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Surgical Trainee Opinions in the United Kingdom Regarding a Three-Dimensional Virtual Mentoring Environment (MentorSL) in Second Life: Pilot Study

Surgical Trainee Opinions in the United Kingdom Regarding a Three-Dimensional Virtual Mentoring... Background: Medical mentoring is becoming increasingly complex with the evolving needs of trainees and the complexities of their personal and social lives. The Internet is an enabling technology, which increasingly facilitates interaction with multiple people at a distance. Web 2.0 and 3.0 technology shows promise in furthering this facilitation. Objective: The objective of our study was to establish opinions among doctors in postgraduate surgical training regarding mentoring and whether these doctors would readily accept virtual mentoring following a brief experience. Methods: On the 12th of February 2012, an introductory teaching class was arranged by The London Postgraduate School of Surgery for doctors in training. Participants were introduced to a novel virtual mentoring system and asked to complete a questionnaire regarding their opinions before and after the demonstration. Results: A total of 57 junior doctors attended. Among them, 35 completed questionnaires pre- and postdemonstration. Regarding usefulness of a 3D virtual environment for mentoring, 6/35 (17%) agreed or strongly agreed and 20/35 (57%) were unsure prior to the session. Following 20 minutes using MentorSL, this significantly increased to 14/35 (40%) agreeing or strongly agreeing with 11/35 (31%) unsure (P<.001). Prior to using MentorSL, regarding usefulness of voice communication for virtual mentoring, 11/35 (31%) agreed or strongly agreed and 18/35 (51%) were unsure. Following 20 minutes using MentorSL, 19/35 (54%) agreed or strongly agreed and 10/35 (29%) were unsure of usefulness. Regarding ease of use of navigation, search mentor, meeting scheduling, and voice communication features, 17/35 (49%), 13/35 (37%), 15/35 (43%), and 16/35 (46%) participants agreed or strongly agreed, respectively. Regarding usefulness of telementoring, 24/35 (69%) agreed or strongly agreed, increasing to 28/35 (80%) following the introduction. For usefulness of multiple mentors, initially 24/35 (69%) agreed or strongly agreed increasing to 29/35 (83%). For overall satisfaction, 30/35 (86%) reported good or adequate and 19/35 (54%) agreed or strongly agreed with using the system again. Conclusions: These data suggest that a short introduction on how to use virtual systems may result in significant participation and use of virtual mentoring systems. (JMIR Serious Games 2013;1(1):e2) doi: 10.2196/games.2822 KEYWORDS education; Internet; training http://games.jmir.org/2013/1/e2/ JMIR Serious Games 2013 | vol. 1 | iss. 1 | e2 | p. 1 (page number not for citation purposes) XSL FO RenderX JMIR SERIOUS GAMES Jaffer et al in the WWW [6]. Today’s WWW provides for an immersive, Introduction interactive, and information-rich potential resource. e-mentoring has been shown to be efficacious in the context of North Background American school children, interestingly reporting that the Doctors in postgraduate surgical training often require guidance frequency of mentor-mentee interaction moderates the to overcome hurdles associated with modern-day surgical relationship between mentee “self-efficacy” and previous training. Good mentoring delivered in a timely fashion is a way Internet experience with positive outcome [7]. The Web 3.0 in which surgical trainees may be helped through these format encompasses virtual worlds, the semantic Web, difficulties in a manner compatible with the principles of adult microformats, natural language search, data mining, machine learning. learning, recommendation agents, artificial intelligence, and augmented reality technologies. Augmented reality involves a The Standing Conference on Postgraduate Medical and Dental fusion of the physical world and computer-generated content, Education (SCOPME) in the United Kingdom, describes potentially delivered through the Internet. The use of augmented mentoring as: reality for anatomy education has been demonstrated [8], and The process whereby an experienced, highly regarded, there is great potential for this technology. empathic person (the mentor) guides another MentorSL individual (the mentee) in the development and re-examination of their own ideas, learning, and Virtual worlds including Second Life (SL) by Linden personal and professional development. The mentor, Laboratories [9] and Olive by Forterra Systems [10] provide who may or may not work in the same organization content as a three-dimensional (3D) environment in which we or field as the mentee, achieves this by listening and can navigate and interact with others as virtual representations talking in confidence to the mentee [1] of ourselves, avatars. Second Life, currently the most popular virtual world, facilitates streaming audio/video/TV/YouTube The mentors have many roles that have previously been collections, 3D virtual libraries, and virtual tourist attractions reviewed [2]. Briefly, these include advisor, coach, and destinations [11]. A virtual emergency department training counselor/guide, and role model. As someone who has study has reported that ease of use and limited access to the successfully negotiated some of these difficulties, a mentor may software were identified as barriers to adoption [12]. Meskó offer motivation, hope, and advice for the mentee. As technology summarized educational applications’ uses of SL [13]. He increasingly becomes part of a managed learning process, expert discussed potential advantages as being global collaboration mentoring of trainees, facilitated by technology, may become without boundaries; interactivity in a manner better than a essential for ensuring patient safety. videoconference with use of videos, presentations, images, and It has been previously reported that trainees often do not have Web links at the same time in one place. Being able to draw mentors or are unaware of the role of the mentor and therefore from a worldwide pool of experts and having the ability to do not have beneficial meetings with them [2,3]. The establish exhibits which are not possible via a videoconference management concept “Just-in-time” was popularized by the [14] or a website are also cited as advantages [15,16]. Toyota Motor Company and resulted in huge increases in Interactions between SL residents may benefit each others’ efficiency and productivity. The essence of the system is to participation via networks that allow for dynamic, evolving respond to needs and only call upon resources when they are systems all made possible by “semantic” Web technology [17]. required [4]. A parallel may be drawn with mentoring in that it Virtual reality resources have been successfully used as is potentially a labor-intensive and costly resource, which is not educational resources [18-27]. necessarily required at all times. Mentoring may be best For the purposes of exploring new methods to support achieved in a “just-in-time” fashion where an appropriate mentor mentoring, a 3D virtual system, MentorSL, was developed [28]. is available to facilitate problem solving in response to a Avatars assemble in a registration area, where they have a range real-world need. In order for this mentoring to be achieved in of mentoring databases available to them (Figure 1). Mentors a comfortable learning environment, a knowledgeable, yet not are able to log on to SL as avatars and provide mentoring, necessarily proximate mentor may be most suitable. through virtual world communication, to their mentees. A range World Wide Web of online mentoring resources is available to both mentors and The latest digital technologies may be a key enabler to support mentees and there are links to other mentoring resources. these requirements. The Department of Health in the United Doctors in postgraduate surgical training in the London Kingdom has recently published a “Framework for Technology Postgraduate School of Surgery (see Textbox 1) were invited Enhanced Learning” that advocates the use of e-learning and to experience the system and submit their views. The