Archived case study

Adaptation of Shareville virtual world

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Innovation

Adaptation of a virtual immersive world to introduce students working with people with learning disability. We adapted Shareville, a virtual whole town environment developed at Birmingham City University. Student nurses learned from realistic, problem-based scenarios featuring adults with learning disabilities in a residential care home and children with learning disabilities in an out-patient clinic. This was supported by a workbook and classroom discussions.

Shareville is a virtual town where students from different disciplines can interact with video scenarios in real-world contexts. Students observe scenarios and have choice of actions to select from; depending on their choice they move to another video. The students are therefore able to respond to life-like scenarios.

What prompted innovation?

In our pre-registration courses students have limited exposure to learning disabilities in adult, mental health and children’s nursing; which has implications for current and future practice. Academic staff became more concerned about this deficit in light of high profile reports such as Death by Indifference (Mencap 2007) and the Winterbourne View inquiry (DH, 2012). The subsequent Confidential Inquiry into Premature Deaths of People with Learning Disabilities (Heslop et al 2013) details evidence that inadequate health care is implicated in people with learning disabilities dying prematurely.

Learning disability is a subject area that crosses all fields of nurse education, and we felt that we wanted to give it greater prominence in our pre-registration curricula. We were also keen to explore attitudes and beliefs of student nurses towards people with learning disabilities. (Lewis and Stenfert-Kroese, 2010). Use of Shareville enabled students to test out their knowledge, skills and attitudes in a safe environment, raising awareness of challenges and increasing knowledge about working with people with learning disabilities.

References

Department of Health (2012): Transforming care: A National response to Winterbourne View Hospital . Department of Health Review: Final Report. London: DH (available at https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/127310/final-report.pdf.pdf)

Heslop P, Blair P, Fleming P, Hoghton M, Marriott A, Russ L (2013): Confidential Inquiry into Premature Deaths of People with Learning Disabilities, Final Report. Bristol: Norah Fry Research Centre (available at http://www.bristol.ac.uk/cipold/fullfinalreport.pdf)

What makes innovation different?

Use of an immersive world to simulate actual practice is not in itself different. Using this to develop realistic scenarios about working with people with Learning Disabilities has enabled us to introduce and reinforce this theme in our curriculum. Of particular note is the inclusion of scenarios based on children with learning disabilities in an outpatient clinic as there is a paucity of resources for Children’s Nurses in this area.

Changes in practice

  • Students reported having increased insight into the additional needs of the Learning Disabled client group and that they encountered scenarios that they would not have anticipated, learning how best to address these situations.
  • Students also reported increased knowledge about clinical episodes and that they had developed awareness of and consideration for ensuring patients with a Learning Disability receive equitable and compassionate care.
  • Students reported having greater confidence in the simulated environment to test out ideas and their responses to the scenarios, increased self-efficacy and valuable insight from the feedback.
  • Students greatly valued the opportunity to go back a single step to try out or see the consequences of alternative actions.
  • Students clearly engaged in the delivery of this aspect of the curriculum.

Impact

This innovation has been highly evaluated by students both in interviews and paper based evaluations.

Dissemination

  • This innovation has been highly evaluated by students both in interviews and paper based evaluations.
  • This innovation was presented at the Innovation in Health & Social Care Learning and Teaching: HEA Health & Social Care 2013 Annual Conference Higher Education Academy Conference in June 2013
  • Shareville at City University London has been promoted and disseminated through an Educational Vignette, presented in a blog http://blogs.city.ac.uk/educationalvignettes/2013/01/22/shareville/#.Ufklq5arF8E
  • Received a prize at the School’s ‘Health has got Talent” event.
  • Promoted in ‘City News’ an in-house journal for all staff at City University London.
  • A paper has been prepared, based on student experiences and an observation of the taught sessions, this will be submitted to educational journals.