Teaching Health Care in Virtual Space

Front matter

TEACHING HEALTH CARE IN VIRTUAL

SPACE

——— N Fi Y Best Practices for | | A

Part II: Types of MUVE Learning Activities

4. An Introduction to General Types of MUVE Learning Activities

5. Solo Learning Activities in Content- or Context-Rich MUVEs: The MUVE as a Learning Crucible

6. Sample Learning Activities 1-3: Solo Learning in Content- or Context-Rich MUVEs

7. Pedagogical Benefits of One-on-One MUVE Learning Activities

8. Sample Learning Activities 4-5: One-on-One MUVE Learning Activities

9. Pedagogical Benefits of MUVE Small Group Learning Activities

10. Sample Learning Activities 6-8: Ethics, Genetics, and Disability Small Group Activities ix

Sample Learning Activity 9 (Complex Small Group MUVE Learning Activity): Clinical Rounds

Sample Learning Activity 10 (Complex Small Group MUVE Learning Activity): Building Small Group Consensus Skills

Part III: Planning, Designing, and Executing a MUVE 13. 14

15. 16.

18. 19. 20.

Learning Activity

Assessment of Students and Other Factors Related to MUVE Teaching Success

Designing a MUVE Learning Activity, Part I: Readiness for MUVE Learning

Designing a MUVE Learning Activity, Part II: Implementing MUVE Learning

Special Topics Problems and Pitfalls of MUVE Learning

Design and Implementation of a MUVE Emotional Intelligence Course

Part IV: Appendixes `o oO FF Q x

. Eight Characteristics of a Third Place

. Grading Rubric Template for a Clinic Patient

Interview Assignment

. Sample Learning Activity 12: Mock Job Interview . Summative Evaluations for MUVE Learning Activities . Tracking Student Performance over Time

. Student Self-Evaluation Rubric for Ethics Small

Group Discussion

. Peer Evaluation for Ethics Small Group Discussion

. Group Evaluation for Ethics Small Group Discussion

Contents

117 124

130 141

157 165 179

189 190

192 194 195 196

198 199

26. 27. 28. 29.

. Instructor Summary for Individual Students: Ethics

Small Group Discussion

. Grading Rubric: Genetics Discussion Group . Grading Rubric: Small Group Learning Activity for Disabilities

. Sample Learning Activity 13: Clinical Rounds for Systemic

Lupus Erythematosus (SLE)

. Clinical Rounds Learning Activity Description

. Sample Dialogue from the First Third of Clinical Rounds

. Sample Dialogue from the Second Third of Clinical Rounds . Sample Dialogue from the Last Third of Clinical Rounds

. Clinical Rounds: Summative Evaluation

. Tracking Student Performance over Time

. Grading Rubric for Clinical Rounds Learning Activity 14:

Asthma

Grading Rubric for Clinical Rounds Learning Activity 15: Osteoporosis

Grading Rubric for Clinical Rounds Learning Activity 16: Hyponatremia

Grading Rubric for Clinical Rounds Learning Activity 17: Pituitary Function and Pathology

Grading Rubric for Clinical Rounds Learning Activity 18: Peripheral Vascular Disease

Grading Rubric for Clinical Rounds Learning Activity 19: Pneumonia

Clinical Rounds: Template for Planning a Pathology-Focused Learning Activity

Student Introduction to Second Life® Student Checklist: Orientation to Second Life® Instructor Checklist: Orientation to Second Life®

Emotional Intelligence Learning Activity 20: EI Ability Observed in Public Interactions

202 203 205

234 241 242 244

Contents | xi

30. Emotional Intelligence Learning Activity 21: Quest 1 31. Quest 1 Data Analysis Paper: Quantitative Measures Assignment 32. Emotional Intelligence Learning Activity 22: Quest 2 EI Attributes