primary simulation to enhance learning where there is a clear benefit to aims of our study were to establish whether barriers existed to patient care [5]. Internet-based technology developments, the adoption of the 3D virtual mentoring environment and to including the World Wide Web (WWW), allow for increasing establish whether a short introduction would be sufficient to interactivity and may be of use in fulfilling tele- and achieve participant “buy-in”. The secondary aims were to multiple-mentoring needs. Improved mentoring may lead to establish which aspects of the system were deemed most useful improved trainee development, which may lead to improved and which further aspects should be developed further. patient care. There has been an evolution of the ways that interaction is facilitated and information processed and retrieved http://games.jmir.org/2013/1/e2/ JMIR Serious Games 2013 | vol. 1 | iss. 1 | e2 | p. 2 (page number not for citation purposes) XSL FO RenderX JMIR SERIOUS GAMES Jaffer et al Textbox 1. Doctors in postgraduate surgical training. The London Postgraduate School of Surgery is the largest surgical training organization in the world. It is responsible for managing more than 900 trainees. The school offers programs at prestigious teaching centers across the capital city. Doctors in postgraduate training spend an initial 2 years (FY1, FY2) in generic foundation training; this is followed by a further 2 years (CT1, CT2) in core surgical training. Successful competitive progression results in spending an additional 6 years in specialty surgical training (ST3 to ST8) toward award of completion of training. Figure 1. Photograph from Second Life showing the MentorSL meeting complex. Licensed under Creative Commons Attribution 2.0. Data Collection Methods Participants were invited to fill in an anonymous questionnaire regarding their perceptions both prior to and after the session. Study Participants The questionnaire consisted of 7 domains: (A) demographic Doctors in postgraduate surgical training were invited to attend data, (B) perceptions regarding mentoring, (C) perceptions a “taster” session introducing virtual mentoring via the online regarding the 3D Web, (D) perceptions regarding the virtual world SL at the London Postgraduate School of Surgery, practicalities of MentorSL, (E) perceptions regarding tele- and UK. This session was a subsection of a wider training meeting multiple mentoring, (F) perceptions regarding further being held. The trainees were within the first four years of enhancements in virtual mentoring, and (G) perceptions postgraduate training. All participants had previously experience regarding future use of MentorSL (see Multimedia Appendix of mentoring as a component of “Foundation Training” which 1 for the questionnaire). These questions were determined with includes appointing of an “Assigned Educational Supervisor” a view to establishing whether doctors in postgraduate surgical by the training program. A 10-minute presentation on SL and training would readily accept use of a virtual mentoring facility specifically on MentorSL including an “in-world” walk through and whether any particular aspect of the facility was related to was given via a large screen projector. SL as a virtual world future use of the system. Demographic data were only collected facilitating interaction of virtual people or avatars was explained. once, questions in domains (B), (C), and (E) were posed both Methods used to navigating and communicate in SL were before and after participants spent 20 minutes using MentorSL. explained to participants. MentorSL was introduced as a tool Questions in domains (D), (F), and (G) were only asked after to facilitate mentoring in the virtual world of SL. The search participants spent 20 minutes using MentorSL. mentor facilities in MentorSL and the facilities to arrange and hold meeting within the MentorSL framework were explained Statistical Analysis and demonstrated. Following a short questions and answers Statistical analysis was performed using SAS (Cary, USA). session, participants were able to sit in groups at computer Data were presented as ratios and percentages. The chi-square stations running Second Life fitted with multiple headsets. test was used for significance testing. Facilitators in the real world as well as SL were available to help and guide participants. http://games.jmir.org/2013/1/e2/ JMIR Serious Games 2013 | vol. 1 | iss. 1 | e2 | p. 3 (page number not for citation purposes) XSL FO RenderX JMIR SERIOUS GAMES Jaffer et al 22/57 (39%) were in core surgical training 1 (CT1), and 15/57 Results (26%) were in core training 2 (CT2). Demographic Data Of the 57 participants, 40/57 (70%) participants reported that they had firm plans for which specialty they would like to enter, There were 57 participants in total, median age was 28.1 years 3/57 (5%) had no plans as yet, and 14/57 (25%) were unsure of (range 24-43). There were 32 females (32/57, 56%) and 25 their choice. The response rate for the questionnaire was 35/57 males (25/57, 44%). (61%). Of the total participants, 1/57 (2%) qualified in 2004, 3/57 (5%) In terms of previous experience with the 3D virtual qualified in 2007, 23/57 (40%) qualified in 2008, 13/57 (23%) environments, 6/57 (11%) had had previous experience and qualified in 2009, and 17/57 (30%) qualified in 2011. Of the 51/57 (89%) had no experience or were unsure. Mentee total participants, 20/57 (35%) were in foundation year 1 (FY1), perceptions are described below and summarized in Figure 2. Figure 2. Stacked bar chart of response to questions pre- (above) and post-experience (below) of the MentorSL system. *Improvement in response; P<.05, **improvement of response; P<.001 (one-way chi-square test). chi-square test). Of 35 participants, 14/35 (40%) strongly agreed, Perceptions Regarding Concepts of Mentoring 17/35 (49%) agreed, and 4/35 (11%) were unsure. With regards to having understood of the roles of a mentor, Perceptions Regarding Mentoring via the 3D Web prior to the experience, 3/35 (9%) said they strongly agreed, 19/35 (54%) said they agreed, 12/35 (34%) were unsure, and When asked whether they thought whether a 3D virtual 1/35 (3%) strongly disagreed. Following the experience, there environment would be useful in mentoring prior to experiencing was a statistically significant improvement toward agreement it, 2/35 (6%) strongly agreed, 4/35 (11%) agreed, 20/35 (57%) (P<.001; chi-square test). Of 35 participants, 11/35 (31%) were unsure, and 9/35 (26%) disagreed. Following the strongly agreed, 20/35 (57%) agreed, 3/35 (9%) were unsure, experience, there was a statistically significant improvement and 1/35 (3%) disagreed. toward agreement (P<.001; chi-square test). Of 35 participants, 3/35 (9%) strongly agreed, 11/35 (31%) agreed, 11/35 (31%) With regards to whether mentoring was thought to be useful, were unsure, 8/35 (23%) disagreed, and 2/35 (6%) strongly 10/35 (29%) strongly agreed, 21/35 (60%) agreed, and 4/35 disagreed. (11%) were unsure. Following the experience, there was a statistically significant improvement toward agreement (P=.04; http://games.jmir.org/2013/1/e2/ JMIR Serious Games 2013 | vol. 1 | iss. 1 | e2 | p. 4 (page number not for citation purposes) XSL FO RenderX JMIR SERIOUS GAMES Jaffer et al (34%) agreed, 14/35 (40%) were undecided, and 7/35 (20%) Perceptions Regarding the Practicalities of MentorSL disagreed. Prior to experiencing MentorSL, when asked whether voice communication would be useful in the mentoring relationship, Perceptions Regarding Future Use of MentorSL 3/35 (9%) strongly agreed, 9/35 (26%) agreed, 18/35 (51%) When asked whether participants would use MentorSL in the were unsure, and 5/35 (14%) disagreed. Following experiencing future, 4/35 (11%) strongly agreed, 15/35 (43%) agreed, 10/35 MentorSL, there was a statistically significant improvement (29%) were undecided, 4/35 (11%) disagreed, and 2/35 (6%) toward agreement (P<.001; chi-square test). Of 35 participants, strongly disagreed. 