Andrade Allen D, Cifuentes Pedro, Oliveira Marcelo C, Anam Ramanakumar, Roos Bernard A, Ruiz Jorge G
J Grad Med Educ. 2011 Dec;3(4):541-5. doi: 10.4300/JGME-D-11-00236.1.
Avatars and virtual worlds offer medical educators new approaches to assess learners' competency in home-safety assessments that are less time-consuming and more flexible than traditional home visits. We sought to evaluate the feasibility and acceptability of implementing an avatar-mediated, 3-dimensional (3-D) home simulation as a virtual objective structured clinical examination station for geriatric medicine fellows.
We developed a 3-D home simulation in the virtual world Second Life (Linden Lab, San Francisco, CA) containing 50 safety hazards that could affect the safety of an elderly person at home. Eight geriatric medicine fellows participated in a 16-station objective structured clinical examination, with one station assigned to the 15-minute 3-D virtual world simulation, where the fellow's "home visit" was performed by navigating his or her avatar in the virtual world simulation. The fellows were instructed to find the home safety hazards in the simulated environment and then provide specific written recommendations. Two reviewers independently scored the fellows' written findings against an inventory-based checklist.
The geriatric medicine fellows scored a mean of 43% ± SD 9 on the inventory-based checklist. The scoring of the 2 reviewers showed a high interrater reliability (88%). Six of the 8 participants (75%) rated the simulation as "excellent." Four of the 5 women (80%) and none of the 3 men (20%) participating in the virtual objective structured clinical examination needed navigation assistance in the 3-D virtual house.
The 3-D, avatar-based, virtual geriatric home safety objective structured clinical examination is a practical and acceptable alternative to the traditional home safety visits in an objective structured clinical examination setting.
虚拟化身和虚拟世界为医学教育工作者提供了新方法，以评估学习者在家居安全评估方面的能力，这些方法比传统的家访耗时更少且更灵活。我们试图评估实施一种由虚拟化身介导的三维（3-D）家庭模拟作为老年医学住院医师虚拟客观结构化临床考试站点的可行性和可接受性。
我们在虚拟世界“第二人生”（加利福尼亚州旧金山的林登实验室）中开发了一个3-D家庭模拟，其中包含50种可能影响老年人居家安全的危险因素。八名老年医学住院医师参加了一个有16个站点的客观结构化临床考试，其中一个站点被分配为15分钟的3-D虚拟世界模拟，住院医师在虚拟世界模拟中通过操控其虚拟化身进行“家访”。要求住院医师在模拟环境中找出家居安全危险因素，然后提供具体的书面建议。两名评审员根据基于清单的检查表对住院医师的书面检查结果进行独立评分。
老年医学住院医师在基于清单的检查表上的平均得分为43%±标准差9%。两名评审员的评分显示出较高的评分者间信度（88%）。8名参与者中有6名（75%）将该模拟评为“优秀”。参与虚拟客观结构化临床考试的5名女性中有4名（80%），3名男性中无人（20%）在3-D虚拟房屋中需要导航协助。
在客观结构化临床考试环境中，基于虚拟化身的3-D虚拟老年家居安全客观结构化临床考试是传统家居安全家访的一种实用且可接受的替代方式。