33. Emotional Intelligence Attributes Chart and Operational Definitions xii | Contents

246 249 253 256

Sample Second Life® Learning Activities

Sample Learning Activities Included in the Text

1. The Genome Island Postcard 57 2. The Genome Island Treasure Hunt 59 3. Scientific Evaluation of Herbal Preparations 61 4. Interviewing a Patient 75 5. A Nurse Practitioner Clinic 77 6. Ethics Discussion Group 90 7. Genetics Discussion Group 93 8. Disabilities Discussion Group 95 9. Clinical Rounds 97 10. Developing Small Group Consensus Skills 106 11. Rewriting History 162

Additional Sample Learning Activities Included in the Appendix

12. Mock Job Interview (Appendix 3) 192 13. Systemic Lupus Erythematosus (SLE) Clinical Rounds

(Appendix 12) 205 14. Asthma Clinical Rounds (Appendix 19) 219 15. Osteoporosis Clinical Rounds (Appendix 20) 221

16. Hyponatremia Clinical Rounds (Appendix 21) 223 xiii

17. Pituitary Function and Pathology Clinical Rounds (Appendix 22) 18. Peripheral Vascular Disease Clinical Rounds (Appendix 23)

19. Pneumonia Clinical Rounds (Appendix 24)

20. EI Ability Observed in Public Interactions (Appendix 29)

21. Emotional Intelligence Leadership: Quest 1 (Appendix 30)

22. Emotional Intelligence Attributes: Quest 2 (Appendix 32)

xiv | Sample Second Life® Learning Activities

225 227 229 244 246 253

Index: Tools to Use

How to Send a Postcard in Second Life®

How to Accept a Notecard or Other Object

How to Watch a Presentation in Second Life®

How to Chat and to Copy a Second Life® Learning Activity Transcript How to Manage Two Avatars at One Time

How to Adjust Regional Lighting

How to Send an Invitation to Teleport to Your Location (Student Rescue)

How to Report Griefing

XV

The author waiting for small group discussion to begin

Preface

Why Virtual Worlds?

As long as there has been imagination, there have been virtual worlds. J. R. R. Tolkien’s Middle-earth, C. S. Lewis’ Narnia, the islands of Odysseus’ journey— these are all places well known by readers transported to them through alchemy of word, imagery, and imagination. We know these places by sight and sound and smell. Wholly fictional, they are real to us. Computer-generated worlds are the most recent iteration in a long history of virtual worlds, created by human imagination and inhabited through spoken story, printed book, video film, or computer-generated images.

Imagination is the best friend of learning. When imagination is alive, learning is active, energized, and vital. As new technology has evolved, imagination-fueled learning has become funded in new ways. As soon as there was writing, narrative evoked imagery. When motion picture filming became possible, stories played out through visual images themselves. With the advent of computer-generated three-dimensional worlds, new generations of students can walk, talk, and interact with others in rich sensory virtual learning environments. Computer-generated three-dimensional virtual environments, inhabited simultaneously by many users, are rich with imaginal possibility. There, students can learn business practices by running a business. They can learn genetics on an island dedicated to genetics education. They can practice health care skills by interviewing patients in a virtual hospital. They can interact with patients in a nurse practitioner's clinic or practice interdisciplinary teamwork through interactions with other professionals. These learning activities are easy to create and access, free of charge, in virtual worlds accessible to any student anywhere who has a computer and Internet access.

xvii

Why Me?

What I bring to this work is the experience of teaching hundreds of learning activities in Second Life®, a public and free multi-user virtual environment (MUVE) created in 2002 and now used by millions of people worldwide. For over seven years I have had the pleasure of using Second Life® to teach undergraduate and graduate student nurses, other health care providers, nonmedical undergraduate students, and interdisciplinary teams. Introducing students and teachers to MUVE learning has become an important part of both my own teaching practice and my research into innovative methods to support student learning.

For Geeks Only?