6/35 (17%) strongly agreed, 13/35 (37%) agreed, 10/35 (29%) were unsure, 5/35 (14%) disagreed, and 1/35 (3%) strongly Discussion disagreed. Principal Findings When asked regarding navigation in SL was sufficiently simple to use, 6/35 (17%) strongly agreed, 11/35 (31%) agreed, 14/35 This study demonstrates that doctors in postgraduate surgical (40%) were undecided, 2/35 (6%) disagreed, and 2/35 (6%) training are willing to “buy-in” to a virtual mentoring system strongly disagreed. in SL. The most well-received facilities were those of tele- and multiple mentoring and that of voice communication. The When asked whether the search for mentor facility in MentorSL implication of these findings is that this mentoring system may was sufficiently simple to use, 7/35 (20%) strongly agreed, 6/35 be able to deliver mentoring to this group of doctors in a manner (17%) agreed, 19/35 (54%) were undecided, 2/35 (6%) commensurate with their needs. disagreed, and 1/35(3%) strongly disagreed. The response rate of 61% (35/57) in this study, seemingly low When asked whether the meeting scheduling facility in and a limitation of the study, is commensurate with other studies MentorSL was sufficiently simple to use, 4/35 (11%) strongly in this population [29]. We would suggest that a subsequent agreed, 11/35 (31%) agreed, 18/35(51%) were undecided, and usability study would result in increased participant involvement 2/35 (6%) disagreed. and perceived benefit. Thus, we would suggest that this would When asked regarding ease of using voice communication in be the lower limit of what a future usability study would SL, 6/35 (17%) strongly agreed, 10/35 (29%) agreed, and 19/35 engender. This study is not able to inform on the potential (54%) were undecided. benefit of virtual mentoring using this system, and further work will be needed to establish this. Regarding overall satisfaction with MentorSL, 6/35 (17%) reported very good, 24/35 (69%) reported adequate, 4/35 (11%) Perceptions reported slightly disappointing, and 1/35 (3%) reported very It the context of team training for triage of mass casualties, it poor. has been demonstrated that trainees quickly adapt to a virtual environment and find it an experience that is beneficial to their Perceptions Regarding Tele- and Multiple Mentoring professional development [30]. Regarding the usefulness of a specialist mentor who may be geographically remote, prior to the experience, 6/35 (19%) Despite the all-pervasive nature of the Internet in today’s strongly agreed, 18/35 (51%) agreed, and 11/35 (31%) were society, 89% (51/57) of participants had no significant previous unsure. Following the experience, there was a statistically experience of 3D Web 3.0 technology. Despite this, we found significant improvement toward agreement (P<.001; chi-square that only 17% (6/35) of participants disagreed or strongly test). Of 35 participants, 13/35 (37%) strongly agreed, 15/35 disagreed, following a short introduction, with using the system (43%) agreed, 6/35 (17%) were unsure, and 1/35 (3%) disagreed. in the future. When asked regarding the perceived benefits of having multiple Central to the provision of a virtual “just-in-time” mentoring mentors available for specific mentoring needs, prior to the system is the mentee perceiving the need for being mentored. experience, 8/35 (23%) strongly agreed, 16/35 (46%) agreed, At outset, only 21/35 (60%) participants agreed or strongly 10/35 (29%) were unsure, and 1/35 (3%) disagreed. Following agreed that they understood the concept of mentoring; this the experience, there was a statistically significant improvement improved to 31/35 (89%). In addition, the initial high agreement toward agreement (P=.002; chi-square test). Of the participants, with the usefulness of mentoring was maintained following the 12/35 (34%) strongly agreed, 17/35 (49%) agreed, and 6/35 introduction (31 predemonstration vs 32 postdemonstration). (19%) were unsure. The specific use of the 3D virtual world for mentoring is perhaps Perceptions Regarding Further Enhancement of the most contentious issue to be assessed in the confines of a Virtual Mentoring short introduction. More formed decisions will most likely require the on-going usage of the system by mentees. This seems When asked whether participants thought that real life facial to be reflected in that 14/35 (40%) were positive regarding the recognition and animation of avatar facial features would be system, and 11/35 (31%) were unsure. useful, 2/35 (6%) strongly agreed, 13/35 (37%) agreed, 13/35 (37%) were undecided, and 7/35 (20%) disagreed. Importantly, the more immediate and apparent facilitatory benefits of the system seemed to be well received by the When asked whether hand gesture recognition and animation participants. This was reflected by the strong performance in of avatar would be useful, 2/35 (6%) strongly agreed, 12/35 the voice communication, tele-, and multiple-mentoring http://games.jmir.org/2013/1/e2/ JMIR Serious Games 2013 | vol. 1 | iss. 1 | e2 | p. 5 (page number not for citation purposes) XSL FO RenderX JMIR SERIOUS GAMES Jaffer et al domains. Indeed, the voice communication domain showed a factors in new technology adoption [34], and these also may be large increase in agreement from 4/35 (11%) to 16/35 (46%). important domains to investigate in future work. The user-friendliness of the voice communication was found With regards to future developments in the MentorSL, to have a major impact in acceptance of a SL training program equivalent numbers were positive regarding animation of the for nurses [24]. avatars facial features and hand gestures to improve the There may be barriers to the adoption of these new technologies experience. for medical mentoring. Hansen et al recalled Roger’s diffusion Conclusions of innovation theory in explaining attributes of a new technology We have demonstrated that the MentorSL system has the affecting an individual’s decision to adopt [31]. These attributes potential to be well accepted by mentees. This may be a include the relative advantage of the innovation over the idea reflection of the rapidly acquired understanding of the role of it supersedes, how the innovation meets the needs of potential a mentor and the feeling of need for mentoring. Junior surgical adopters, how difficult the innovation is to understand and use, trainees are able to rapidly familiarize with this novel how the innovation may be tested in a timely fashion, and how communication modality and seem interested in further outcomes associated with the innovation are visible to others. expansion of the virtual mentoring experience using facial and Interestingly, a study investigating these factors in adoption of gesture recognition and avatar animation technology. Further e-mentoring by Greek mentors reported that only relative work is required to evaluate utilization of this virtual mentoring advantage was a significant factor in adoption [32]. Other facility when made available to doctors in postgraduate surgical potential drivers for adoption that may be important to further training and to establish benefit. We are currently establishing work are alluded to by the “Uses and Gratification” theory [33], a pilot study to trial medical mentoring using MentorSL in a suggesting that various forms of gratification affect utility. The cohort of surgical trainees in the London Postgraduate School well-established “Technology Acceptance Model” emphasizes of Surgery. “perceived usefulness” and “perceived ease-of-use” as important Acknowledgments We would like to acknowledge statistical support from Jonathan Alsop, statistician at Numerus, UK. The development of the mentoring environment was supported by small grants from the NANIME charitable trust and the London Postgraduate School of Surgery. Authors' Contributions UJ conceived the idea, helped develop the software, and wrote the manuscript. NS is guarantor, and critically appraised the design and manuscript. NWJ critically appraised the manuscript and was involved with design. Conflicts of Interest None declared. Multimedia Appendix 1 Questionnaire. [PDF File (Adobe PDF File), 54KB-Multimedia Appendix 1] References 1. SCOPME. Supporting Doctors and Dentists at Work: An Inquiry into Mentoring. London: Standing Committee on Postgraduate Medical and Dental Education; 1998. 