James Madison University

Second Round in Second Life

Story: Daniel Vieth '15, '17
Video: Henry Zhou '17
Posted: December 7, 2015

Despite having some of the best medical facilities in the world, recent studies on patient safety have shown that mistakes still happen often in American healthcare. Interprofessional collaborative practice (IPP) is seen as one means of addressing this issue, advocating a safe, accessible, high-quality, and patient-centered experience for medical personnel. In an effort to promote IPP, the National Academy of Medicine has recommended that health-education programs teach students interprofessional skills and competencies. As a means to accomplish this at JMU, departments from the College of Health and Behavioral Studies successfully came together last year to create and explore the use of the Virtual Interprofessional Clinic in Second Life, a simulated world. Following their initial success, nursing, speech language pathology, and graduate psychology expanded their use of virtual clinics this semester with funding from a Health Resources and Services Administration (HRSA) grant. By using Second Life as a means to communicate and interact with patients virtually, the new ‘Madison Interprofessional Clinic’ has allowed students the chance to work to improve patient safety and their skills at interprofessional communication.


Second Life is a virtual reality world where users develop avatars to create communities, play games, or in this case pursue educational opportunities. Compared to more traditional face-to-face or phone conferencing, the use of a virtual world allows for participants to come together from any distance with much more scheduling flexibility. “It’s also a safe environment for students to learn, where there is no real patient to be harmed,” said Dr. Carol Dudding, Director of the Speech, Language Pathology Graduate Program. “Students have the opportunity to try things out and see if it works, and if it doesn’t then to try it again in another way.”

The idea to host clinics in the virtual world of Second Life originally came about as a way to bring people together in a way that was easy, safe, inexpensive, and would boost learning opportunities. “For smaller programs like speech-language pathology, who don’t necessarily have access to physical simulation labs, a virtual space makes sense,” Dudding continued. “It affords us an opportunity to bring in students and faculty from other disciplines into a virtual space even if we can’t be together physically.” As a proof of concept, last year’s Virtual Interprofessional Clinic had student participants from speech-language pathology, nursing, occupational therapy and physician’s assistant studies read over a simulated case study and met virtually to make a diagnosis. “It was nice to have a pilot,” added Dr. Sharon Strang, a nursing professor and one of the main coordinators behind the virtual clinics. “It gave us more confidence going into the clinics this year.”

Expanding on the methodology from last year’s virtual clinics, the Madison Interprofessional Clinic had teams of students from nursing, speech language pathology, and graduate psychology work together to diagnose simulated patients in four case studies. “Each team is responsible for being actively involved as the management team in one of the cases,” explained Dudding. “Once assigned to their case, each team has the opportunity to go online, examine the history and physicals, look at lab reports in some cases, read patients’ histories, then meet as a team prior to their simulation event to determine and decide what they’re going to do when they interact with the avatars in Second Life.” Through this teamwork, the students get valuable exposure to interprofessional education. “It’s been an interesting evolution,” said Strang. “The clinics first started out being about technology and technology issues, but I think we’ve managed to move beyond the technology issues and get to the patient care, which is what we really want to do.”

In addition to helping students learn interprofessional and clinical skills, the Madison Virtual Clinic is also collecting data on how this type of virtual learning can help build cultural competence. “Last year we collected data on teamwork and teamwork concepts, and we found that students do value working in teams,” explained Strang. “This semester we’re looking at how students do with cultural competence.” To accomplish this, the simulated patients were intentionally created to be diverse, such as Carlita, a Latino grandmother suffering from heart failure, and Myriam, a Middle Eastern woman who is having lung transplant issues.

“We’re familiar with only a couple of other universities and health care settings that are using virtual worlds in the health field,” said Dudding. “We’re really excited to have this program up and running.” With two successful semesters under their belts, these departments are looking for ways to expand the program. “The ultimate goal is to make patient safety and patient care better, and I think that Second Life and virtual worlds are a great platform for that,” added Strang. “It does require some training, but once you get past that it has worked out wonderfully.”