You may assume that I am a computer geek, an expert on all things computer. Cue the gales of laughter arising from our school’s information technology (IT) department! They are on my office phone speed dial. I suspect they draw straws to see who gets to field the next in my endless stream of questions. I am a teacher, not a “techie” or education innovation specialist. If I can teach in the MUVE setting, anyone can do it. Truly I am “one beggar telling another where she found bread,” sharing a methodology that has transformed my own teaching and offered my students learning activities that have energized and inspired them. Findings from my own research as well as that of others across many disciplines have provided evidence for the effectiveness of MUVE learning. As I and others “on the ground” who are committed to MUVE learning have discovered, the ease and effectiveness of this novel approach transform both students’ experience of learning and instructors’ experience of teaching. It epitomizes a kind of learning many teachers have always hoped and believed was possible.

What Is the Purpose of This Book?

The purpose of this book is to present a handbook of best practices for MUVE teaching, illustrated with examples from teaching in Second Life®, the first and one of the largest public (free) MUVEs. Although this book was written for nurse educators, instructors from other disciplines can benefit from the best practices this handbook identifies and describes. The chapters on teaching pedagogy, the history of Second Life®, MUVE learning, orientation to Second Life®, and the problems/pitfalls common for MUVE teaching are not discipline specific. Although the sample learning activities included in the text were designed for nurses, instructors outside of nursing, both those in other xviii | Preface health care disciplines and those outside of health care, could easily adapt them for use.

Second Life® is a great teaching tool. It is free, easy to learn, and easy to use. This handbook offers specific, step-by-step suggestions for developing MUVE learning activities and samples to illustrate these steps. Second Life® is referenced frequently throughout the book because it is the MUVE I use for both teaching and research. Most of the best practices described within the text apply to teaching in any MUVE. The sample learning activities described within the text can be used in any MUVE, including Second Life®, other public MUVEs, or private (purchased or independently built) MUVEs. All of the sample learning activities in the text have been used in some form with a wide range of students across disciplines. Readers are invited to use, adapt, and share all materials included in the text.

Sometimes a story is the best teacher. “Talking Story” is a Hawaiian tradition honored at the University of Hawaiʻi, where I am a tenured professor. Stories of my own successes and failures and also student experiences that have inspired me are included.

Who Is This Book For?

This book is for instructors looking for new and better ways to teach, to expand their pedagogical menu. This book is not for programmers interested in building multi-user virtual environments or creation of land, islands, or structures for use in MUVE learning. The MUVE learning activities I describe do not require building skills or advanced computer expertise. This text is designed as an entry-level, basic, “how-to” handbook for instructors interested in using MUVE technology in their teaching.

Talking Story: How It Began for Me

I discovered Second Life® as I was looking for ways to teach emotional intelligence ability, my academic research focus and primary passion. After only a cursory orientation to Second Life®, I immediately appreciated what MUVEs could mean for student learning. What happened next was unexpected. I began using Second Life® in the classes I was already teaching: physical assessment, medical ethics, advanced pathophysiology, emotional intelligence, development of interdisciplinary teams, and research methodology. My students were undergraduate and graduate nursing students from both health care and non-health care disciplines.

The students’ responses stunned me. Students not only excelled in these learning activities but also described their learning experiences as deeper,

Preface | xix more engaged, and more lasting compared to traditional learning methods. I gradually increased both the frequency and complexity of MUVE learning activities across all the classes I taught and eventually taught a course entirely in a MUVE. I applied for and received funding to study MUVE learning outcomes. I invited teaching professionals from the University of Hawaiʻi Center for Teaching Excellence to evaluate MUVE learning in my classes. After one session, the evaluator became quiet. After a few minutes, she simply said, “You are an outstanding teacher in a classroom. However, from what I’ve observed, your students’ MUVE learning is exceptional. I would encourage you to cut back on class time and do more of these learning activities.”