2. Jaffer U, Pennell A, Musonda P. General surgical trainee experiences of mentoring: a UK regional audit. J Surg Educ 2010;67(1):19-24. [doi: 10.1016/j.jsurg.2009.10.004] [Medline: 20421085] 3. Kaderli R, Muff B, Stefenelli U, Businger A. Female surgeons' mentoring experiences and success in an academic career in Switzerland. Swiss Med Wkly 2011;141:w13233 [FREE Full text] [doi: 10.4414/smw.2011.13233] [Medline: 21769754] 4. Sugimori Y, Kusunoki K, Cho F, Uchikawa S. Toyota production system and Kanban system materialization of just-in-time and respect-for-human system. Intl J Production Res 1977 Jan;15(6):553-564. [doi: 10.1080/00207547708943149] 5. DOH. Framework for technology enhanced learning. 2012. URL: https://www.gov.uk/government/publications/ a-framework-for-technology-enhanced-learning [accessed 2013-09-14] [WebCite Cache ID 6JcKTfn6D] 6. Markoff J. Entrepreneurs see a Web guided by common sense. New York Times. 2006. URL: http://www.nytimes.com/ 2006/11/12/business/12web.html?ex=1320987600&en=254d697964cedc62&ei=5088 [accessed 2013-09-04] [WebCite Cache ID 6JcKc2LOk] 7. DiRenzo MS, Linnehan F, Shao P, Rosenberg WL. A moderated mediation model of e-mentoring. J Vocat Behav 2010 Apr;76(2):292-305. [doi: 10.1016/j.jvb.2009.10.003] http://games.jmir.org/2013/1/e2/ JMIR Serious Games 2013 | vol. 1 | iss. 1 | e2 | p. 6 (page number not for citation purposes) XSL FO RenderX JMIR SERIOUS GAMES Jaffer et al 8. Thomas RG, John NW, Delieu JM. Augmented reality for anatomical education. J Vis Commun Med 2010 Mar;33(1):6-15. [doi: 10.3109/17453050903557359] [Medline: 20297908] 9. Linden. Second Life. 2011. URL: http://secondlife.com/ [accessed 2013-09-14] [WebCite Cache ID 6JcKlZSEi] 10. Forterra. Olive. 2011. URL: http://www.saic.com/products/simulation/olive/ [accessed 2013-09-14] [WebCite Cache ID 6JcKtIl55] 11. Boulos MN, Hetherington L, Wheeler S. Second Life: an overview of the potential of 3-D virtual worlds in medical and health education. Health Info Libr J 2007 Dec;24(4):233-245. [doi: 10.1111/j.1471-1842.2007.00733.x] [Medline: 18005298] 12. Heinrichs WL, Youngblood P, Harter P, Kusumoto L, Dev P. Training healthcare personnel for mass-casualty incidents in a virtual emergency department: VED II. Prehosp Disaster Med 2010;25(5):424-432. [Medline: 21053190] 13. Meskó B. How and why to use Second Life for education? ScienceRoll. 2007. URL: http://scienceroll.com/2007/09/19/ how-and-why-to-use-second-life-for-education/ [accessed 2013-09-14] [WebCite Cache ID 6JcL9ZUxj] 14. Dev P, Heinrichs WL, Youngblood P. CliniSpace: a multiperson 3D online immersive training environment accessible through a browser. Stud Health Technol Inform 2011;163:173-179. [Medline: 21335784] 15. Toro-Troconis M, Kamat A, Partridge MR. Design and development of a component-based system for virtual patients in the virtual world of Second Life®. J Emerg Technol Web Intell 2011 Nov 01;3(4):308-316. [doi: 10.4304/jetwi.3.4.308-316] 16. Goodchild L. Researchers pilot virtual clinic to help train doctors. London. 2009. URL: http://www3.imperial.ac.uk/ newsandeventspggrp/imperialcollege/newssummary/news_6-3-2009-15-46-3 [accessed 2013-09-14] [WebCite Cache ID 6JcLRyszb] 17. Oishi L. Surfing Second Life: what does Second Life have to do with real world learning? (virtual world). Tech Learn 2007;27(11):54 [FREE Full text] 18. Tan SS, Sarker SK. Simulation in surgery: a review. Scott Med J 2011 May;56(2):104-109. [doi: 10.1258/smj.2011.011098] [Medline: 21670138] 19. Crochet P, Aggarwal R, Dubb SS, Ziprin P, Rajaretnam N, Grantcharov T, et al. Deliberate practice on a virtual reality laparoscopic simulator enhances the quality of surgical technical skills. Ann Surg 2011 Jun;253(6):1216-1222. [doi: 10.1097/SLA.0b013e3182197016] [Medline: 21516035] 20. Mohtashami F, von Dadelszen P, Allaire C. A surgical virtual reality simulator distinguishes between expert gynecologic laparoscopic surgeons and perinatologists. JSLS 2011;15(3):365-372 [FREE Full text] [doi: 10.4293/108680811X13125733356477] [Medline: 21985726] 21. Voelker W, Maier S, Lengenfelder B, Schöbel W, Petersen J, Bonz A, et al. Improved quality of coronary diagnostics and interventions by virtual reality simulation. Herz 2011 Aug;36(5):430-435. [doi: 10.1007/s00059-011-3488-6] [Medline: 21748387] 22. Boyle E, O'Keeffe DA, Naughton PA, Hill AD, McDonnell CO, Moneley D. The importance of expert feedback during endovascular simulator training. J Vasc Surg 2011 Jul;54(1):240-248.e1. [doi: 10.1016/j.jvs.2011.01.058] [Medline: 21636241] 23. Patel V, Aggarwal R, Osinibi E, Taylor D, Arora S, Darzi A. Operating room introduction for the novice. Am J Surg 2012 Feb;203(2):266-275. [doi: 10.1016/j.amjsurg.2011.03.003] [Medline: 21703594] 24. Schmidt B, Stewart S. Implementing the virtual reality learning environment: Second Life. Nurse Educ 2009;34(4):152-155. [doi: 10.1097/NNE.0b013e3181aabbe8] [Medline: 19574850] 25. Weiner E, McNew R, Trangenstein P, Gordon J. Using the virtual reality world of Second Life to teach nursing faculty simulation management. Stud Health Technol Inform 2010;160(Pt 1):615-619. [Medline: 20841760] 26. Mitchell S, Heyden R, Heyden N, Schroy P, Andrew S, Sadikova E, et al. A pilot study of motivational interviewing training in a virtual world. J Med Internet Res 2011;13(3):e77 [FREE Full text] [doi: 10.2196/jmir.1825] [Medline: 21946183] 27. Hall V, Conboy-Hill S, Taylor D. Using virtual reality to provide health care information to people with intellectual disabilities: acceptability, usability, and potential utility. J Med Internet Res 2011;13(4):e91 [FREE Full text] [doi: 10.2196/jmir.1917] [Medline: 22082765] 28. Jaffer U, Standfield NJ. Mentor [Second Life]. 2011. URL: http://slurl.com/secondlife/Bangor%20University/172/40/27 [accessed 2013-09-14] [WebCite Cache ID 6JcMObgzS] 29. Hill J, Rolfe IE, Pearson SA, Heathcote A. Do junior doctors feel they are prepared for hospital practice? A study of graduates from traditional and non-traditional medical schools. Med Educ 1998 Jan;32(1):19-24. [Medline: 9624395] 30. LeRoy Heinrichs W, Youngblood P, Harter PM, Dev P. Simulation for team training and assessment: case studies of online training with virtual worlds. World J Surg 2008 Feb;32(2):161-170. [doi: 10.1007/s00268-007-9354-2] [Medline: 18188640] 31. Hansen MM, Murray PJ, Erdley WS. The potential of 3-D virtual worlds in professional nursing education. Stud Health Technol Inform 2009;146:582-586. [Medline: 19592909] 32. Panopoulos AP, Sarri K. E-mentoring: the adoption process and innovation challenge. Intl J Inform Manage 2013 Feb;33(1):217-226. [doi: 10.1016/j.ijinfomgt.2012.10.003] 33. Blumler JG. The role of theory in uses and gratifications studies. Commun Res 1979 Jan 01;6(1):9-36. [doi: 10.1177/009365027900600102] 34. Davis FD. Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Quart 1989 Sep;13(3):319-340. [doi: 10.2307/249008] http://games.jmir.org/2013/1/e2/ JMIR Serious Games 2013 | vol. 1 | iss. 1 | e2 | p. 7 (page number not for citation purposes) XSL FO RenderX JMIR SERIOUS GAMES Jaffer et al Abbreviations CT1: core surgical training 1 CT2: core surgical training 2 FY1: foundation year 1 FY2: foundation year 2 SL: Second Life 3D: three-dimensional Edited by G Eysenbach; submitted 10.07.13; peer-reviewed by T Gourlay, M McLaughlin, Y Jayaratne; comments to author 20.08.13; revised version received 21.08.13; accepted 29.08.13; published 20.09.13 Please cite as: Jaffer U, John NW, Standfield N Surgical Trainee Opinions in the United Kingdom Regarding a Three-Dimensional Virtual Mentoring Environment (MentorSL) in Second Life: Pilot Study JMIR Serious Games 2013;1(1):e2 URL: http://games.jmir.org/2013/1/e2/ doi: 10.2196/games.2822 PMID: 25658652 ©Usman Jaffer, Nigel W John, Nigel Standfield. Originally published in JMIR Serious Games (http://games.jmir.org), 20.09.2013. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Serious Games, is properly cited. The complete bibliographic information, a link to the original publication on http://games.jmir.org/, as well as this copyright and license information must be included. http://games.jmir.org/2013/1/e2/ JMIR Serious Games 2013 | vol. 1 | iss. 1 | e2 | p. 8 (page number not for citation purposes) XSL FO RenderX http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JMIR Serious Games JMIR Publications

