26 Formative Evaluation The instructor will constantly monitoring achievement of goals and objectives though the use of assessment sheets. In addition, they should note any unusual movements, clicks, or comments provided by the participant. Short and simple questions should also be used during instruction. This does two things, (1) gives a stream of constant feedback as the task is being completed, or not, and (2) can be used to bolster the participant’s confidence in navigating and socializing (not an objective) within Second Life. Some of the questions that should be asked are: o Which do you like best: walking, running, or flying? o What seems to be the hardest thing about walking, running, and flying? o Do you want to try the key board instead of the mouse? o What do you think when you see other avatars chatting and dancing? o After seeing other avatars are you interested in changing yours? o Which world did you like the best, or least (interests)? o Are you comfortable in moving from one world to another?

27 Formative Evaluation The formative evaluation is flexible and can take place by any number of means. One possibility, for stake holders, is to have a mock run through of the instruction. If the instructor is lucky enough to have them as a group, the feedback can take the form of barn raising, whereby the group pitches in with ideas and builds upon them. The second half of the formative evaluation process is for the instructor to constantly monitor the participant and make changes during the event. Do not hesitate to modify, add, or delete an any instruction, even if it is achieving the objective, but is causing an undue hardship on the participant. It is vital that any modifications or changes be written down for future instruction.

28 Summative Evaluation The summative evaluation of this instruction is two-fold, (1) it provides feedback from the participant, social services, nursing, family, and doctor after the instruction has been provided, and (2) is creating a database of information for future participants. As discussed earlier, it should be a feedback into the formative stages of the current participant for possible answers to issues already highlighted and resolved. Delivery of the summative evaluation will be two weeks out from the instructional event and again at the six week mark. The first evaluation will concentrate on the needs assessment verses the outcome. Was the participant able to take advantage of this social platform and increase his level of socialization? Did he feel any type of release from the bonds of the physical world? Did he continue to participate in Second Life at all? Was his life enriched by this program?

29 Summative Evaluation A second evaluation should be completed by those who know this person’s typical cognitive abilities and can identify changes of attitude or behavior. My participant has certain nurses and certified nursing assistants with which he discusses everyday life. Finally, these evaluations will be subjective in nature due to the fact the participant has already demonstrated his ability by completing the objects and goals during instruction. The assessment sheets are used for this purpose and should be referred back to when conducting the evaluation with the participant. Some of the questions have been added from the participant’s analysis questionnaire. I would also like to test his abilities by having him meet me at a certain time and place on Second Life. Forms can be found at:

30 Reference Cohen-Mansfield, J., & Werner, P. (1998). The effects of an enhanced environment on nursing home residents who pace. The Gerontologist, 38(2), 199-208. Cutler, L. J., & Kane, R. A. (2006). Low cost practical strategies to transform nursing home environments: Towards better quality of life. Retrieved from web address Design Applause. (2013) Info graphics. the variables within design process. Retrieved from web address process/31329 Rivlin, A. M., & Wiener, J. M. with Hanley, R., & Spence, D. (1988). Caring for the disabled elderly: Who will pay? Table 2-4 (pp. 30-50) Washington, DC: The Brookings Institution. Seels, B., & Glasgow, Z. (1998). Making instructional design decisions (2nd ed.) Upper Saddle River, NJ: Merrill, Prentice-Hall

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