Ihad hoped and expected to see a higher level of learning effectiveness demonstrated by students in MUVE learning activities. Existing research data supported this expectation. What surprised me was the extent to which MUVE learning enabled students to practice new behavior, to make mistakes in a safe place, and to overcome personal shyness and passive learning habits as well as cultural and even language obstacles. With MUVE technology, I could evaluate students’ application of course content in simulated situations to a degree and with an objectivity not possible using traditional methods. As an instructor chronically frustrated by the limits of test-taking evaluation, this was a turning point for my own teaching.

Even as I write this, more advanced and commercial MUVE education platforms are becoming available. We are on the brink of holographic virtual environments. Simulation technology will continue to develop, in computer simulation laboratories, online, and in holographic and other virtual applications. It is hoped that the best practices described in this handbook will provide a foundation for use of these future applications as well.

To those wishing to begin a journey of teaching transformation, this book is offered.

xx | Preface

Introduction: How to Navigate This Book

Although the historical, theoretical, philosophical, and pedagogical concepts on which MUVE learning is based are reviewed in Chapter 1, this is primarily a “how-to” handbook focused on practical aspects of teaching in MUVEs like Second Life®. The book includes sample learning activities, assessment grids, grading matrices, and step-by-step instructions. Upon completion of the book and review of the appendix materials, an instructor previously unfamiliar with MUVE learning will be able to design, execute, evaluate, and troubleshoot both basic and complex MUVE learning activities.

This book can be read cover to cover or by moving back and forth between selected chapters. At the beginning of each chapter, the “This chapter is for you if” section will help readers with specific interests focus on chapters most relevant for them. The “Reader’s Roadmap” that follows describes the topography of the material presented.

ps r NIN

Reader’s Roadmap: Where Are We?

Part I (Chapters 1-3) focuses on the background for MUVE learning, including the history of virtual environments and the theoretical, social, philosophical, and pedagogical foundations for MUVE learning. This section of the book provides a history of the development of MUVE learning, as well as a description of MUVE learning as a social, philosophical, and technological phenomenon. This history of Second Life® is described.

Part II (Chapters 4-12) presents and discusses samples of general types of MUVE learning activities. For each type of activity, the following are described: purpose, target population, performance outcomes, setup requirements, steps for completing the activity, and procedures for evaluation. Specifics for each type are presented. This is a great reference section for instructors interested xxi in what MUVE learning activities can look like. Sample learning activities of increasing complexity are used to illustrate these descriptions.

Part III (Chapters 13-20) constitutes the specific “How To” section of the handbook. It includes a review of Second Life® orientation requirements for instructors and students as well as specific steps for getting started. Topics include picking the right time to begin MUVE teaching, identifying instructor readiness and a good student group to begin with, and targeting course content most amenable to a successful MUVE learning activity. This section ends with a case study of a MUVE implementation project from beginning to end.

Part IV of the book is the Appendixes, a treasure trove of learning activities, evaluation forms, and other supporting materials that support MUVE learning activities.

Working Glossary for MUVE Terms

Like most exciting journeys, traveling in the MUVE world requires some new language. The chapters ahead will be most useful if the reader takes a few moments to review the following terms, which include both definitions and some additional information that applies to their use. (Note: The terms are listed in the order in which they are encountered in the text.)

Multi-user virtual environment (MUVE): A multi-user virtual environment, or MUVE, is an Internet-based, virtual world that a user accesses via a personal computer. Think of it as a three-dimensional animated landscape in which YOU are one of the animated characters and each of your students is one as well. In this world, avatars can communicate with each other, interact with objects in the environment, and explore by walking, running, sitting, flying, and teleporting from one place to another. This world consists of regions, which are specific locations or places within the overall MUVE world. Some MUVEs are used for online gaming; others are open-ended worlds that can be used for a variety of purposes.

Second Life®: The Second Life® world was the first widely accessible, free public MUVE. Not a game but rather an open-ended world, the user can visit tens of thousands of regions that can be used for many different user-driven purposes. A history and description of Second Life® are included in Chapter 2.