Surgical Trainee Opinions in the United Kingdom Regarding a Three-Dimensional Virtual Mentoring Environment (MentorSL) in Second Life: Pilot Study

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Abstract

Background: Medical mentoring is becoming increasingly complex with the evolving needs of trainees and the complexities of their personal and social lives. The Internet is an enabling technology, which increasingly facilitates interaction with multiple people at a distance. Web 2.0 and 3.0 technology shows promise in furthering this facilitation. Objective: The objective of our study was to establish opinions among doctors in postgraduate surgical training regarding mentoring and whether these doctors would readily accept virtual mentoring following a brief experience. Methods: On the 12th of February 2012, an introductory teaching class was arranged by The London Postgraduate School of Surgery for doctors in training. Participants were introduced to a novel virtual mentoring system and asked to complete a questionnaire regarding their opinions before and after the demonstration. Results: A total of 57 junior doctors attended. Among them, 35 completed questionnaires pre- and postdemonstration. Regarding usefulness of a 3D virtual environment for mentoring, 6/35 (17%) agreed or strongly agreed and 20/35 (57%) were unsure prior to the session. Following 20 minutes using MentorSL, this significantly increased to 14/35 (40%) agreeing or strongly agreeing with 11/35 (31%) unsure (P<.001). Prior to using MentorSL, regarding usefulness of voice communication for virtual mentoring, 11/35 (31%) agreed or strongly agreed and 18/35 (51%) were unsure. Following 20 minutes using MentorSL, 19/35 (54%) agreed or strongly agreed and 10/35 (29%) were unsure of usefulness. Regarding ease of use of navigation, search mentor, meeting scheduling, and voice communication features, 17/35 (49%), 13/35 (37%), 15/35 (43%), and 16/35 (46%) participants agreed or strongly agreed, respectively. Regarding usefulness of telementoring, 24/35 (69%) agreed or strongly agreed, increasing to 28/35 (80%) following the introduction. For usefulness of multiple mentors, initially 24/35 (69%) agreed or strongly agreed increasing to 29/35 (83%). For overall satisfaction, 30/35 (86%) reported good or adequate and 19/35 (54%) agreed or strongly agreed with using the system again. Conclusions: These data suggest that a short introduction on how to use virtual systems may result in significant participation and use of virtual mentoring systems. (JMIR Serious Games 2013;1(1):e2) doi: 10.2196/games.2822 KEYWORDS education; Internet; training http://games.jmir.org/2013/1/e2/ JMIR Serious Games 2013 | vol. 1 | iss. 1 | e2 | p. 1 (page number not for citation purposes) XSL FO RenderX JMIR SERIOUS GAMES Jaffer et al in the WWW [6]. Today’s WWW provides for an immersive, Introduction interactive, and information-rich potential resource. e-mentoring has been shown to be efficacious in the context of North Background American school children, interestingly reporting that the Doctors in postgraduate surgical training often require guidance frequency of mentor-mentee interaction moderates the to overcome hurdles associated with modern-day surgical relationship between mentee “self-efficacy” and previous training. Good mentoring delivered in a timely fashion is a way Internet experience with positive outcome [7]. The Web 3.0 in which surgical trainees may be helped through these format encompasses virtual worlds, the semantic Web, difficulties in a manner compatible with the principles of adult microformats, natural language search, data mining, machine learning. learning, recommendation agents, artificial intelligence, and augmented reality technologies. Augmented reality involves a The Standing Conference on Postgraduate Medical and Dental fusion of the physical world and computer-generated content, Education (SCOPME) in the United Kingdom, describes potentially delivered through the Internet. The use of augmented mentoring as: reality for anatomy education has been demonstrated [8], and The process whereby an experienced, highly regarded, there is great potential for this technology. empathic person (the mentor) guides another MentorSL individual (the mentee) in the development and re-examination of their own ideas, learning, and Virtual worlds including Second Life (SL) by Linden personal and professional development. The mentor, Laboratories [9] and Olive by Forterra Systems [10] provide who may or may not work in the same organization content as a three-dimensional (3D) environment in which we or field as the mentee, achieves this by listening and can navigate and interact with others as virtual representations talking in confidence to the mentee [1] of ourselves, avatars. Second Life, currently the most popular virtual world, facilitates streaming audio/video/TV/YouTube The mentors have many roles that have previously been collections, 3D virtual libraries, and virtual tourist attractions reviewed [2]. Briefly, these include advisor, coach, and destinations [11]. A virtual emergency department training counselor/guide, and role model. As someone who has study has reported that ease of use and limited access to the successfully negotiated some of these difficulties, a mentor may software were identified as barriers to adoption [12]. Meskó offer motivation, hope, and advice for the mentee. As technology summarized educational applications’ uses of SL [13]. He increasingly becomes part of a managed learning process, expert discussed potential advantages as being global collaboration mentoring of trainees, facilitated by technology, may become without boundaries; interactivity in a manner better than a essential for ensuring patient safety. videoconference with use of videos, presentations, images, and It has been previously reported that trainees often do not have Web links at the same time in one place. Being able to draw mentors or are unaware of the role of the mentor and therefore from a worldwide pool of experts and having the ability to do not have beneficial meetings with them [2,3]. The establish exhibits which are not possible via a videoconference management concept “Just-in-time” was popularized by the [14] or a website are also cited as advantages [15,16]. Toyota Motor Company and resulted in huge increases in Interactions between SL residents may benefit each others’ efficiency and productivity. The essence of the system is to participation via networks that allow for dynamic, evolving respond to needs and only call upon resources when they are systems all made possible by “semantic” Web technology [17]. required [4]. A parallel may be drawn with mentoring in that it Virtual reality resources have been successfully used as is potentially a labor-intensive and costly resource, which is not educational resources [18-27]. necessarily required at all times. Mentoring may be best For the purposes of exploring new methods to support achieved in a “just-in-time” fashion where an appropriate mentor mentoring, a 3D virtual system, MentorSL, was developed [28]. is available to facilitate problem solving in response to a Avatars assemble in a registration area, where they have a range real-world need. In order for this mentoring to be achieved in of mentoring databases available to them (Figure 1). Mentors a comfortable learning environment, a knowledgeable, yet not are able to log on to SL as avatars and provide mentoring, necessarily proximate mentor may be most suitable. through virtual world communication, to their mentees. A range World Wide Web of online mentoring resources is available to both mentors and The latest digital technologies may be a key enabler to support mentees and there are links to other mentoring resources. these requirements. The Department of Health in the United Doctors in postgraduate surgical training in the London Kingdom has recently published a “Framework for Technology Postgraduate School of Surgery (see Textbox 1) were invited Enhanced Learning” that advocates the use of e-learning and to experience the system and submit their views. The primary simulation to enhance learning where there is a clear benefit to aims of