In light of the evidence that pharmacists can improve health outcomes for individuals and populations, schools of pharmacy are currently reviewing and revising their curricula to ensure that they include the most progressive systems for training future pharmacists.
To this end, pharmacy educators worldwide are exploring how to use technology to deliver pharmacy instruction more efficiently, effectively and powerfully. Indeed, pharmacy’s investment in technology to support learning mirrors what is happening in other health professional fields.
According to a recent article in the BMJ, universities that have been developing online learning facilities for doctors and medical students for many years are now turning to the virtual world of Second Life.
Second Life is an internet-based virtual world (video overview) developed by Linden Research, US, and used, via a free downloadable client, since 2003. Second Life users, called “residents”, use relatively straightforward software to design motional avatars to interact with one another in an advanced form of social networking.
Residents can communicate (via voice, chat or instant messaging), explore (by walking, flying, riding in a variety of vehicles or teleporting), participate in activities (eg, training courses, meetings, social activities) and trade virtual property and services with other avatars.
Although games can be played within the “metaverse”, Second Life itself is not a typical game — there are no points, scores, winners or losers. In April 2008, approximately 13 million accounts were registered and Linden Research estimates that about 40,000 residents are logged on at any moment, with 70 per cent of these from outside the US.
One of the distinguishing characteristics about Second Life is that residents (not the software developers) create most of the content of the world, so things only exist if there is a perceived need for them. With this in mind, there are museums, concerts and theatres that showcase residents’ talents.
It has also become an increasingly popular site for businesses, with embassies (eg, the Maldives, Sweden), virtual classrooms (eg, the University of Florida, the Open University), libraries and other forms of interaction. There is a currency called Linden Dollars in Second Life, which can be exchanged with real world currencies.
Although a recent informal survey of staff and students at The School of Pharmacy, University of London, suggests that uptake of Second Life technology has been limited, there are some pioneers who are interested in whether or not a virtual environment can emulate the engagement and interaction with tasks and activities, in the pharmacy classroom.
The Victorian College of Pharmacy at Monash University, Australia, has embarked on a pilot project to determine how students and teachers engage in immersive environments like Second Life.
They have leased a virtual island called Pharmatopia and have opened the space to pharmacy collaborators at The School of Pharmacy, Nottingham University, Keele University, Uppsala University, the University of Copenhagen, the University of North Carolina at Chapel Hill, the University of Kansas, the University of Sydney and the University of Queensland.
In phase one of this project, the project team has developed a virtual pharmaceutical manufacturing plant to, among other things, help them address the challenges (eg, expense, safety) of teaching pharmaceutical manufacturing in real-life laboratory space. The Pharmatopia group recently held a live meeting in London, but plans for the next to occur virtually, within Second Life itself.
One of the areas of greatest growth in the Second Life environment is that of health information. Virtual medical sites such as the “hospital of the future” (a collaboration between Imperial College London and the National Physical Laboratory) have been built in Second Life, with sites such as the Ann Myers Medical Centre and the American Cancer Society becoming more popular.
There are a variety of medical information sites (often staffed by avatars of real-life medical librarians), including the Healthinfo Island which is funded by the US National Library of Medicine, to see how people with real-life health information concerns can be helped in a virtual environment. There are numerous support groups within Second Life, such as Alcoholics Anonymous and groups dedicated to depression, bipolar disorder, stroke and cancer.
Considering that many schools have embraced technology as an instructional tool for their pharmacy students, should pharmacy practitioners be considering the use of these technologies as instructional tools for their patients?
How will the patient of the not-too-distant future choose to receive health information and what can we learn from the early adopters of these technologies that may help us prepare for this? Student researchers at The School of Pharmacy set out to explore these questions.
After creating avatars and learning to use the environment, they approached 50 residents at several health-related sites about what types of health information they sought in Second Life, whether this was to complement or replace information accessed in real life, and how confident they were that the information they received in Second Life was correct.
The results suggest that many users are attracted to Second Life because it allows for communication with other avatars around the globe, as a form of social contact. Most indicated that they felt comfortable discussing health information with other avatars, because their identity is protected and they can reveal as much (or as little) as they choose.
They recognised that avatars are not always who they appear to be, for example, a male resident may choose to be represented by a female avatar, and that some sources of information are more reliable than others, but they valued the ability to be able to access health resources at their convenience and to combine information received in Second Life with that received in real life.
The ability to connect with other people experiencing the same chronic illnesses and to ask questions that they may be embarrassed about in real life was important. Several respondents noted that there is a lot of information on mental disorders available in Second Life, which they believe is good for family members of mentally ill patients.
So, perhaps one way to modernise the way pharmacists convey information to patients is to embrace the use of virtual worlds to teach real-life health lessons.
People are seeking health information in Second Life, in particular about medicines and treatment modalities, because there is a perceived need for this information to be communicated in a convenient, confidential manner.
This medium will not be appropriate for all patients, but we should not resist using technologies that have been shown to be effective in the pharmacy classroom to improve access to and outcomes for the patients we treat.
For information about the Pharmatopia project, contact:
Marian.Costelloe@vcp.monash.edu.au
Tina Brock, Sarah Clifford, Faiza Khan, Hafsa Mehdi and David West are from The School of Pharmacy, University of London