the learning program to help bring the nursing home resident and technology together in a virtual...

The learning program to help bring the nursing home resident and technology together in a virtual world

It’s Never 2 Late® for a Second Life®

By Thomas W. Whiteley

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.

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.

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® (http://www.edenalt.org/). 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 (http://lindenlab.com/).

Change is Happening

Second LifeSecond 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).

OpportunityThis 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

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.

Presentation of MaterialThe 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.

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 .

Goals & ObjectivesPhase 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.

Goals & ObjectivesPhase 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.


will be able to scroll, locate, and save a new avatar at least once in an

hour session.


will be able to locate and open the “appearance” button within 3

attempts.


will be able to scroll, locate, and save new outfits at least once in an

hour session.

Goals & ObjectivesPhase 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.

Goals & ObjectivesPhase IV (continued)


will be able to locate and open the “Destination” button within 3

attempts .


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

Sections of Instructional Design

.

History, Environment and Model

Audience Analysis

Learning Assessment

Content Outline and Program

Evaluation

Summary

History, Environment & ModelThis 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.

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.

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.

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.

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.

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.

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:

http://twwhiteley.com/education/education.htm

lPlease click “Audience analysis”

http://twwhiteley.com/education/education.html


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.

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.

Syllabus & Instruction Program

http://twwhiteley.com/education/education.html Please click “Instruction Program”



Formative EvaluationThe 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?

Formative EvaluationThe 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?

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.

Summative EvaluationThe 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?

Summative EvaluationA 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:



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

http://www.pioneernetwork.net/Data/Documents/Cutler-Low-Cost-Practical-Strategies.pdf

Design Applause. (2013) Info graphics. the variables within design process. Retrieved from web

address http://designapplause.com/2012/infographics-the-variables-within- design-

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