our study were to establish whether barriers existed to patient care [5]. Internet-based technology developments, the adoption of the 3D virtual mentoring environment and to including the World Wide Web (WWW), allow for increasing establish whether a short introduction would be sufficient to interactivity and may be of use in fulfilling tele- and achieve participant “buy-in”. The secondary aims were to multiple-mentoring needs. Improved mentoring may lead to establish which aspects of the system were deemed most useful improved trainee development, which may lead to improved and which further aspects should be developed further. patient care. There has been an evolution of the ways that interaction is facilitated and information processed and retrieved http://games.jmir.org/2013/1/e2/ JMIR Serious Games 2013 | vol. 1 | iss. 1 | e2 | p. 2 (page number not for citation purposes) XSL FO RenderX JMIR SERIOUS GAMES Jaffer et al Textbox 1. Doctors in postgraduate surgical training. The London Postgraduate School of Surgery is the largest surgical training organization in the world. It is responsible for managing more than 900 trainees. The school offers programs at prestigious teaching centers across the capital city. Doctors in postgraduate training spend an initial 2 years (FY1, FY2) in generic foundation training; this is followed by a further 2 years (CT1, CT2) in core surgical training. Successful competitive progression results in spending an additional 6 years in specialty surgical training (ST3 to ST8) toward award of completion of training. Figure 1. Photograph from Second Life showing the MentorSL meeting complex. Licensed under Creative Commons Attribution 2.0. Data Collection Methods Participants were invited to fill in an anonymous questionnaire regarding their perceptions both prior to and after the session. Study Participants The questionnaire consisted of 7 domains: (A) demographic Doctors in postgraduate surgical training were invited to attend data, (B) perceptions regarding mentoring, (C) perceptions a “taster” session introducing virtual mentoring via the online regarding the 3D Web, (D) perceptions regarding the virtual world SL at the London Postgraduate School of Surgery, practicalities of MentorSL, (E) perceptions regarding tele- and UK. This session was a subsection of a wider training meeting multiple mentoring, (F) perceptions regarding further being held. The trainees were within the first four years of enhancements in virtual mentoring, and (G) perceptions postgraduate training. All participants had previously experience regarding future use of MentorSL (see Multimedia Appendix of mentoring as a component of “Foundation Training” which 1 for the questionnaire). These questions were determined with includes appointing of an “Assigned Educational Supervisor” a view to establishing whether doctors in postgraduate surgical by the training program. A 10-minute presentation on SL and training would readily accept use of a virtual mentoring facility specifically on MentorSL including an “in-world” walk through and whether any particular aspect of the facility was related to was given via a large screen projector. SL as a virtual world future use of the system. Demographic data were only collected facilitating interaction of virtual people or avatars was explained. once, questions in domains (B), (C), and (E) were posed both Methods used to navigating and communicate in SL were before and after participants spent 20 minutes using MentorSL. explained to participants. MentorSL was introduced as a tool Questions in domains (D), (F), and (G) were only asked after to facilitate mentoring in the virtual world of SL. The search participants spent 20 minutes using MentorSL. mentor facilities in MentorSL and the facilities to arrange and hold meeting within the MentorSL framework were explained Statistical Analysis and demonstrated. Following a short questions and answers Statistical analysis was performed using SAS (Cary, USA). session, participants were able to sit in groups at computer Data were presented as ratios and percentages. The chi-square stations running Second Life fitted with multiple headsets. test was used for significance testing. Facilitators in the real world as well as SL were available to help and guide participants. http://games.jmir.org/2013/1/e2/ JMIR Serious Games 2013 | vol. 1 | iss. 1 | e2 | p. 3 (page number not for citation purposes) XSL FO RenderX JMIR SERIOUS GAMES Jaffer et al 22/57 (39%) were in core surgical training 1 (CT1), and 15/57 Results (26%) were in core training 2 (CT2). Demographic Data Of the 57 participants, 40/57 (70%) participants reported that they had firm plans for which specialty they would like to enter, There were 57 participants in total, median age was 28.1 years 3/57 (5%) had no plans as yet, and 14/57 (25%) were unsure of (range 24-43). There were 32 females (32/57, 56%) and 25 their choice. The response rate for the questionnaire was 35/57 males (25/57, 44%). (61%). Of the total participants, 1/57 (2%) qualified in 2004, 3/57 (5%) In terms of previous experience with the 3D virtual qualified in 2007, 23/57 (40%) qualified in 2008, 13/57 (23%) environments, 6/57 (11%) had had previous experience and qualified in 2009, and 17/57 (30%) qualified in 2011. Of the 51/57 (89%) had no experience or were unsure. Mentee total participants, 20/57 (35%) were in foundation year 1 (FY1), perceptions are described below and summarized in Figure 2. Figure 2. Stacked bar chart of response to questions pre- (above) and post-experience (below) of the MentorSL system. *Improvement in response; P<.05, **improvement of response; P<.001 (one-way chi-square test). chi-square test). Of 35 participants, 14/35 (40%) strongly agreed, Perceptions Regarding Concepts of Mentoring 17/35 (49%) agreed, and 4/35 (11%) were unsure. With regards to having understood of the roles of a mentor, Perceptions Regarding Mentoring via the 3D Web prior to the experience, 3/35 (9%) said they strongly agreed, 19/35 (54%) said they agreed, 12/35 (34%) were unsure, and When asked whether they thought whether a 3D virtual 1/35 (3%) strongly disagreed. Following the experience, there environment would be useful in mentoring prior to experiencing was a statistically significant improvement toward agreement it, 2/35 (6%) strongly agreed, 4/35 (11%) agreed, 20/35 (57%) (P<.001; chi-square test). Of 35 participants, 11/35 (31%) were unsure, and 9/35 (26%) disagreed. Following the strongly agreed, 20/35 (57%) agreed, 3/35 (9%) were unsure, experience, there was a statistically significant improvement and 1/35 (3%) disagreed. toward agreement (P<.001; chi-square test). Of 35 participants, 3/35 (9%) strongly agreed, 11/35 (31%) agreed, 11/35 (31%) With regards to whether mentoring was thought to be useful, were unsure, 8/35 (23%) disagreed, and 2/35 (6%) strongly 10/35 (29%) strongly agreed, 21/35 (60%) agreed, and 4/35 disagreed. (11%) were unsure. Following the experience, there was a statistically significant improvement toward agreement (P=.04; http://games.jmir.org/2013/1/e2/ JMIR Serious Games 2013 | vol. 1 | iss. 1 | e2 | p. 4 (page number not for citation purposes) XSL FO RenderX JMIR SERIOUS GAMES Jaffer et al (34%) agreed, 14/35 (40%) were undecided, and 7/35 (20%) Perceptions Regarding the Practicalities of MentorSL disagreed. Prior to experiencing MentorSL, when asked whether voice communication would be useful in the mentoring relationship, Perceptions Regarding Future Use of MentorSL 3/35 (9%) strongly agreed, 9/35 (26%) agreed, 18/35 (51%) When asked whether participants would use MentorSL in the were unsure, and 5/35 (14%) disagreed. Following experiencing future, 4/35 (11%) strongly agreed, 15/35 (43%) agreed, 10/35 MentorSL, there was a statistically significant improvement (29%) were undecided, 4/35 (11%) disagreed, and 2/35 (6%) toward agreement (P<.001; chi-square test). Of 35 participants, strongly disagreed. 