1. Designing and Testing a Pedagogical Model for
Simulation-based Learning Environments:
Preliminary Findings and Perspectives
for Future Research
2008–2010
March 2, 2010
SiME Seminar Series
Heli Ruokamo
Tuulikki Keskitalo

2. MediPeda III Project`s background
ENVI – Virtual Centre of Wellness Campus
Unique environment, which utilizes 3D technology and simulations
New possibilities, but also challenges for teachers, learners, designers, and researchers
Video 1, Video 2, Video 3
We need more research that possibilities of ENVI and other similar environments could be used in a pedagogically
appropriate way
Figure 1. ENVI Virtual Centre of Wellness Campus.
Rovaniemi University of Applied Sciences©2009.

3. MediPeda III
Multidisciplinary research and development project ( )
Aims:
Research and develop pedagogical model, user-centered design methods as well as value creation model for virtual and simulation-based learning environments of healthcare
Content:
Developing a pedagogical model (Tuulikki Keskitalo & Heli Ruokamo)
Long-term research of students` learning experiences in virtual and simulation-based learning environments (Paula Yliniemi)
Developing a user-centered design methods (Pia Yliräisänen-Seppänen & Eija Timonen)
Developing a value creation model (Jussi Haukkamaa)
Comparative research in three different simulation-centers (Tuulikki Keskitalo & Heli Ruokamo)

4. MediPeda III Research Partners: University of Lapland
Faculty of Education, Centre for Media Pedagogy (Coord.)
International Research Partners:
Stanford University, School of Medicine (Palo Alto, California, USA)
Development of Education:
Rovaniemi University of Applied Sciences
Arcada University of Applied Sciences
Stanford University, California
Financiers:
Rovaniemi University of Applied Sciences
City of Rovaniemi
Hospital District of Lapland
Medieco Corp.
Nordic Simulators Corp.
Heat-IT Corp.
Tekes
European Regional Development Fund

5. Developing a Pedagogical Model
(Keskitalo, Ruokamo, & Väisänen, accepted)

6. Goal and Theoretical Background
Aim of this research was to develop a pedagogical model to support facilitating, training and learning processes in VR and simulation-based learning environments
A pedagogical model can be used to shape curriculums or long term courses of studies, to design instructional materials, and to guide instruction in the classroom and other settings (Joyce & Weil, 1980, p. 1)
Generally, this research builds on the socio-constructivist and socio-cultural perspectives on learning (Lave & Wenger, 1991; Vygotsky, 1978)
Learning is related to all actions that take into account a person as a whole (body, mind and spirit) and the role of cultural tools and artefacts (technology and language)
Learning is also seen as active, life wide, life long
collaborative knowledge co-creation process

7. Pedagogical Model Pedagogical model is built on
the facilitating-training-learning (FTL) -processes (cf. Teaching-, studying- and learning (TSL) -process, Kansanen, Tirri, Meri, Krokfors, Husu & Jyrhämä, 2000; Uljens, 1997) and
the characteristics of meaningful learning (Hakkarainen, 2007; Jonassen, 1995; Jonassen et al., 1999; Nevgi & Tirri 2003; Ruokamo & Pohjolainen 1999; Vahtivuori-Hänninen et al., 2004)
Facilitating
Training
Learning

8. Facilitating describes teacher`s activity
Facilitators promote students` meaningful learning (e.g. Jonassen, 1995):
choose the resources and scenario based on students’
characteristics, characteristics of meaningful learning and competencies
facilitate and guide students` meaningful learning process
Facilitating

9. The Characteristics of Meaningful Learning
Training
In training, students` meaningful learning should be promoted:
Experiential and experimental
Students can use their own experiences as a starting point for learning (Kolb, 1984), but they also have an opportunity to gain valuable experiences before entering real healthcare practice (Cleave-Hogg & Morgan, 2002).
Emotional
Emotions are always intertwined with learning (Engeström, 1982).
Emotions affect motivation, but they also affect how we act in the simulation setting and what we remember later on (Damasio, 2001).