Avatar: An animated, visual representation of oneself in a MUVE. The avatar’s appearance (gender, clothes, hair, skin, body shape, and size) can be changed to suit the avatar owner’s preference. The avatar’s name floats over its head, xxii | Introduction identifying the avatar to other users. With a few exceptions, every avatar in Second Life® represents a live person who guides the avatar’s behavior.

Born: An avatar is born the first day a Second Life® account is made and an avatar created.

Virtual world: Second Life® and other MUVEs are referred to as “worlds.” Large MUVEs such as Second Life® are subdivided into smaller areas called regions. In Second Life®, some of these regions are on the mainland of the Second Life® world and others are on individual islands off the coast of the mainland.

Resident: Second Life® can only be visited by a person who has acquired a Second Life® account. Basic Second Life® accounts are free of charge. Once a person has opened a Second Life® account and created an avatar, he or she is considered a resident of Second Life®.

Region: Each region (a locale within a MUVE world) has its own particular characteristics. Locations for learning activities are selected on the basis of these characteristics. For example, if a learning activity is designed for doctors or nurse practitioners, a region that contains a hospital might be appropriate. The builders of MUVE regions often focus on a theme or purpose. Second Life®’s Genome Island was designed by geneticists to help people learn genetics. Regions may represent real places (Paris in the 1800s) or imagined ones (Mars City). As of 2014, more than 77,000 individual public regions were available for use by Second Life® residents.

Inworld: This is MUVE slang that is used to indicate that a user is currently operating his or her avatar in the MUVE world. On my office door I frequently hang a sign that says, “Please do not disturb—I am inworld.” MUVE learning activities are described as taking place inworld.

First Life: This term refers to life outside of the MUVE world. For example, “Where do you live in First Life?”

Rezzing: Upon entering a MUVE or when teleporting from one region to another, there is a brief period during which the environment and avatars in it come into focus. This gradual visual change of an appearing object from fuzzy and ill-defined to clear and visually complete is called “rezzing,” from the word “resolution.” In highly complex and detailed environments, rezzing takes longer than usual.

Introduction | xxiii

Lag: A slow computer or Internet connection can cause some MUVE functions to be slow. Environments may rez more slowly than normal. Movements in the environment (speed of a car or plane) may be slow. There may be delays in communication. This is referred to as lag.

Newbie: A newbie is a person who is new to the MUVE world, specifically someone with fewer than thirty hours of inworld experience. Example: If, as a newbie you were to bump into another avatar by mistake, you could say, “Sorry, newbie!” This indicates to others around you that patience and perhaps some help are appropriate.

Griefing: Bad behavior on the part of one MUVE resident that disturbs another resident. Griefing should always be reported and can result in loss of privileges for the disruptive resident.

For more terms, consult the wiki.secondlife.com/wiki/Second_Life_Glossary.

xxiv | Introduction

Teaching Health Care in Virtual Space

Part I

Introduction to Multi-user Virtual Environments and the Second Life® World

Have You Ever Wanted Your Students to Experience...

e Student discussion groups in which the role and contributions of each student could be easily evaluated by the student, their peers, and the course instructor? Exercises where no student can “fly under the radar” or coast on the work of other students and where air hogs and group disrupters are easily identified and their behavior changed?

Role-playing that is nonthreatening and low-risk; where feedback is objective, easy, and measurable, so students can identify opportunities for performance improvement?

The practice of professional skills such as interviewing, communication skills, psychosocial interventions, and peer coaching, in a setting where evaluation against specific performance outcome criteria can be easily documented?

Group activities that focus on group dynamics such as consensus building, conflict resolution, and group process evaluation, in a setting in which participation can be documented easily and objectively evaluated by students, peers, and instructors?

Clinical experiences such as rounds, crisis intervention, and clinical teamwork, in a setting in which simulations can be slowed down and clearly documented in a way that facilitates identification of strengths, weaknesses, and skills that need improvement?