6/35 (17%) strongly agreed, 13/35 (37%) agreed, 10/35 (29%) were unsure, 5/35 (14%) disagreed, and 1/35 (3%) strongly Discussion disagreed. Principal Findings When asked regarding navigation in SL was sufficiently simple to use, 6/35 (17%) strongly agreed, 11/35 (31%) agreed, 14/35 This study demonstrates that doctors in postgraduate surgical (40%) were undecided, 2/35 (6%) disagreed, and 2/35 (6%) training are willing to “buy-in” to a virtual mentoring system strongly disagreed. in SL. The most well-received facilities were those of tele- and multiple mentoring and that of voice communication. The When asked whether the search for mentor facility in MentorSL implication of these findings is that this mentoring system may was sufficiently simple to use, 7/35 (20%) strongly agreed, 6/35 be able to deliver mentoring to this group of doctors in a manner (17%) agreed, 19/35 (54%) were undecided, 2/35 (6%) commensurate with their needs. disagreed, and 1/35(3%) strongly disagreed. The response rate of 61% (35/57) in this study, seemingly low When asked whether the meeting scheduling facility in and a limitation of the study, is commensurate with other studies MentorSL was sufficiently simple to use, 4/35 (11%) strongly in this population [29]. We would suggest that a subsequent agreed, 11/35 (31%) agreed, 18/35(51%) were undecided, and usability study would result in increased participant involvement 2/35 (6%) disagreed. and perceived benefit. Thus, we would suggest that this would When asked regarding ease of using voice communication in be the lower limit of what a future usability study would SL, 6/35 (17%) strongly agreed, 10/35 (29%) agreed, and 19/35 engender. This study is not able to inform on the potential (54%) were undecided. benefit of virtual mentoring using this system, and further work will be needed to establish this. Regarding overall satisfaction with MentorSL, 6/35 (17%) reported very good, 24/35 (69%) reported adequate, 4/35 (11%) Perceptions reported slightly disappointing, and 1/35 (3%) reported very It the context of team training for triage of mass casualties, it poor. has been demonstrated that trainees quickly adapt to a virtual environment and find it an experience that is beneficial to their Perceptions Regarding Tele- and Multiple Mentoring professional development [30]. Regarding the usefulness of a specialist mentor who may be geographically remote, prior to the experience, 6/35 (19%) Despite the all-pervasive nature of the Internet in today’s strongly agreed, 18/35 (51%) agreed, and 11/35 (31%) were society, 89% (51/57) of participants had no significant previous unsure. Following the experience, there was a statistically experience of 3D Web 3.0 technology. Despite this, we found significant improvement toward agreement (P<.001; chi-square that only 17% (6/35) of participants disagreed or strongly test). Of 35 participants, 13/35 (37%) strongly agreed, 15/35 disagreed, following a short introduction, with using the system (43%) agreed, 6/35 (17%) were unsure, and 1/35 (3%) disagreed. in the future. When asked regarding the perceived benefits of having multiple Central to the provision of a virtual “just-in-time” mentoring mentors available for specific mentoring needs, prior to the system is the mentee perceiving the need for being mentored. experience, 8/35 (23%) strongly agreed, 16/35 (46%) agreed, At outset, only 21/35 (60%) participants agreed or strongly 10/35 (29%) were unsure, and 1/35 (3%) disagreed. Following agreed that they understood the concept of mentoring; this the experience, there was a statistically significant improvement improved to 31/35 (89%). In addition, the initial high agreement toward agreement (P=.002; chi-square test). Of the participants, with the usefulness of mentoring was maintained following the 12/35 (34%) strongly agreed, 17/35 (49%) agreed, and 6/35 introduction (31 predemonstration vs 32 postdemonstration). (19%) were unsure. The specific use of the 3D virtual world for mentoring is perhaps Perceptions Regarding Further Enhancement of the most contentious issue to be assessed in the confines of a Virtual Mentoring short introduction. More formed decisions will most likely require the on-going usage of the system by mentees. This seems When asked whether participants thought that real life facial to be reflected in that 14/35 (40%) were positive regarding the recognition and animation of avatar facial features would be system, and 11/35 (31%) were unsure. useful, 2/35 (6%) strongly agreed, 13/35 (37%) agreed, 13/35 (37%) were undecided, and 7/35 (20%) disagreed. Importantly, the more immediate and apparent facilitatory benefits of the system seemed to be well received by the When asked whether hand gesture recognition and animation participants. This was reflected by the strong performance in of avatar would be useful, 2/35 (6%) strongly agreed, 12/35 the voice communication, tele-, and multiple-mentoring http://games.jmir.org/2013/1/e2/ JMIR Serious Games 2013 | vol. 1 | iss. 1 | e2 | p. 5 (page number not for citation purposes) XSL FO RenderX JMIR SERIOUS GAMES Jaffer et al domains. Indeed, the voice communication domain showed a factors in new technology adoption [34], and these also may be large increase in agreement from 4/35 (11%) to 16/35 (46%). important domains to investigate in future work. The user-friendliness of the voice communication was found With regards to future developments in the MentorSL, to have a major impact in acceptance of a SL training program equivalent numbers were positive regarding animation of the for nurses [24]. avatars facial features and hand gestures to improve the There may be barriers to the adoption of these new technologies experience. for medical mentoring. Hansen et al recalled Roger’s diffusion Conclusions of innovation theory in explaining attributes of a new technology We have demonstrated that the MentorSL system has the affecting an individual’s decision to adopt [31]. These attributes potential to be well accepted by mentees. This may be a include the relative advantage of the innovation over the idea reflection of the rapidly acquired understanding of the role of it supersedes, how the innovation meets the needs of potential a mentor and the feeling of need for mentoring. Junior surgical adopters, how difficult the innovation is to understand and use, trainees are able to rapidly familiarize with this novel how the innovation may be tested in a timely fashion, and how communication modality and seem interested in further outcomes associated with the innovation are visible to others. expansion of the virtual mentoring experience using facial and Interestingly, a study investigating these factors in adoption of gesture recognition and avatar animation technology. Further e-mentoring by Greek mentors reported that only relative work is required to evaluate utilization of this virtual mentoring advantage was a significant factor in adoption [32]. Other facility when made available to doctors in postgraduate surgical potential drivers for adoption that may be important to further training and to establish benefit. We are currently establishing work are alluded to by the “Uses and Gratification” theory [33], a pilot study to trial medical mentoring using MentorSL in a suggesting that various forms of gratification affect utility. The cohort of surgical trainees in the London Postgraduate School well-established “Technology Acceptance Model” emphasizes of Surgery. “perceived usefulness” and “perceived ease-of-use” as important Acknowledgments We would like to acknowledge statistical support from Jonathan Alsop, statistician at Numerus, UK. The development of the mentoring environment was supported by small grants from the NANIME charitable trust and the London Postgraduate School of Surgery. Authors' Contributions UJ conceived the idea, helped develop the software, and wrote the manuscript. NS is guarantor, and critically appraised the design and manuscript. NWJ critically appraised the manuscript and was involved with design. Conflicts of Interest None declared. Multimedia Appendix 1 Questionnaire. [PDF File (Adobe PDF File), 54KB-Multimedia Appendix 1] References 1. SCOPME. Supporting Doctors and Dentists at Work: An Inquiry into Mentoring. London: Standing Committee on Postgraduate Medical and Dental Education; 1998. 