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SCHOOL OF HEALTH SERVICES MANAGEMENT
Winston Isaac PhD, CHEJake Pringle MBA, DC
Pria Nippak PhD
SIMULATION
A CHANGEMANAGEMENT
RYERSON UNIVERSITY
2009 Annual Meeting
AGENDA
Background1234
56
789
10
11
Why a Simulation?
Pedagogical Evidence for Simulations
THE SIMULATION – EXPERIENCEPOINTCentral-Valleyview | ExperienceChange
Objective
Methodology
Results
Discussion
Conclusion
Questions
Limitations
BACKGROUND
• Course – CHIM 300 (Managing Health Information Services)
• Online Delivery through Blackboard
• Section on Innovation and Change Management
• Past – Williams, Kondra, Vibert (2008). Management,(2nd Canadian
Ed.) . Toronto: Ontario. Thomson-Nelson– Supplemented with additional readings/case studies
1
• Student Feedback
– Difficult conceptualizing what is “Change Management”
BACKGROUND1
http://www.youtube.com/v/P3-qfeCQvNA
BACKGROUND1
Change
SIMULATION?
noun 1. imitation or enactment, as of something anticipated or in testing. 2. the act or process of pretending; feigning. 3. an assumption or imitation of a particular appearance or form; counterfeit; sham. 4. Psychiatry. a conscious attempt to feign some mental or physical disorder to escape punishment or to gain a desired objective. 5. the representation of the behavior or characteristics of one system through the use of another system, esp. a computer program designed for the purpose.
(simulation. (n.d.). Dictionary.com Unabridged (v 1.1). Retrieved June 17, 2009, from Dictionary.com website: http://dictionary.reference.com/browse/simulation)
BACKGROUND1
CHANGE MANAGEMENT
• High Failure Rate (~60-70%)
• Failure– Performance measures are not achieved
BACKGROUND1
CHANGE MANAGEMENT
• Why important?– The problem may not be a lack of knowledge but an inability to translate the
knowledge into practice
• Remember – definition of simulation– The representation of the behavior or characteristics of one system through the
use of another system, esp. a computer program designed for the purpose.
(simulation. (n.d.). Dictionary.com Unabridged (v 1.1). Retrieved June 17, 2009, from Dictionary.com website: http://dictionary.reference.com/browse/simulation)
BACKGROUND1
• A Simulation:– Provides a safe platform for practice– Provides an opportunity to test theory through application – Provides a powerful alternative approach to complement and
extend traditional teaching approaches in change management.
WHY A SIMULATION?2
• Multiple studies have evaluated the efficacy of simulations as an educational tool
• Two recent meta-analysis studies– Vogel, J.F., Vogel, D.S., Cannon-Bowes, J., Bowes, C.A., Muse, K., & Wright, M.
(2006). Computer Gaming and interactive simulations for learning: A meta-analysis. Journal of Educational Computing Research, 34(3), 229-243
– Ke, F. (2008). A qualitative meta-analysis of computer games as learning tools. In R. E. Ferdig (Ed.), Handbook of Research on Effective Electronic Gaming in Education (pp 1-32), New York: IGI Global.
PEDAGOGICAL EVIDENCE FOR SIMULATIONS AS AN EDUCATIONAL TOOL
3
Vogel et al. (2006)
• Objective:– Evaluate which teaching method is better
a. games and interactive simulations or
b. traditional instruction
• Findings:– Those using interactive simulations or games report higher cognitive
gains and better attitudes toward learning compared to those using traditional teaching methods.
PEDAGOGICAL EVIDENCE FOR SIMULATIONS AS AN EDUCATIONAL TOOL
3
Ke, Fengfeng (2008)
• Objective:– To inform policy and practice based on existing studies.