A type of simulation that offers many of the benefits of high-fidelity simulation, without the expense and logistical challenges of face-to-face simulation?

e More efficient learning by replacing “sit and listen” hours with high-quality out-of-class learning experiences?

If so, teaching/learning in multi-user virtual environments may be for you!

Imagine This...

You assign a small group discussion for your class. In groups of five or six students, the class will be discussing ethical issues related to abortion. The objectives for the discussion and the grading rubric are sent to the class, along with the location in a virtual world where the discussions will take place.

At an agreed-upon time, each student, from his or her home or other Internet location, logs on to the virtual world website. Each student’s avatar enters the virtual world and assembles with the other group members. Tonight, the discussion is personal. The meeting place has been chosen to support an intimate, comfortable environment, a campfire at a beach.

The fire is glowing in the gathering dark of evening. An ocean surf can be heard in the background. The students sit on comfortable seats around the fire. No one looks like they do in First Life, but a name floats over each avatar’s head, so everyone is easy to identify. The avatars are not “frozen statues”: they gesture during speech, fidget, or adjust their position. Some sit on the ground; others are in chairs or on large pillows. Students greet each other and chat as they wait for the discussion to begin.

The assigned leader for the discussion welcomes everyone and reviews goals for the activity. The discussion begins. Each person types his or her comments

2 | Introduction to Multi-user Virtual Environments and remarks in a chat box. The dialogue in the chat box is visible to all participants. Each entry is identified with the speaker’s name and time stamped. Each entry is saved in the chat box, creating a continuous dialogue that will be saved as a transcript of the learning activity.

The conversation is rapid fire and dynamic. There are social exchanges and affirmations. The discussion goes deep fast. It is easy to notice that the group dynamics are a little different. The “air hog” from class is not talking so much. Shy people are speaking up more than usual. It seems easier to share personal opinions.

The discussion ends in thirty minutes. Everyone thinks, “Wow, that went fast!” The group is energized; people linger and talk after the assignment is over. One person copies the discussion group transcript from the chat box and sends it to each group member and the instructor. Later, each member of the group will use the transcript and the assignment grading rubric to complete three short evaluations: a self-evaluation, a peer evaluation, and an evaluation of the group. Participants will identify their strengths and opportunities to improve their participation.

Each person's grade for the assignment is based on data from these evaluations and depends on how each person performed in the group discussion. Evaluations are based on what the student actually said and did, as reflected in the activity transcript. The student’s grade is accompanied by feedback and suggestions for improvement that are based on objective criteria and data from the student’s performance.

How is this kind of learning possible? How did MUVEs evolve, and how can they be used to design high-quality, accessible, and multidimensional learning that is student focused and evaluated by performance outcomes? To find out, let’s begin. ...

Introduction to Multi-user Virtual Environments | 3

Chapter 1

Theoretical, Philosophical, and Pedagogical Foundations for MUVE Learning

This chapter describes the theoretical foundations for MUVE learning. Subjects that will be discussed include:

e Distributed Cognition: A grounding theory for MUVE learning e The MUVE learner: Whole learning, multiple intelligences, and student power/agency e The MUVE learning environment: The virtual world e MUVE learning in relationships: Social and emotional intelligence in learning e MUVE learning as a societal phenomenon: Situated learning, MUVE as a “Third Place,” experiential learning, MUVE as simulation learning, and the role of imagination in learning: the virtual as real

1. You are interested in the theoretical, philosophical, and pedagogical foundations for MUVE learning.

2. You are interested in a rationale for adding teaching in MUVE teaching to your personal teaching methods repertoire.

Introduction: Virtual Environments and the Evolution of Learning

The argument over use of Internet technology for learning is over. The issue is no longer if Internet technology should be used for learning but rather how best it can be. There is more going on here than the availability of new and more sophisticated equipment. Use of electronic platforms for learning on the worldwide web has caused a tectonic shift in our understanding of learning as a social and cultural process. It also reflects a major change in modern society, the harbinger of a new age. We are no longer in the Information Age but the “Age of Techne”—the creative human online . . . Homo cyber (Boellstorff 2008). This book does not defend this evolution but rather accepts it as a given. We are in the midst of a sea change. How, what, when, and where learning happens is changing quickly and profoundly.