2. Jaffer U, Pennell A, Musonda P. General surgical trainee experiences of mentoring: a UK regional audit. J Surg Educ 2010;67(1):19-24. [doi: 10.1016/j.jsurg.2009.10.004] [Medline: 20421085] 3. Kaderli R, Muff B, Stefenelli U, Businger A. Female surgeons' mentoring experiences and success in an academic career in Switzerland. Swiss Med Wkly 2011;141:w13233 [FREE Full text] [doi: 10.4414/smw.2011.13233] [Medline: 21769754] 4. Sugimori Y, Kusunoki K, Cho F, Uchikawa S. Toyota production system and Kanban system materialization of just-in-time and respect-for-human system. Intl J Production Res 1977 Jan;15(6):553-564. [doi: 10.1080/00207547708943149] 5. DOH. Framework for technology enhanced learning. 2012. URL: https://www.gov.uk/government/publications/ a-framework-for-technology-enhanced-learning [accessed 2013-09-14] [WebCite Cache ID 6JcKTfn6D] 6. Markoff J. Entrepreneurs see a Web guided by common sense. New York Times. 2006. URL: http://www.nytimes.com/ 2006/11/12/business/12web.html?ex=1320987600&en=254d697964cedc62&ei=5088 [accessed 2013-09-04] [WebCite Cache ID 6JcKc2LOk] 7. DiRenzo MS, Linnehan F, Shao P, Rosenberg WL. A moderated mediation model of e-mentoring. J Vocat Behav 2010 Apr;76(2):292-305. [doi: 10.1016/j.jvb.2009.10.003] http://games.jmir.org/2013/1/e2/ JMIR Serious Games 2013 | vol. 1 | iss. 1 | e2 | p. 6 (page number not for citation purposes) XSL FO RenderX JMIR SERIOUS GAMES Jaffer et al 8. Thomas RG, John NW, Delieu JM. Augmented reality for anatomical education. J Vis Commun Med 2010 Mar;33(1):6-15. [doi: 10.3109/17453050903557359] [Medline: 20297908] 9. Linden. Second Life. 2011. URL: http://secondlife.com/ [accessed 2013-09-14] [WebCite Cache ID 6JcKlZSEi] 10. Forterra. Olive. 2011. URL: http://www.saic.com/products/simulation/olive/ [accessed 2013-09-14] [WebCite Cache ID 6JcKtIl55] 11. Boulos MN, Hetherington L, Wheeler S. Second Life: an overview of the potential of 3-D virtual worlds in medical and health education. Health Info Libr J 2007 Dec;24(4):233-245. [doi: 10.1111/j.1471-1842.2007.00733.x] [Medline: 18005298] 12. Heinrichs WL, Youngblood P, Harter P, Kusumoto L, Dev P. Training healthcare personnel for mass-casualty incidents in a virtual emergency department: VED II. Prehosp Disaster Med 2010;25(5):424-432. [Medline: 21053190] 13. Meskó B. How and why to use Second Life for education? ScienceRoll. 2007. URL: http://scienceroll.com/2007/09/19/ how-and-why-to-use-second-life-for-education/ [accessed 2013-09-14] [WebCite Cache ID 6JcL9ZUxj] 14. Dev P, Heinrichs WL, Youngblood P. CliniSpace: a multiperson 3D online immersive training environment accessible through a browser. Stud Health Technol Inform 2011;163:173-179. [Medline: 21335784] 15. Toro-Troconis M, Kamat A, Partridge MR. Design and development of a component-based system for virtual patients in the virtual world of Second Life®. J Emerg Technol Web Intell 2011 Nov 01;3(4):308-316. [doi: 10.4304/jetwi.3.4.308-316] 16. Goodchild L. Researchers pilot virtual clinic to help train doctors. London. 2009. URL: http://www3.imperial.ac.uk/ newsandeventspggrp/imperialcollege/newssummary/news_6-3-2009-15-46-3 [accessed 2013-09-14] [WebCite Cache ID 6JcLRyszb] 17. Oishi L. Surfing Second Life: what does Second Life have to do with real world learning? (virtual world). Tech Learn 2007;27(11):54 [FREE Full text] 18. Tan SS, Sarker SK. Simulation in surgery: a review. Scott Med J 2011 May;56(2):104-109. [doi: 10.1258/smj.2011.011098] [Medline: 21670138] 19. Crochet P, Aggarwal R, Dubb SS, Ziprin P, Rajaretnam N, Grantcharov T, et al. Deliberate practice on a virtual reality laparoscopic simulator enhances the quality of surgical technical skills. Ann Surg 2011 Jun;253(6):1216-1222. [doi: 10.1097/SLA.0b013e3182197016] [Medline: 21516035] 20. Mohtashami F, von Dadelszen P, Allaire C. A surgical virtual reality simulator distinguishes between expert gynecologic laparoscopic surgeons and perinatologists. JSLS 2011;15(3):365-372 [FREE Full text] [doi: 10.4293/108680811X13125733356477] [Medline: 21985726] 21. Voelker W, Maier S, Lengenfelder B, Schöbel W, Petersen J, Bonz A, et al. Improved quality of coronary diagnostics and interventions by virtual reality simulation. Herz 2011 Aug;36(5):430-435. [doi: 10.1007/s00059-011-3488-6] [Medline: 21748387] 22. Boyle E, O'Keeffe DA, Naughton PA, Hill AD, McDonnell CO, Moneley D. The importance of expert feedback during endovascular simulator training. J Vasc Surg 2011 Jul;54(1):240-248.e1. [doi: 10.1016/j.jvs.2011.01.058] [Medline: 21636241] 23. Patel V, Aggarwal R, Osinibi E, Taylor D, Arora S, Darzi A. Operating room introduction for the novice. Am J Surg 2012 Feb;203(2):266-275. [doi: 10.1016/j.amjsurg.2011.03.003] [Medline: 21703594] 24. Schmidt B, Stewart S. Implementing the virtual reality learning environment: Second Life. Nurse Educ 2009;34(4):152-155. [doi: 10.1097/NNE.0b013e3181aabbe8] [Medline: 19574850] 25. Weiner E, McNew R, Trangenstein P, Gordon J. Using the virtual reality world of Second Life to teach nursing faculty simulation management. Stud Health Technol Inform 2010;160(Pt 1):615-619. [Medline: 20841760] 26. Mitchell S, Heyden R, Heyden N, Schroy P, Andrew S, Sadikova E, et al. A pilot study of motivational interviewing training in a virtual world. J Med Internet Res 2011;13(3):e77 [FREE Full text] [doi: 10.2196/jmir.1825] [Medline: 21946183] 27. Hall V, Conboy-Hill S, Taylor D. Using virtual reality to provide health care information to people with intellectual disabilities: acceptability, usability, and potential utility. J Med Internet Res 2011;13(4):e91 [FREE Full text] [doi: 10.2196/jmir.1917] [Medline: 22082765] 28. Jaffer U, Standfield NJ. Mentor [Second Life]. 2011. URL: http://slurl.com/secondlife/Bangor%20University/172/40/27 [accessed 2013-09-14] [WebCite Cache ID 6JcMObgzS] 29. Hill J, Rolfe IE, Pearson SA, Heathcote A. Do junior doctors feel they are prepared for hospital practice? A study of graduates from traditional and non-traditional medical schools. Med Educ 1998 Jan;32(1):19-24. [Medline: 9624395] 30. LeRoy Heinrichs W, Youngblood P, Harter PM, Dev P. Simulation for team training and assessment: case studies of online training with virtual worlds. World J Surg 2008 Feb;32(2):161-170. [doi: 10.1007/s00268-007-9354-2] [Medline: 18188640] 31. Hansen MM, Murray PJ, Erdley WS. The potential of 3-D virtual worlds in professional nursing education. Stud Health Technol Inform 2009;146:582-586. [Medline: 19592909] 32. Panopoulos AP, Sarri K. E-mentoring: the adoption process and innovation challenge. Intl J Inform Manage 2013 Feb;33(1):217-226. [doi: 10.1016/j.ijinfomgt.2012.10.003] 33. Blumler JG. The role of theory in uses and gratifications studies. Commun Res 1979 Jan 01;6(1):9-36. [doi: 10.1177/009365027900600102] 34. Davis FD. Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Quart 1989 Sep;13(3):319-340. [doi: 10.2307/249008] http://games.jmir.org/2013/1/e2/ JMIR Serious Games 2013 | vol. 1 | iss. 1 | e2 | p. 7 (page number not for citation purposes) XSL FO RenderX JMIR SERIOUS GAMES Jaffer et al Abbreviations CT1: core surgical training 1 CT2: core surgical training 2 FY1: foundation year 1 FY2: foundation year 2 SL: Second Life 3D: three-dimensional Edited by G Eysenbach; submitted 10.07.13; peer-reviewed by T Gourlay, M McLaughlin, Y Jayaratne; comments to author 20.08.13; revised version received 21.08.13; accepted 29.08.13; published 20.09.13 Please cite as: Jaffer U, John NW, Standfield N Surgical Trainee Opinions in the United Kingdom Regarding a Three-Dimensional Virtual Mentoring Environment (MentorSL) in Second Life: Pilot Study JMIR Serious Games 2013;1(1):e2 URL: http://games.jmir.org/2013/1/e2/ doi: 10.2196/games.2822 PMID: 25658652 ©Usman Jaffer, Nigel W John, Nigel Standfield. Originally published in JMIR Serious Games (http://games.jmir.org), 20.09.2013. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Serious Games, is properly cited. The complete bibliographic information, a link to the original publication on http://games.jmir.org/, as well as this copyright and license information must be included. http://games.jmir.org/2013/1/e2/ JMIR Serious Games 2013 | vol. 1 | iss. 1 | e2 | p. 8 (page number not for citation purposes) XSL FO RenderX

Journal

JMIR Serious GamesJMIR Publications

Published: Sep 18, 2013

Keywords: education; Internet; training

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