10. …the Characteristics of Meaningful Learning
Socio-constructive and collaborative
Training collaboratively means that students provide support and modelling as well as construct their own knowledge while solving the healthcare cases together with other students (Jonassen, 1995; Lave & Wenger, 1991).
Learning is also seen as being tool-dependent (Vygotsky, 1978).
Active and responsible
Students should engage in finding, evaluating, and constructing knowledge (Jonassen, 1995), while also being responsible for planning, executing, and evaluating their own learning.
Consequently, instruction involves supporting these processes.

11. …the Characteristics of Meaningful Learning
Reflective and critical
Reflectivity means that learners articulate what they have learned and reflect on the processes and decisions that were entailed by the process (Jonassen, 1995).
In higher education, learners should also critically evaluate the FTL process as well as the acquired information and the learning environment.
Competence-based and contextual
Facilitators should structure the training with specific learning objectives in mind, based on the competencies students will need to handle real-life situations (Fanning & Gaba, 2007).
These competencies are usually embedded into a scenario whose aim is to transfer the learned skills into real-life settings, since learning is typically contextual (Jonassen, 1995).

12. …The Characteristics of Meaningful Learning
Goal-oriented and self-directed
Characteristics indicate that students are encouraged to set their own goals for learning, which they try to attain by planning, realizing and evaluating their own learning (Brockett & Hiemstra, 1991).
Individual
Learning is also individually different (De Corte, 1995); therefore, facilitators should provide time and effort to get to know each student and his or her level of competency properly in order to provide an individual learning experience, guidance and feedback.

13. At best, training has been meaningful for students.
Learning
The students have reached the learning goals and the new learning goals have been set.
At best, training has been meaningful for students.

14. Figure 2. The preliminary pedagogical model.

15. Research Question
From facilitators` and students` perspective, what are the most important characteristics of meaningful learning that are realized during the simulation-based learning?

16. Methods
Designing a pedagogical model is conducted using design-based research method (DBR) (Brown, 1992; Design-based Research Collective, 2003)

17. Figure 3. Arcada Patient Safety and Learning Centre
Figure 3. Arcada Patient Safety and Learning Centre. Arcada University of Applied Sciences©2009.

18. Data Collection: Data Analysis:
Altogether 14 second year paramedic students and four teachers participated in the course titled The Treatment of Critically Ill Patient
Students had 11 scenarios (7–26 min) at the Arcada Medical Simulation Centre as well as lectures and self-studying
During the training sessions students worked in teams on scenarios related to the topic areas
The structure of the course followed the Learning through Simulations model (Introduction, Simulator Briefing, Scenarios, Debriefing) (Joyce et al., 2002; cf. Dieckmann, Gaba & Rall, 2007)
Data collected using pre- and post questionnaires, interviews, learning diaries, video-recordings
Data Analysis:
Qualitative content analysis of facilitators and students` interviews, open questions of the pre- and post questionnaires, learning diaries and video recordings

19. Results
The characteristics that were strongly supported were experiential, experimental, socio-constructive, collaborative, active, responsible, reflective, competence-based, contextual and self-directed.
“…we have to be active, that we can have most of it…” (student 13.)
Emotional, Critical, goal-oriented and individual characteristics were not fully realized.
“…they do not arouse so much emotions…” (student 14.)