• Key Findings:– 5 major themes
• Evaluating the effects of computer-based game on learning (65 out of 89 studies)
• Exploring effective instructional game design (17 out of 89)• Exploring game-based learning activities or pedagogy (9 our of 89)• Evaluating the influence of learner characteristics on game based
learning process (10 out of 89)• Investigating cognitive or motivational processes during game playing (4 out
of 89)
PEDAGOGICAL EVIDENCE FOR SIMULATIONS AS AN EDUCATIONAL TOOL
3
• Studies on the Effects of Instructional Gaming
Ke, Fengfeng (2008)
PEDAGOGICAL EVIDENCE FOR SIMULATIONS AS AN EDUCATIONAL TOOL
3
Significant Positive EffectMixed ResultsNo DifferenceTraditional better
• Studies on Learner Characteristics:
– Gender is the most examined and seems evenly split – Gender has an effect– Gender has no effect
Ke, Fengfeng (2008)
PEDAGOGICAL EVIDENCE FOR SIMULATIONS AS AN EDUCATIONAL TOOL
3
ExperiencePoint• Founded by James Chisholm and Greg Warman on August 6, 2006
• “The best way to learn is through experience. We create experiences that enable people to practice decision-making in realistic situations, so they can perform in real situations”
THE SIMULATION – EXPERIENCEPOINTCentral-Valleyview | ExperienceChange
4
THE SIMULATION – EXPERIENCEPOINTCentral-Valleyview | ExperienceChange
4
Leading Organizations Leading Educators
Explore Primer on Change Player’s Guide
THE SIMULATION – EXPERIENCEPOINTCentral-Valleyview | ExperienceChange
4
Student• Assume role of Vice President Patient Care Programs (Operations)
Long term GOAL• To successfully oversee the merger of two hospitals, Central and
Valleyview Hospital
THE SIMULATION – EXPERIENCEPOINTCentral-Valleyview | ExperienceChange
4
THE SIMULATION – EXPERIENCEPOINTCentral-Valleyview | ExperienceChange
4
SIMULATION GOAL:
• Spearhead the process of re-structuring the Emergency department of the two hospitals
– Create an urgent care centre at the former Valleyview Emergency
– Expand the 24/7 full service Emergency at Central Emergency
THE SIMULATION – EXPERIENCEPOINTCentral-Valleyview | ExperienceChange
4
Essential Elements
• Stakeholder Analysis
• Planning– Organize and choose Tactics which are grouped into 4 categories:
• Informational (Gather Tactics), • Educational (Share Tactics), • Social (Lead Tactics), and • Structural (Organize Tactics),
• Resources– Cost and time allocated to each tactic.
• Implement
THE SIMULATION – EXPERIENCEPOINTCentral-Valleyview | ExperienceChange
4
THE SIMULATION – EXPERIENCEPOINTCentral-Valleyview | ExperienceChange
4
ExperiencePoint trailer (2 minutes)
THE SIMULATION – EXPERIENCEPOINTCentral-Valleyview | ExperienceChange
4
STUDY:
What is the influence of repeat simulation testing on performance scores?
OBJECTIVE5
• Sample: – 2 groups of students
• Group 1: Basic Instructions (12 females, 4 males)• Group 2: Advanced Instructions (10 females, 4 males)
• Instrument– EXPERIENCEPOINT simulation:
Central-Valleyview | ExperienceChange Simulation
METHODOLOGY6
• Procedures: – Students performed the simulation twice within seven days
• Group 1: were given standard instructions
• Group 2: were given the same instructions a Group 1 plus additional instructions created by the instructor
METHODOLOGY6
Standard Instructions (Group 1):
• Before you play the simulation please read the case study and take the quickstart tour. The case study, quickstart tour, and simulation are all found within the 'Experience' section. The case study and tour should take you approximately 30 minutes. Plan on an additional 2 hours (or more) to play the simulation.
• BIG HINT #1: You may benefit from reviewing the change management primer found within the 'Explore' section of ExperienceChange. Success in the simulation depends upon how well you apply the primer's 'staged approach to change'.
