revised aupha presentation june25, 2009

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

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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

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• 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

http://dictionary.reference.com/browse/simulation

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

http://dictionary.reference.com/browse/simulation

• 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

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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.


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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)


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• Studies on the Effects of Instructional Gaming

Ke, Fengfeng (2008)


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)


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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”


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Leading Organizations Leading Educators

Explore Primer on Change Player’s Guide


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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


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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


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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


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ExperiencePoint trailer (2 minutes)


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http://www.experiencepoint.com/sims/CentralValleyview

http://www.experiencepoint.com/sims/CentralValleyview

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

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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

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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

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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

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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

Change is Good:

http://www.changeisgoodmovie.com

DISCUSSION9

http://www.changeisgoodmovie.com/

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

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QUESTIONS?11

SCHOOL OF HEALTH SERVICES MANAGEMENT

Winston Isaac PhD, CHE: [email protected] Pringle MBA, DC: [email protected]

Pria Nippak PhD: [email protected]

SIMULATION

A CHANGEMANAGEMENT

RYERSON UNIVERSITY

2009 Annual Meeting

revised aupha presentation june25, 2009

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