20. Figure 4. Redesigned pedagogical model.
1. INTRODUCTION
Presentation of a course topic as well as
other important concepts.
Explanation of how course is organised
(pedagogical models and methods).
2. SIMULATOR BRIEFING
Introduction of a scenario, case, problem etc.
Introduction of goals, roles, rules, procedures, and decisions.
Setting the individual goals.
Participants familiarise themselves with the environment, the case and their roles.
4. DEBRIEFING
Comprehensive evaluation, reflection and critical analysis of the FTL process, the knowledge and the learning environment.
Providing individual guidance and feedback.
3. SCENARIOS
Participating in simulations.
Practising of skills and knowledge.
Training
Experiential
Experimental
EMOTIONAL
Socio-constructive
Collaborative
Active
Responsible
Reflective
CRITICAL
Competence-based
Contextual
GOAL-ORIENTED
Self-directed
INDIVIDUAL
Competencies
set for the
healthcare
personnel
Facilitating
Choosing the resources and scenario based on students` characteristics, characteristics of meaning learning and competencies.
Facilitate and guide students` meaningful learning.
Learning
VR and simulation-based learning environment (context)
Figure 4. Redesigned pedagogical model.

21. Future Development of Pedagogical Model
Testing the pedagogical model is conducted applying design-based research method (DBR) (Brown, 1992; Design-based Research Collective, 2003)
2. Cycle of the pedagogical model design:
1. Designing of the pedagogical model based on theories
and results of previous researches.
2. Testing the redesigned pedagogical
model and data collection at the Stanford
University, School of Medicine 2009–2010.
3. Analysis of Data.
4. Redesigning of the pedagogical model based
on data collection and analysis.

22. Data Collection at Stanford University
Started February 18, 2010 and ends March 12, 2010
Pre- and post questionnaires for students dealing with expectations and experiences of meaningful learning
Group interviews of students
Group interviews of facilitators
Video recordings of simulation sessions
Participant observations during the session and field notes
Participants
At the moment 11 students and 4 facilitators
Courses
ACRM 2 (VA), Surg 313a (GC), IMPES (VA)
and Anes 306a

23. Data Analysis
Qualitative content analysis of facilitators and students` group interviews
Quantitative analysis of the pre- and post questionnaires
Qualitative content analysis of video recordings
Analysis is supported by field notes

24. Future research
The redesigned model is developed further on the basis of the results from Stanford University
Facilitators will be trained in Finland on the basis of the results
New project funding will be applied
The 3. cycle of DBR will be carried out at the Rovaniemi University of Applied Sciences 2011
Additional value of VR will be tested
The final model will be presented

25. Conclusion
This study provides us with a learning theoretical approach to realize VR and simulation-based learning
It develops a new pedagogical model for VR and simulation-based learning environments
It gives more information about the use of the pedagogical model and the VR and simulation-based learning environments from facilitators, students and researchers perspectives

26. Publications
Keskitalo, T. (accepted). Teachers` Conceptions and Their Approaches to Teaching in
Virtual Reality and Simulation-based Learning Environments. Teachers and Teaching: Theory and
Practise.
Keskitalo, T., Ruokamo, H., & Väisänen, O. (Accepted). How Does the Facilitating,
Training and Learning Support Characteristics of Meaningful Learning in Simulation-based
Learning Environment from Facilitators and Students Perspectives? ED-Media (World
Conference on Educational Multimedia, Hypermedia and Telecommunications) 2010.
Yliräisänen, P., & Timonen, E., (Accepted). Development of an Immersive Learning
Environment Based on User Experiences. ED-Media (World Conference on Educational
Multimedia, Hypermedia and Telecommunications) 2010.
Keskitalo, T., & Ruokamo, H. (2009). Designing a Pedagogical Model for Virtual Reality
and Simulation-based Learning Environments of Healthcare. Manuscript submitted for publication.
Yliniemi, P. (2009). Nursing and Health Care Students’ Experiences of Training in
Simulation-based Learning Environment - “ENVI”. In T. Bastiaens et al. (Eds.), Proceedings of
World Conference on E-Learning in Corporate, Government, Healthcare, and Higher Education 2009 (pp.
). Chesapeake, VA: AACE.

27. Centre for Media Pedagogy (CMP)
Thank you!
Centre for Media Pedagogy (CMP)
MediPedaIII
P.O.Box 122, FI Rovaniemi, FINLAND
Tel