Evidence of this is everywhere. Harvard University, a US leader for education innovation, sponsors Project Zero, dedicated to a whole-scale reimagination of learning supported by new pedagogies and new technology. The Khan Academy, founded by American educator and intrepreneur Salman Khan, is dedicated to cost-free education to any person, anywhere, based on Internet learning platforms and new approaches to learning. Within the profession of nursing, Dr. Patricia Benner, a leader in education innovation, has called for a revolution in nursing education. Her vision includes the challenge to contextualize learning using new approaches and new tools (Benner et al. 2010).

The revolution these education innovators leaders espouse has emerged as a product of new understanding about intelligence, teaching, and how students learn. It has also been affected by an evolution in education philosophy, particularly as it concerns instructor and student power relationships. Last, it has been profoundly affected by integration of the World Wide Web and online learning into student processing, understanding, and sharing of information.

MUVE learning operationalizes these changes into learning activities in virtual space. Because MUVE learning is deeply connected with emerging learning theory, it is not surprising that it has been referred to by some as perhaps the most important educational opportunity of the twenty-first century (Richter, Anderson-Inman, and Frisbee 2007).

The Theoretical, Conceptual, and Pedagogical Foundations for MUVE Learning

A comprehensive review of the theoretical and conceptual elements that undergird these changes in education is beyond the scope of this text. It is, however, important to outline some of the important elements that provide a foundation for MUVE learning. To do this, these foundational elements will be summarized using a schematic diagram. In this diagram, learners are located at the center of the learning, imbedded in and deeply connected to their environment, relationships, society, and culture.

The Philosophy of MUVE Learning: Distributed Cognition

Figure 1 depicts Distributed Cognition, a theory about how cognition works. Distributed Cognition is a relatively new psychological theory that posits that

Society & culture

Figure 1. Schema of Socially Distributed Cognition knowledge does not reside in an individual (the lonely brain of the student). It is, rather, distributed across individuals in a group, interwoven with their environment and processed through complex interactions between individuals, their social/cultural world, and the objects that facilitate these interactions (Hutchins 1995). Viewed through this theoretical lens, social media platforms such as Facebook, Twitter, and MUVES such as Second Life® are integral parts of a cognition system that encompasses the people, relationships, social context, and the interactions they make possible. Learners are intertwined with each other in this network.

This view of cognition as a learning system that includes all participants, interactions, and media provides an excellent foundation for MUVE learning. Ina MUVE learning activity, the student, at the center of the learning, is imbedded within a system of cognition that includes other students, the instructor, and both the physical and electronic environments that surround and connect them.

Such a learning system has important differences from traditional learning systems. In a traditional system, the focus is an academic hierarchy located in a physical location. Information flows from the top down. Students, the recipients of learning and at the bottom of the hierarchy, have had little power or agency. The perspective of Distributed Cognition situates the learner at the center of the learning phenomenon, with power, agency, and control over their learning. This is epitomized by MUVE learning.

The MUVE Learner

This new student is a whole being (mental, emotional, spiritual, and social) whose experience of learning is guided by multiple intelligences and fueled by his or her own yearnings, preferences, intuitions, and imagination. Learner agency is at the core of this model. This learner has power and independence in learning. This means that it is the student who ultimately holds accountability and responsibility for learning. Within this view, the instructor is no longer understood simply as a dispenser of knowledge but rather as a midwife and mentor to learning—a creator, protector, and guide for the learning crucible.