• BIG HINT #2: The simulation is tough. Really tough (fewer than 20% of players succeed the first time through). If you find that you are struggling, think back to the staged model - maybe you've missed a step. Once you are done, check out the 'Reflect' section of ExperienceChange to see where you could improve and play again!
METHODOLOGY6
Instructors Instructions (Group 2):
• Same instructions as Group 1
PLUS
• Complete Stakeholder analysis FIRST and review feedback before proceeding• Choose Tactics appropriately to fit Change Process outlined in Primer
• Pay attention to available resources – cost and time
METHODOLOGY6
• Statistical Analysis– A repeated measures ANOVA examining the influence of Gender
and Instruction on two dependent measures• Conversion Score• Session Score
– No effect of Instruction was observed• Two groups were collapsed
METHODOLOGY6
Trial 1 Trial 20
5
10
15
20
25
30
35
40
45Mean Conversion Score for Each Simulation Trial
Mea
n Co
nver
sion
Scor
e
P =. 0000
RESULTS: Conversion Score Effect
7
Trial 1 Trial 20
5
10
15
20
25
30
35
40 Mean Sessional Score for Each Simulation Trial
Mea
n Se
ssio
nal S
core
P= .0000
RESULTS: Session Score Effect
7
Females Males0
10
20
30
40
50
60 Mean Simulation Trial Conversion Score by Gender
Trial 1Trial 2
Mea
n Co
nver
sion
Sore
P = .043
RESULTS7
Females Males0
10
20
30
40
50
60
Mean Simulation Trial Session Score by Gender
Trial 1Trial 2
Mea
n Se
ssio
n Sc
ore
P = .045
RESULTS7
Trial 1 Trial 2 Trial 30
10
20
30
40
50
60
Mean Coversion Score by Trial for Group 2
Mea
n Co
nver
sion
Scor
e
RESULTS: Conversion Score Effect for Group 2
7
Note: Only Group 2 was required to complete 3 simulation trials.
Trial 1 Trial 2 Trial 30
10
20
30
40
50
60
Mean Session Scores by Trial for Group 2
Mea
n Se
ssio
nal S
core
RESULTS: Session Effect for Group 2
7
Note: Only Group 2 was required to complete 3 simulation trials.
• Small Sample size• Unequal Gender Distribution• Some subjects failed to complete the simulation twice (N = 2)• No verification that students read the additional instructions• No idea if knowledge was transferable beyond the simulation
– Evaluate student knowledge using another measurement– Expose students to another simulation and assess for improved
performance
• Did not examine the influence of gaming capabilities as a tertiary factor
LIMITATIONS8
To reiterate:• As indicated by Vogel et al (2006) – The overall result of the meta-
analysis was that those using interactive simulations or games report higher cognitive gains and better attitudes toward learning compared to those using traditional methods.
• Our study demonstrated that when delivering a simulation in an online environment, students should be required to run through the simulation at least twice to achieve targeted scores.
• Practice, Practice
DISCUSSION9
• Additional instructions may be beneficial– Not significant in the current study, but scores were lower in the
standard group – Variability may have accounted for the absence of an effect– Ensure that the delivery method can be verified
• Provide another method of Change Management Evaluation– Ensures translation of Knowledge
• Provide a forum to apply the Change Management Principles– Ensures generalized application of simulation learning objectives
DISCUSSION9
Simulations should be considered a valuable experiential tool for increasing motivation and learning outcomes when teaching change management.
CONCLUSION10
ACKNOWLEDGEMENT
?
11
QUESTIONS?11
SCHOOL OF HEALTH SERVICES MANAGEMENT
Winston Isaac PhD, CHE: wisaac@ryerson.caJake Pringle MBA, DC: pringle@ryerson.ca
Pria Nippak PhD: pnippak@ryerson.ca
SIMULATION
A CHANGEMANAGEMENT
RYERSON UNIVERSITY
2009 Annual Meeting
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